Osteoarthritis management should comprise the combination of drugs aimed to mitigate risk, decrease disease progression and helps to improve quality of life. This detailed review concluded that the oral NSAIDs, COX-2 inhibitors, and opioids have similar efficay to which, has previously been mentioned in the literature. Moreover, it was observed that the topical NSAIDs have a greater RC (Relative % changes) value than oral NSAIDs.

Management of pain is a mainstay of osteoarthritis (OA) control. This review aims to collect recent, literature-based assessments of the impact of common pharmacologic therapies on pain reduction in OA patients.

Randomised controlled trials comprising topical NSAIDs, opioids, acetaminophen, oral NSAIDs, and COX-2 inhibitors for OA treatment were searched from 2006 to 2016 at MEDLINE.  Relative change in pain was used to estimate the drug effect on pain which later expressed as a percentage change. An overall outcome for each drug class was taken with weights based on each study's sample size as a weighted average of study-specific effects.

A total of 29 patients were included. A total of 43 treatment arms was used to determine the effect of the drug on pain. The relative (%) changes in pain were observed as; COX-2 inhibitors = 36.9, Acetaminophen = 32.5, opioids = 35.4, oral NSAIDs = 34.3, and topical NSAIDs = 40.9.

The impacts of 5 major drug classes in the management of OA pain were analysed with data selection from 29 studies advertised from 2006 to 2016.  The oral NSAIDs was observed to have an RC value resembling that of Acetaminophen. The impressions of opioids, COX-2 inhibitors, and oral NSAIDs in managing pain were comparable to what has been described in the preceding literature. Topical NSAIDs were discovered to have a higher RC than oral NSAIDs.