TY - JOUR T1 - Experts document about an adequate utilization of SYSADOAs in controversial clinical situations JO - Reumatología Clínica (English Edition) T2 - AU - Monfort,Jordi AU - Carné,Xavier AU - Abarca,Benjamín AU - Giménez,Sergio AU - Romera,Montserrat AU - Möller,Ingrid AU - Bibas,Marco AU - Vitaloni,Marianna AU - Batlle,Aina AU - Vergés,Josep SN - 21735743 M3 - 10.1016/j.reumae.2020.06.009 DO - 10.1016/j.reumae.2020.06.009 UR - https://www.reumatologiaclinica.org/en-experts-document-about-an-adequate-articulo-S2173574321000551 AB - Background and objectiveSYSADOAs (Symptomatic Slow-Acting Drugs for Osteoarthritis) are natural compounds that have been shown to be useful and safe in the treatment of osteoarthritis (OA). However, their use in certain clinical situations still lacks scientific evidence and clear recommendations. The objective of this work was to learn the opinion of a group of experts regarding the appropriate use of SYSADOA in the treatment of OA in controversial clinical situations. Materials and methodsFollowing the Delphi technique, 206 specific consultations, structured in 24 clinical questions, were evaluated. A panel of experts composed of a total of 15 specialists, answered the two rounds of consultation through an online platform. The results were analysed and discussed in a face-to-face meeting with the coordinators and the scientific committee. According to the percentage of panellists who agreed on their findings, the results were classified in terms of unanimity, consensus, majority and discrepancy. ResultsThe following points were agreed upon: (1) the patient's phenotype determines the use of SYSADOAs; (2) SYSADOAs are considered appropriate in primary OA (knee, hand and hip) and in some types of secondary OA; they are not considered appropriate in OA of the shoulder, spine, ankle and erosive OA of the hands; (3) SYSADOAs may be prescribed for patients at risk of or with cardiovascular disease, digestive disease, hypertension, dyslipaemia, peripheral vascular disease, type 2 diabetes and, excluding Diacerein, for patients with oesophageal reflux. No agreement was obtained on the prescription of SYSADOAs for patients with hepatic and renal disease. ConclusionsThere is limited literature on the use of SYSADOAs for the treatment of OA in controversial situations. Through this work it has been possible to establish the position of a group of experts regarding clinical situations for which there is no scientific evidence concerning their use. This work may contribute towards improving the management protocols of SYSADOAs in the treatment of OA and offer a useful approach in uncertain situations. ER -