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Primary care
Paracetamol as first line for treatment of knee and hip osteoarthritis
  1. Igho J Onakpoya
  1. Department of Primary Care, University of Oxford, Oxford, UK
  1. Correspondence to Dr Igho J Onakpoya, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; igho.onakpoya{at}

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Although several clinical guidelines recommend paracetamol as a first-line agent in the management of knee and hip osteoarthritis, the authors of a recently published Cochrane review called for a review of this recommendation.

Paracetamol is widely used as a first-line treatment for symptom relief in patients with osteoarthritis (OA). It is usually preferred to non-steroidal anti-inflammatory drugs because of its better harms profile, especially in people at risk of gastrointestinal bleeding.

In a recent Cochrane review,1 the authors compared the effectiveness of paracetamol versus placebo in the management of knee or hip OA. They searched seven scientific databases for relevant studies, including randomised controlled trials of participants with hip or knee OA irrespective of the intensity or duration of symptoms. The main outcomes were pain intensity, physical …

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