Recommendations for weight management in osteoarthritis: A systematic review of clinical practice guidelines.

Autor:	Lim YZ; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Wong J; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Hussain SM; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Estee MM; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Zolio L; Alfred Health, Melbourne, VIC 3004, Australia., Page MJ; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Harrison CL; Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia., Wluka AE; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Wang Y; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia., Cicuttini FM; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Jazyk:	angličtina
Zdroj:	Osteoarthritis and cartilage open [Osteoarthr Cartil Open] 2022 Aug 05; Vol. 4 (4), pp. 100298. Date of Electronic Publication: 2022 Aug 05 (Print Publication: 2022).
DOI:	10.1016/j.ocarto.2022.100298
Abstrakt:	Objective: While targeting obesity is central to osteoarthritis management, recent meta-analyses demonstrate only modest effects of weight loss on symptoms, and little on structure. The World Health Organisation recommends that effective management of obesity include prevention of weight gain, weight maintenance and weight loss. Therefore, we systematically reviewed the recommendations and approaches for management of obesity in clinical practice guidelines (CPGs) for osteoarthritis. Design: Nine databases were searched (01.01.2010-15.03.2022) to identify guidelines informing the non-pharmacological management of osteoarthritis. Three reviewers appraised guidelines according to the AGREE II instrument, and independently extracted data on their characteristics. One author extracted and summarised guideline recommendations on weight management. This systematic review is registered on PROSPERO (CRD42021274195). Results: Of the included fifteen CPGs (median AGREE II domain score 78.7%), weight loss was recommended for knee (12 of 13) and hip (10 of 11) but not hand (0 of 4) osteoarthritis. Combination approaches of diet and/or exercise were recommended for overweight or obese individuals in knee (8 of 12) and hip (4 of 10) osteoarthritis. Two guidelines specified ≥5% weight loss. One guideline specified strategies for maintenance of lost weight; none specifically recommended preventing weight gain. There was discordance between strength of recommendation for weight loss and level of evidence (3 of 15). Conclusion: Most CPGs for knee and hip osteoarthritis recommend weight loss to manage obesity in osteoarthritis. As steady weight accumulation is common in adults, preventing weight gain should also be considered as it is a missed opportunity to improve outcomes in osteoarthritis. Competing Interests: All authors declare that they have no conflict of interest. (© 2022 The Authors.)
Databáze:	MEDLINE
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