[Current management of osteoarthritis. Part 1: pharmacological strategies]

Osteoarthritis represents one of the most frequent pathologies today and so constitutes one of the main priorities of health service in proportion to the ageing of the population. This general review of the pharmacological therapies of osteoarthritis is conducted in the light of recent controlled studies.

Some controlled studies seem to demonstrate an analgesic superiority of the non steroidal anti-inflammatory drugs versus acetaminophen. Some studies suggest the potential structural effect of so called slow-acting symptom modifying drugs. Among the local treatments, the interest of the viscosupplementation seems well established. On the contrary, recent controlled studies do not confirm the efficiency of the articular lavage or of the arthroscopic debridment.

In the light of several recent international guidelines, it seems necessary to optimise in the individual patient the best possible combination of pharmacological and not medicinal therapeutic modalities. The place and the modalities of use of the slow-acting symptom modifying drugs remain to be determined more precisely.