[en] AIM: The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) algorithm for the management of knee osteoarthritis (OA) is available worldwide from 2014, but in 2019 an update was published. Based on this algorithm, a Working Group (WG), including ESCEO members and Chinese experts, wished to see how the new ESCEO algorithm was perceived by Chinese experts in knee OA and how it was integrated into their clinical practice. METHODS: A WG was held between members of the international ESCEO task force and a group of Chinese experts. RESULTS: Non-pharmacological approach should be combined with pharmacological interventions. In step 1, symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are the most important background drugs. Evidence, supported by high-quality research, is available only for crystalline glucosamine sulfate (pCGS) and chondroitin sulfate. Topical NSAIDs could be used as an additional option. In step 2, oral NSAIDs could be useful, but cardiovascular/renal/gastrointestinal profiles of the patients should be considered. Intra-articular hyaluronic acid and corticosteroids are alternative to oral NSAIDs, but the evidence is still limited. If steps 1 and 2 are not sufficient, weak opioids could be used. Overall, the conclusions of the ESCEO algorithm are accepted in China for products available in this country. The WG suggests the importance of economic studies, specifically made in China. CONCLUSION: This work provides evidence-based advice to establish a treatment algorithm in knee OA, for practical implementation in clinical practice in China.
Disciplines :
Public health, health care sciences & services Laboratory medicine & medical technology
Author, co-author :
Zhang, Zhiyi
Huang, Cibo
Cao, Yongping
Mu, Rong
Zhang, Mun Chan
Xing, Dan
Fan, Dongwei
Ding, Yunpong
Guo, Junhuan
Hou, Yong
Jianhao, Lin
Veronese, Nicola
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Murray CJ, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2197–2223 DOI: 10.1016/S0140-6736(12)61689-4
Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81:646–656
Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2163–2196 DOI: 10.1016/S0140-6736(12)61729-2
Cross M, Smith E, Hoy D et al (2014) The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73:1323–1330 DOI: 10.1136/annrheumdis-2013-204763
Clynes MA, Jameson KA, Edwards MH et al (2019) Impact of osteoarthritis on activities of daily living: does joint site matter? Aging Clin Exp Res 31:1049–1056 DOI: 10.1007/s40520-019-01163-0
Beaudart C, Biver E, Bruyère O et al (2018) Quality of life assessment in musculo-skeletal health. Aging Clin Exp Res 30:413–418 DOI: 10.1007/s40520-017-0794-8
Bruyere O, Cooper C, Pelletier JP et al (2014) An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 44:253–263 DOI: 10.1016/j.semarthrit.2014.05.014
Honvo G, Leclercq V, Geerinck A et al (2019) Safety of topical non-steroidal anti-inflammatory drugs in osteoarthritis: outcomes of a systematic review and meta-analysis. Drugs Aging 36:45–64 DOI: 10.1007/s40266-019-00661-0
Honvo G, Reginster J-Y, Rannou F et al (2019) Safety of intra-articular hyaluronic acid injections in osteoarthritis: outcomes of a systematic review and meta-analysis. Drugs Aging 36:101–127 DOI: 10.1007/s40266-019-00657-w
Cooper C, Chapurlat R, Al-Daghri N et al (2019) Safety of oral non-selective non-steroidal anti-inflammatory drugs in osteoarthritis: what does the literature say? Drugs Aging 36:15–24 DOI: 10.1007/s40266-019-00660-1
Honvo G, Reginster J-Y, Rabenda V et al (2019) Safety of symptomatic slow-acting drugs for osteoarthritis: outcomes of a systematic review and meta-analysis. Drugs Aging 36:65–99 DOI: 10.1007/s40266-019-00662-z
Bruyere O, Cooper C, Pelletier J-P et al (2016) A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis—from evidence-based medicine to the real-life setting. Semin Arthritis Rheum 45:S3–S11 DOI: 10.1016/j.semarthrit.2015.11.010
Bruyère O, Honvo G, Veronese N et al (2019) An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum 49:337–350 DOI: 10.1016/j.semarthrit.2019.04.008
Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336:924 DOI: 10.1136/bmj.39489.470347.AD
Zhang Z, Duan X, Gu J et al (2016) The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis is applicable to Chinese clinical practice: a consensus statement of leading Chinese and ESCEO osteoarthritis experts. Chin J Pract Int Med 36:762–772
Denisov L, Tsvetkova E, Golubev G et al (2016) The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis is applicable to Russian clinical practice: a consensus statement of leading Russian and ESCEO osteoarthritis experts. Hayчнo-пpaктичecкaя peвмaтoлoгия/Rheumatol Sci Pract 54:641–652
Saengnipanthkul S, Waikakul S, Rojanasthien S et al (2019) Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations will optimize osteoarthritis treatment. Int J Rheum Dis 22:376–385 DOI: 10.1111/1756-185X.13068
Bruyere O, Cooper C, Cutolo M et al (2017) International endorsement of the ESCEO algorithm for management of knee osteoarthritis in clinical practice. Semin Arthritis Rheum 47:e10 DOI: 10.1016/j.semarthrit.2017.07.002
Xia W, Cooper C, Li M et al (2019) East meets West: current practices and policies in the management of musculoskeletal aging. Aging Clin Exp Res 31:1351–1373 DOI: 10.1007/s40520-019-01282-8
Yeap SS, Tanavalee A, Perez EC et al (2021) 2019 revised algorithm for the management of knee osteoarthritis: the Southeast Asian viewpoint. Aging Clin Exp Res 33:1149–1156 DOI: 10.1007/s40520-021-01834-x
Tang X, Wang S, Zhan S et al (2016) The prevalence of symptomatic knee osteoarthritis in China: results from the China health and retirement longitudinal study. Arthritis Rheumatol 68:648–653 DOI: 10.1002/art.39465
Liu Q, Wang S, Lin J et al (2018) The burden for knee osteoarthritis among Chinese elderly: estimates from a nationally representative study. Osteoarthr Cartil 26:1636–1642 DOI: 10.1016/j.joca.2018.07.019
Yu S, Guo X, Yang H et al (2020) Cardiometabolic comorbidities and epidemiological features among rural Chinese elderly people. Aging Clin Exp Res 32:1–12 DOI: 10.1007/s40520-019-01356-7
Liu X, Wu W, Mao Z et al (2018) Prevalence and influencing factors of overweight and obesity in a Chinese rural population: the Henan Rural Cohort Study. Sci Rep 8:1–11
Zheng H, Chen C (2015) Body mass index and risk of knee osteoarthritis: systematic review and meta-analysis of prospective studies. BMJ Open 5:e007568 DOI: 10.1136/bmjopen-2014-007568
Dequeker J, Aerssens J, Luyten FP (2003) Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res 15:426–439 DOI: 10.1007/BF03327364
Wang L, Guo L, Tian F et al (2015) Analysis of single nucleotide polymorphisms within ADAM12 and risk of knee osteoarthritis in a Chinese Han population. BioMed Res Int 2015:518643
Veronese N, Cooper C, Reginster J-Y et al (2019) Type 2 diabetes mellitus and osteoarthritis. Semin Arthritis Rheum 49:9–19 DOI: 10.1016/j.semarthrit.2019.01.005
Zhang Q, Wang Y, Yu N et al (2021) Metabolic syndrome predicts incident disability and functional decline among Chinese older adults: results from the China Health and Retirement Longitudinal Study. Aging Clin Exp Res. 10.1007/s40520-021-01827-w DOI: 10.1007/s40520-021-01827-w
Fernandes L, Hagen KB, Bijlsma JW et al (2013) EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 72:1125–1135 DOI: 10.1136/annrheumdis-2012-202745
Cutolo M, Berenbaum F, Hochberg M et al (2014) Commentary on recent therapeutic guidelines for osteoarthritis. Semin Arthritis Rheum 44:611–617 DOI: 10.1016/j.semarthrit.2014.12.003
Lauche R, Langhorst J, Dobos G et al (2013) A systematic review and meta-analysis of Tai Chi for osteoarthritis of the knee. Complement Ther Med 21:396–406 DOI: 10.1016/j.ctim.2013.06.001
Wang S, Yin H, Wang X et al (2019) Efficacy of different types of exercises on global cognition in adults with mild cognitive impairment: a network meta-analysis. Aging Clin Exp Res 31:1391–1400 DOI: 10.1007/s40520-019-01142-5
Zhang Q, Yue J, Golianu B et al (2017) Updated systematic review and meta-analysis of acupuncture for chronic knee pain. Acupunct Med 35:392–403 DOI: 10.1136/acupmed-2016-011306
