Management of osteoarthritis in dogs typically involves a multimodal approach including one or more of the following: weight management; nutritional support; physical therapy; and administration of nonsteroidal antiinflammatory drugs, analgesic medication, nutriceuticals, and other slow-acting or disease-modifying agents. Many agents for treatment of dogs with osteoarthritis have been introduced during the past decade. They vary widely in their documented efficacy and safety. This systematic review sought to identify and critically evaluate the quality of evidence for the most commonly used pharmacologic, nutriceutical, and slow-acting drugs. The Food and Drug Administration's evidence-based medicine scoring system was used. The analysis consisted of study design rating, quality factor rating, quantity rating, consistency rating, relevance to disease risk reduction rating, and cumulative strength of evidence rating. A broad bibliographic search of many databases was performed for articles published up to May 2006. Meloxicam received the highest ranking of studies and hyaluronan the lowest. Additional controlled studies are needed in all groups of medical treatments to help improve our understanding of osteoarthritis and its treatment.

COMMENTARY: With so many options for the treatment or relief of pain of osteoarthritis, it is a good idea to develop a system to evaluate the studies of the variety of products. The FDA's system is one of many, but all try to rate the quality of the research on the basis of such criteria as study design, relevance of disease to the proposed substance, and a systematic evaluation of the strength of evidence.

Systematic review of clinical trials of treatments for osteoarthritis in dogs. Aragon CL, Hofmeister EH, Budsberg SC. JAVMA 230:514-521, 2007.