Comments on the discordant recommendations for the use of symptomatic slow-acting drugs in knee osteoarthritis

Abstract

Despite the near concurrent publication by influential scientific organizations, there are important differences in interpretation of the evidence base and the conclusions derived from the recent Osteoarthritis Research Society International (OARSI) guidelines for the management of knee osteoarthritis, the American College of Rheumatology (ACR) guidelines (concerning also hip and hand osteoarthritis) and the algorithm recommendations by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). This is particularly evident for the drug class of symptomatic slow-acting drugs in osteoarthritis. In this paper, we highlight these differences and try to understand where they derive from, proposing an evidence-based interpretation.

Keywords: :

• Chondroitin
• Glucosamine
• Hyaluronic acid
• Osteoarthritis
• Symptomatic slow-acting drugs in osteoarthritis

Transparency

Declaration of funding

This project was funded by ESCEO, a not-for-profit Belgian organization, created in 2005.

Author contributions: J.-Y.R. and O.B. wrote the first draft of the manuscript. All authors have taken part in the meeting organized by ESCEO. All authors have commented and approved the final manuscript.

Declaration of financial/other relationships

None of the authors received any financial compensation for participation in the Working Group or the writing process of the article. J.-Y.R. has disclosed that he has received consultancy, grants and lecture fees from Servier, Novartis, Negma, Lilly, Wyeth, Amgen, GlaxoSmithKline, Roche, Merckle, Nycomed-Takeda, NPS, IBSA-Genevrier, Theramex, UCB, Bristol Myers Squibb, Merck Sharp & Dohme, Rottapharm, Teva, Pfizer, IBSA, Genevrier, Teijin, Ebewee Pharma, Zodiac, Analis, Novo-Nordisk and Nolver. C.C. has disclosed that he has received consultancy, lecture fees and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Merck, Medtronic and Roche. M.H. has disclosed that he has received consultancy and lecture fees from Bioiberica SA, Iroko Pharmaceuticals, Merk Serono, Novartis Pharma AG, Pfizer Inc. and IBSA. J.-P.P. has disclosed that he has received consultancy, grants and lecture fees from ArthroLab Inc., AbbVie, Bioiberica, Elanco, Endocyte, Ferring, Merck & Co., Pfizer, Servier, TRB Chemedica and the University of Montreal. He has also received payments for expert testimony from Bioberica and TRB Chemedica and has stock options in ArthroLab Inc. R.R. has disclosed that he has received board membership, consultancy, lecture fees and reimbursements for travel expenses from Amgen, Servier, Danone, GSK and MSD. J.K. has disclosed that he has received grants and personal fees from AgNovos healthcare USA, Amgen, D3A, Lilly, Medimaps, Unigene, Medtronic, Novartis, Pfizer, Sanofi-Aventis, Servier, Warner-Chilcott, and non-financial support from Asahi. E.A. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article. E.M. has received board membership, consultancy, grants and lecture fees from Bioventus, Rottapharm S.A., Pierre Fabre Labs, Expanscience Labs, Servier, IBSA and Genevrier and payment for educational presentations from Expanscience. M.L.B. has disclosed that she has received grants from Amgen, Eli, Lilly, MSD, Novartis, Roche and Servier. O.B. has disclosed that he has received personal fees and grants from Bayer, IBSA, Genevrier, MSD, Novartis, Nutraveris, Pfizer, Rottapharm, Servier, SMB and Theramex. M.H., J.-P. D., J.B. and G.H.-B. have disclosed that they have received reimbursement for travel expenses to the meeting for the study.

P.D'H. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this article. CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work. Peer reviewers 2 and 3 have no relevant financial or other relationships to disclose. Peer reviewer 1 has disclosed that he has received grants from the American College of Rheumatology and Sanofi.