Pan X, Meng H (2020) Pain management and cognitive function among older adults: an exploratory study of the China Health and Retirement Longitudinal Study. Aging Clin Exp Res 32:2611–2620 DOI: 10.1007/s40520-020-01491-6
Towheed TE, Maxwell L, Judd MG et al (2006) Acetaminophen for osteoarthritis. Cochrane Database Syst Rev CD004257
Zhang W, Nuki G, Moskowitz RW et al (2010) OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil 18:476–499 DOI: 10.1016/j.joca.2010.01.013
Bannuru RR, Schmid CH, Kent DM et al (2015) Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann Intern Med 162:46–54 DOI: 10.7326/M14-1231
Conaghan PG, Arden N, Avouac B et al (2019) Safety of paracetamol in osteoarthritis: what does the literature say? Drugs Aging 36:7–14 DOI: 10.1007/s40266-019-00658-9
Lipworth L, Friis S, Mellemkjaer L et al (2003) A population-based cohort study of mortality among adults prescribed paracetamol in Denmark. J Clin Epidemiol 56:796–801 DOI: 10.1016/S0895-4356(03)00152-5
De Wan M, Volpi G (1998) Method of preparing mixed glucosamine salts. Google Patents
Ma H, Li X, Sun D et al (2019) Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ 365:1628 DOI: 10.1136/bmj.l1628
Bruyère O, Cooper C, Al-Daghri NM et al (2018) Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res 30:111–117 DOI: 10.1007/s40520-017-0861-1
Towheed TE, Maxwell L, Anastassiades TP et al (2009) Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev CD002946
Reginster JY (2007) The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest. Arthritis Rheum 56:2105–2110 DOI: 10.1002/art.22852
Eriksen P, Bartels EM, Altman RD et al (2014) Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken) 66:1844–1855 DOI: 10.1002/acr.22376
Reginster JY, Deroisy R, Rovati LC et al (2001) Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 357:251–256 DOI: 10.1016/S0140-6736(00)03610-2
Pavelka K, Gatterova J, Olejarova M et al (2002) Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 162:2113–2123 DOI: 10.1001/archinte.162.18.2113
Herrero-Beaumont G, Ivorra JA, Del Carmen TM et al (2007) Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 56:555–567 DOI: 10.1002/art.22371
Bruyere O, Altman RD, Reginster J-Y (2016) Efficacy and safety of glucosamine sulfate in the management of osteoarthritis: evidence from real-life setting trials and surveys. Semin Arthritis Rheum 45:S12–S17 DOI: 10.1016/j.semarthrit.2015.11.011
Kucharz EJ, Kovalenko V, Szanto S et al (2016) A review of glucosamine for knee osteoarthritis: why patented crystalline glucosamine sulfate should be differentiated from other glucosamines to maximize clinical outcomes. Curr Med Res Opin 32:997–1004 DOI: 10.1185/03007995.2016.1154521
Clegg DO, Reda DJ, Harris CL et al (2006) Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 354:795–808 DOI: 10.1056/NEJMoa052771
Runhaar J, Rozendaal RM, Middelkoop MV et al (2017) Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank. Ann Rheum Dis 76:1862–1869 DOI: 10.1136/annrheumdis-2017-211149
Reginster JL, Bruyere O, Cooper C (2017) Different glucosamine sulfate products generate different outcomes on osteoarthritis symptoms. Ann Rheum Dis 77:e39 DOI: 10.1136/annrheumdis-2017-212251
Bruyère O, Reginster J-Y, Honvo G et al (2019) Cost-effectiveness evaluation of glucosamine for osteoarthritis based on simulation of individual patient data obtained from aggregated data in published studies. Aging Clin Exp Res 31:881–887 DOI: 10.1007/s40520-019-01138-1
Veronese N, Demurtas J, Smith L et al (2020) Glucosamine sulphate: an umbrella review of health outcomes. Therap Adv Musculoskel Dis 12:1759720X20975927
Volpi N (2009) Quality of different chondroitin sulfate preparations in relation to their therapeutic activity. J Pharm Pharmacol 61:1271–1280 DOI: 10.1211/jpp.61.10.0002
Kahan A, Uebelhart D, De Vathaire F et al (2009) Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 60:524–533 DOI: 10.1002/art.24255
Zegels B, Crozes P, Uebelhart D et al (2013) Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study. Osteoarthr Cartil 21:22–27 DOI: 10.1016/j.joca.2012.09.017
