Original Title: Sysadoas. Condroprotectores en el tratamiento de la artrosis

Authors' objectives: To determine the efficacy and safety of SYSADOAs as chondroprotective drugs for treating osteoarthritis.

Authors' results and conclusions: Eight international and two national CPGs met the inclusion criteria, together with two meta-analyses and one systematic review. Of the international CPGs, two were from the United States, one was Australian, one British, one Canadian, one Singaporean and two were from European companies. All included recommendations regarding the use of SYSADOAs. The methods used for preparing the recommendations were: GRADE, NHMRC, NICE, DELPHI consensus and in three CPGs, unweighted SIGNtype direct systems; one did not specify the method. Most CPGs were published between 2007 and 2010, with one published in 2012. The evidence supporting their recommendations on the use of SYSADOAs was similar except the most recent CPG, which incorporated the latest meta-analysis published in 2010. Scores on the AGREE II instrument ranged from 89 to 17 (mean: 55.5). Five CPGs recommended not using SYSADOAs, two recommended using it as second-line treatment, to be discontinued after six months, and one conditionally recommended not using it (GRADE). Those that recommended their use were one CPG with low methodological quality and one whose recommendations were based on the explicit consensus of professionals. Conclusions International CPGs published in large databases offer conflicting recommendations on the use of SYSADOAs in the management of knee osteoarthritis. The differences cannot be explained by the evidence supporting the recommendations, but rather the quality of the method of preparation or gradation of the recommendations, with those that used higher-quality techniques arguing for disinvestment. The high-quality reports concur in not recommending the use of these drugs in the treatment of osteoarthritis of the knee and hip. Such drugs should not be used in the treatment of osteoarthritis, due to their low or lack of efficacy.

Authors' methods: A literature search of secondary sources (clinical practice guidelines, health technology assessment reports, systematic reviews and meta-analyses) on the pharmacological management of osteoarthritis of the knee and hip was performed in order to extract evidence. The searched databases were Medline, EMBASE, NGC, DARE, NHS-EED, INAHTA, GuiaSalud and the Cochrane Database of Systematic Reviews. Inclusion criteria were that the documents were concerned with the pharmacological management of osteoarthritis of the knee and hip and were published after 2007 (considered obsolescent after five years). AGREE II was used as a quality assessment method for the clinical practice guidelines (CPGs), and the FLC critical appraisal tool for systematic reviews and meta-analysis. The quality assessment was performed by two independent evaluators.

Project Status: Completed

Year Published: 2014

URL for published report: https://www.euskadi.eus/contenidos/informacion/2014_osteba_publicacion/es_def/adjuntos/sysadoas.pdf

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government