ArticleJournal of bone and mineral metabolism2026
Pharmacological management of knee and hip osteoarthritis stratified by oral nonsteroidal anti-inflammatory drugs safety status.
Article in Journal of bone and mineral metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionKnee and hip osteoarthritis are treated with oral nonsteroidal anti-inflammatory drugs (NSAIDs); however, pharmacological management by NSAID safety status remains unclear. We characterized pharmacological treatment patterns across safety strata. MATERIALS AND
methodsWe used Japanese health insurance claims database (2014-2024). Adults aged ≥40 years with incident knee or hip osteoarthritis were classified as having oral NSAID contraindications, precautions, or neither. Outcomes were receipt of oral NSAIDs within 90 days of osteoarthritis diagnosis. Adjusted risk differences (RDs) were estimated with identity-link binomial models and facility-clustered standard errors.
resultsFor knee osteoarthritis, oral NSAIDs were prescribed to 49.0%, 44.0%, and 30.2% of patients in the no contraindications or precautions, precaution, and contraindication groups, respectively, and to 53.4%, 48.6%, and 34.5% of patients with hip osteoarthritis. Compared with patients with no contraindications or precautions, the adjusted RDs for receiving oral NSAIDs were -2.0 (95% confidence interval [CI], -2.6 to -1.4) and -12.9 (95% CI -14.1 to -11.7) for knee osteoarthritis, and -1.9 (95% CI -3.3 to -0.5) and -13.0 (95% CI -15.7 to -10.3) for hip osteoarthritis, for the precaution and contraindication groups, respectively. Adjusted RDs for receiving non-NSAID treatments were 0.5 (95% CI -0.1 to 1.1) and -2.0 (95% CI -3.4 to -0.6) for knee osteoarthritis, and 1.1 (95% CI -0.2 to 2.3) and 3.1 (95% CI 0.3 to 5.8) for hip osteoarthritis, respectively.
conclusionOral NSAID use was less frequent among patients classified as having oral NSAID precautions or contraindications than among those without such classifications in both cohorts.
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