An international team of clinical researchers reviewed 6 sets of guidelines for the use of non-steroidal anti-inflammatory drugs (NSAIDS) that had previously been published regarding the treatment of knee osteoarthritis (OA). These guidelines had been developed or updated between 2001 and 2006.

The review team included rheumatologists, physiotherapists, occupational health experts and general practitioners. They applied the Appraisal of Guidelines Research and Evaluation (AGREE) criteria to perform their evaluation.

The purpose of the guidelines is to deal with concerns about cardiovascular risks linked with NSAIDs.

The guidelines indicate that initial treatment should be acetaminophen in combination with exercise and education. If this course of treatment is unsatisfactory the next step would be NSAIDs. The guidelines further indicate surgery for persistent pain and disability.

Most of the guidelines only superficially cover education and activity management interventions, a situation the review team suggests be addressed in more detail in the future.

They also found the only a few of the AGREE criteria were addressed by the guidelines.

Their findings were published in the online open access journal Arthritis Research & Therapy.