# Low dose NSAIDs and sysadoas in the management of knee osteoarthritis

## TL;DR

Combining low-dose diclofenac and chondroitin sulfate may help manage knee osteoarthritis by reducing pain and minimizing side effects.

## Contribution

The study proposes a novel combination therapy using low-dose NSAIDs and chondroitin sulfate for knee osteoarthritis.

## Key findings

- Low-dose diclofenac combined with chondroitin sulfate may reduce pain in knee OA patients.
- The combination could decrease the need for higher NSAID doses, reducing systemic side effects.
- Expert consensus supports the potential of this combination as a therapeutic strategy.

## Abstract

Osteoarthritis (OA) is a chronic, progressive joint disease characterized by the degradation of articular cartilage, subchondral bone remodeling, synovial inflammation, and osteophyte formation. Despite being a leading cause of disability in older people, effective long-term management of OA remains a significant challenge. Current treatment strategies primarily focus on symptom control, with both non-pharmacological and pharmacological interventions.

A systematic literature review followed by a structured Delphi survey was conducted, involving an international Technical Expert Panel (TEP) of OA specialists. The panel evaluated the efficacy, safety, and clinical utility of combining low dose diclofenac and chondroitin sulfate in OA management.

The analysis of expert consensus indicated that the combination of low dose diclofenac and chondroitin sulfate may be effective in reducing pain and improving joint function in patients with knee OA. Additionally, this combination could reduce the need for higher doses of NSAIDs, thereby minimizing systemic adverse effects.

The combination of low dose diclofenac and chondroitin sulfate represents a promising therapeutic strategy for managing knee OA. Further studies are needed to confirm these findings and optimize therapeutic strategies to improve patient outcomes.

The online version contains supplementary material available at 10.1007/s40520-025-03221-2.