What is the first-line pharmacologic treatment for osteoarthritis?

The first-line pharmacologic treatment for osteoarthritis is commonly considered to be nonsteroidal anti-inflammatory drugs (NSAIDs). This is because NSAIDs effectively address both pain and inflammation associated with osteoarthritis, which is a degenerative joint disease characterized by the breakdown of cartilage in the joints leading to pain, stiffness, and functional impairment.

NSAIDs work by inhibiting the cyclooxygenase (COX) enzymes, which play a key role in the production of prostaglandins—substances that mediate inflammation and pain. By reducing prostaglandin synthesis, NSAIDs alleviate the discomfort that patients with osteoarthritis experience, improving their quality of life and ability to function in daily activities.

While other treatments are available for osteoarthritis, such as corticosteroids or disease-modifying agents like methotrexate and gold salts, they are not typically utilized as first-line options for this particular condition. Corticosteroids may be considered for short-term relief in specific situations or joint injections, and methotrexate and gold salts are primarily used in rheumatoid arthritis rather than osteoarthritis. Thus, the preference for NSAIDs as the initial therapeutic approach aligns with clinical guidelines and the common practice for managing osteoarthritis symptoms.