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ADVERTORIAL HOW CAN YOU KEEP PATIENTS WITH OA MOVING IN THE RIGHT DIRECTION? Find the right balance of pain relief for flare-ups1 INFLAMMATION IS A CAUSE OF OA PAIN AND PATHOLOGY2 Movement and exercise are still most important3 BENEFITS THE MIND & BODY4 GUIDELINE RECOMMENDATIONS FOR PAIN RELIEF HAVE CHANGED3 No recommendation for or against paracetamol3 (very low evidence) Conditional recommendation for oral NSAIDs3 (moderate evidence) YOU NEED TO HELP PATIENTS FIND A BALANCE Between ‘just enough to enable movement and not too much to cause adverse effects’1 JUN1E 2020 REVIEW Plus, modified release paracetamol is to be upscheduled due to risks associated with misuse5 SIMILAR SUCCESS RATE in pain relief vs diclofenac 25mg6* 0 % patients 50 SAME LOW RISK of GI side-effects as paracetamol7-9^ 4% IBUPROFEN VS 5.3% PARACETAMOL6 GI events (dyspepsia) ibuprofen 400mg diclofenac 25mg HELP BREAK THE CYCLE OF PAIN:4,10 RECOMMEND & REFER FOR MULTIDISCIPLINARY CARE MONITOR *4 out of 10 of patients achieved at least 50% pain relief with either ibuprofen 400mg or diclofenac 25mg. Graph adapted from a Cochrane review of 21 different pain relief medications.6 Not all medications shown. ^When taken as directed in an over-the-counter setting in patients without contraindications/precautions. NSAID: non-steroidal anti-inflammatory drug. OA: osteoarthritis. References: 1. Kielly J, Davis EM and Marra C Can Pharm J (Ott) 2017;150(3):156–68. 2. Sokolove S, Lepus CM. Ther Adv Musculoskel Dis 2013;5(2):77–94. 3. The Royal Australian College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP, 2018. 4. Therapeutic Guidelines. Introduction to osteoarthritis. eTG December 2019 edition. 5. Australian Government. Department of Health. Modified release paracetamol Available at: https://www.tga.gov.au/modified-release-paracetamol (accessed 14 January 2020). 6. Moore RA et al. Cochr Data Syst Rev 2015;11. Art No.: CD010794. 7. Moore RA et al. Clin Drug Invest 1999;18(2):89-98. 8. Rampal P et al. J Int Med Res 2002;30:301–308. 9. Varrassi G et al. Adv Ther 2019; doi: 10.1007/s12325-019-01144-9. 10. Susko AM and Fitzgerald GK, Open Access Rheumatol 2013;5:81–91. Reckitt Benckiser (Australia) Pty Ltd. Level 47, 680 George St, Sydney 2000, NSW Australia. Prepared February 2020. RB0056.