[Pharmacotherapy of osteoarthritis]

Published guidelines for medical treatment of osteoarthritis nonpharmacological treatment considered as the cornerstone of OA management and all the pharmacological agents should be added to nonpharmacological measures. Drugs in the treatment of osteoarthritis could be shared into fast acting symptomatic, slow acting symptomatic and disease modifying (structure) drugs and shorthly are described in this paper. According ACR and EULAR guidelines paracetamol had to be the first pharmacological choice based on efficacy, tolerability and cost. Data from literature do not support efficacy of paracetamol in treatment of moderate to severe form of osteoarthritis. Randomized controlled trials and metaanalyses show no statistically significant difference in adverse events between paracetamol in maximal daily dose and nonsteroidal anti-inflammatory drugs. Nonsteroidal anti-inflammatory drugs would be first choice for treatment of moderate to severe form of osteoarthritis in lowest effective dose and shortest duration of therapy.