Schneider H, Maheu E, Cucherat M (2012) Symptom-modifying effect of chondroitin sulfate in knee osteoarthritis: a meta-analysis of randomized placebo-controlled trials performed with structum((R)). Open Rheumatol J 6:183–189 DOI: 10.2174/1874312901206010183
Reginster JY, Dudler J, Blicharski T et al (2017) Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT). Ann Rheum Dis 76:1537–1543 DOI: 10.1136/annrheumdis-2016-210860
Honvo G, Bruyère O, Reginster J-Y (2019) Update on the role of pharmaceutical-grade chondroitin sulfate in the symptomatic management of knee osteoarthritis. Aging Clin Exp Res 31:1163–1167 DOI: 10.1007/s40520-019-01253-z
Reginster J-Y, Veronese N (2020) Highly purified chondroitin sulfate: a literature review on clinical efficacy and pharmacoeconomic aspects in osteoarthritis treatment. Aging Clin Exp Res 33:37–47 DOI: 10.1007/s40520-020-01643-8
Rovati LC, Girolami F, D’Amato M et al (2016) Effects of glucosamine sulfate on the use of rescue non-steroidal anti-inflammatory drugs in knee osteoarthritis: results from the Pharmaco-Epidemiology of GonArthroSis (PEGASus) study. Semin Arthritis Rheum 45:S34–S41 DOI: 10.1016/j.semarthrit.2015.10.009
Bruyère O, Pavelka K, Rovati L et al (2008) Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthr Cartil 16:254–260 DOI: 10.1016/j.joca.2007.06.011
Rossetti L, Hawkins M, Chen W et al (1995) In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Investig 96:132–140 DOI: 10.1172/JCI118013
Neil KM, Caron JP, Orth MW (2005) The role of glucosamine and chondroitin sulfate in treatment for and prevention of osteoarthritis in animals. J Am Vet Med Assoc 226:1079–1088 DOI: 10.2460/javma.2005.226.1079
Muniyappa R, Karne RJ, Hall G et al (2006) Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes 55:3142–3150 DOI: 10.2337/db06-0714
Dostrovsky N, Towheed T, Hudson R et al (2011) The effect of glucosamine on glucose metabolism in humans: a systematic review of the literature. Osteoarthr Cartil 19:375–380 DOI: 10.1016/j.joca.2011.01.007
Runhaar J, Deroisy R, van Middelkoop M et al (2016) The role of diet and exercise and of glucosamine sulfate in the prevention of knee osteoarthritis: further results from the PRevention of knee Osteoarthritis in Overweight Females (PROOF) study. Semin Arthritis Rheum 45:S42–S48 DOI: 10.1016/j.semarthrit.2015.11.001
Gommans YM, Runhaar J, Jacobs ML et al (2017) The effect of prolonged glucosamine usage on HbA1c Levels and new-onset diabetes mellitus in overweight and obese middle-aged women. Am J Med 130:731–737 DOI: 10.1016/j.amjmed.2016.11.038
Deyle GD, Allen CS, Allison SC et al (2020) Physical therapy versus glucocorticoid injection for osteoarthritis of the knee. N Engl J Med 382:1420–1429 DOI: 10.1056/NEJMoa1905877
Cepeda MS, Camargo F, Zea C et al (2006) Tramadol for osteoarthritis. Cochrane Database Syst Rev CD005522
Pelletier JP, Martel-Pelletier J, Rannou F et al (2016) Efficacy and safety of oral NSAIDs and analgesics in the management of osteoarthritis: evidence from real-life setting trials and surveys. Semin Arthritis Rheum 45:S22–S27 DOI: 10.1016/j.semarthrit.2015.11.009
Fuggle N, Curtis E, Shaw S et al (2019) Safety of opioids in osteoarthritis: outcomes of a systematic review and meta-analysis. Drugs Aging 36:129–143 DOI: 10.1007/s40266-019-00666-9
Bruyere O, Ethgen O, Neuprez A et al (2012) Health-related quality of life after total knee or hip replacement for osteoarthritis: a 7-year prospective study. Arch Orthop Trauma Surg 132:1583–1587 DOI: 10.1007/s00402-012-1583-7
Ethgen O, Bruyere O, Richy F et al (2004) Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 86:963–974 DOI: 10.2106/00004623-200405000-00012
Shan L, Shan B, Suzuki A et al (2015) Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am 97:156–168 DOI: 10.2106/JBJS.M.00372
Nuesch E, Rutjes AW, Husni E et al (2009) Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev CD003115
Manchikanti L, Kaye AM, Knezevic NN et al (2017) Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Pain Phys 20:S3–S92 DOI: 10.36076/ppj.2017.s92