Effects Of Pharmacological Interventions Research Articles

Beneficial vs harmful effects of pharmacological treatment of patent ductus arteriosus: A Bayesian meta-analysis

Beneficial vs harmful effects of pharmacological treatment of patent ductus arteriosus: A Bayesian meta-analysis

Allergen immunotherapy.

Allergen immunotherapy (AIT) is a potentially disease-modifying therapy that is effective for the treatment of allergic rhinitis/conjunctivitis, allergic asthma and stinging insect hypersensitivity. The decision to proceed with AIT should be made on a case-by-case basis, based on a comprehensive evaluation of the patient, allergy testing and a thorough discussion with the patient about treatment goals, risks vs. benefits, and long-term commitment to the treatment plan. For those with allergic rhinitis and/or asthma, it is also important to consider individual patient factors, such as the degree to which symptoms can be reduced by avoidance measures and pharmacological therapy, the amount and type of medication required to control symptoms, the adverse effects of pharmacological treatment, and patient preferences.Since AIT is associated with a risk of anaphylaxis, it should only be prescribed by physicians who are adequately trained in the treatment of allergic conditions. Furthermore, for subcutaneous therapy, injections must be given under medical supervision in clinics that are equipped to manage anaphylaxis. In this article, we review the indications and contraindications, patient selection criteria, and details regarding the administration, safety and efficacy of AIT for allergens other than foods. Immunotherapy for food allergy will be discussed in the Oral Immunotherapy article in this supplement.

Multiscale computational model predicts how environmental changes and treatments affect microvascular remodeling in fibrotic disease

Abstract Investigating the molecular, cellular, and tissue-level changes caused by disease, and the effects of pharmacological treatments across these biological scales, necessitates the use of multiscale computational modeling in combination with experimentation. Many diseases dynamically alter the tissue microenvironment in ways that trigger microvascular network remodeling, which leads to the expansion or regression of microvessel networks. When microvessels undergo remodeling in idiopathic pulmonary fibrosis (IPF), functional gas exchange is impaired and lung function declines. We integrated a multiscale computational model with independent experiments to investigate how combinations of biomechanical and biochemical cues in IPF alter cell fate decisions leading to microvascular remodeling. Our computational model predicted that extracellular matrix (ECM) stiffening reduced microvessel area, which was accompanied by physical uncoupling of endothelial cell (ECs) and pericytes, the cells that comprise microvessels. Nintedanib, an FDA-approved drug for treating IPF, was predicted to further potentiate microvessel regression by decreasing the percentage of quiescent pericytes while increasing the percentage of pericytes undergoing pericyte-myofibroblast transition (PMT) in high ECM stiffnesses. Importantly, the model suggested that YAP/TAZ inhibition may overcome the deleterious effects of nintedanib by promoting EC-pericyte coupling and maintaining microvessel homeostasis. Overall, our combination of computational and experimental modeling can predict and explain how cell decisions affect tissue changes during disease and in response to treatments.

Synergistic‐like decreases in alcohol intake following combined pharmacotherapy with GLP‐1 and amylin in male rats

Background and PurposeThe limited effectiveness of current pharmacological treatments for alcohol use disorder (AUD) highlights the need for novel therapies. These may involve the glucagon‐like peptide‐1 receptor or the amylin receptor, as treatment with agonists targeting either of these receptors lowers alcohol intake. The complexity of the mechanisms underlying AUD indicates that combining agents could enhance treatment efficacy. While a combination of amylin receptor and GLP‐1 receptor agonists reduced food intake and body weight synergistic‐like, its influence on alcohol intake is unknown.Experimental ApproachEffects of a range of dose‐combinations of GLP‐1 receptor (dulaglutide) and amylin receptor (salmon calcitonin; sCT) agonists on alcohol intake were explored in male and female rats. We used dose combinations that either lowered alcohol intake as monotherapy (0.1 mg·kg−1 + 5 μg·kg−1), or that did not affect alcohol consumption per se (0.075 mg·kg−1 + 2 μg·kg−1).Key ResultsAcute administration of dulaglutide and sCT (0.1 mg·kg−1 + 5 μg·kg−1) reduced alcohol intake in males, but not in females. When higher doses were evaluated in female rats, a decrease in alcohol intake was observed. Furthermore, the low dose combination (0.075 mg·kg−1 + 2 μg·kg−1) decreased, in in a synergistic‐like manner, alcohol intake and prevented abstinence‐induced drinking without affecting kaolin intake in males. However, tolerance developed during sub‐chronic treatment.Conclusion and ImplicationsCollectively, these findings show that the combination of dulaglutide and sCT decreased, in in a synergistic‐like manner, alcohol consumption in male rats. Contrarily, higher doses are required for females.

Comparison of the effectiveness of botulinum toxin, dry needling, pharmacological treatment, and manual therapy for bruxism-induced myalgia: a prospective randomized study.

Bruxism is a significant phenomenon that should not be underestimated, given its prevalence and consequences. The major symptoms associated with bruxism include myalgia, decreased quality of life, and limited mandibular movements. This study aimed to evaluate and compare the effectiveness of four treatment methods for managing bruxism-related symptoms: botulinum toxin (BoNT-A), dry needling (DN), pharmacological therapy (PT), and manual therapy (MT). Eighty patients with bruxism (44 female, 36 male) were randomly assigned to four groups of 20 patients each. All therapies were administered by the same maxillofacial surgeon. Measurements were recorded at baseline (pre-treatment) and at 2, 4 and 12 weeks post-treatment. The metrics assessed included the visual analog scale (VAS) for pain, maximum painless mouth opening (MMO), and the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Statistical analysis was performed using a mixed-design repeated measures two-way analysis of variance (ANOVA) to compare changes within and among the groups over time. Tukey's multiple comparison test was applied for further analysis. The results indicated that both objective and subjective clinical outcomes were similar across all treatment groups. Considering their competitive efficiency, non-invasiveness or minimal invasiveness, and cost-effectiveness, DN, MT and PT appear to be promising alternatives for managing bruxism and its symptoms, especially in the early stages. ClinicalTrials ID: NCT06583551.

Effectiveness of combined pharmacological treatment in patients with lumbar discogenic pain in degenerative dystrophic diseases

Effectiveness of combined pharmacological treatment in patients with lumbar discogenic pain in degenerative dystrophic diseases

Chronic hyperglycemia induces hepatocyte pyroptosis via Gα12/Gα13-associated endoplasmic reticulum stress: Effect of pharmacological intervention

AimsHyperglycemia induces pathophysiological changes. Endoplasmic reticulum (ER) stress with Gα12 overexpression may promote hepatocyte death. This study investigated whether sustained hyperglycemia triggers ER stress-associated pyroptosis and fibrosis in the liver alongside an overexpression of Gα12, and examined the potential link with VEGF-A levels. Main methodsMice were subjected to a high-fat diet (60 kcal% fat) with streptozotocin (50 mg/kg body weight, three consecutive times, between 12‐13th weeks). AZ2 (a functional Gα12 inhibitor) was treated at 10 mg/kg body weight (5 times/week, 3 weeks). Immunoblotting and immunohistochemistry analyses were performed. Key findingsHepatic Gα12/Gα13 were overexpressed in the diabetic mice. The following proteins downstream from the Gα12 axis were upregulated: PGC1α, PPARα, and SIRT1. Sustained hyperglycemia promoted ER stress marker levels. Histopathological and biochemical assays showed large-sized lipid droplet accumulation, hepatocyte degeneration, and damage as blood transaminase activities increased. Moreover, the diabetic condition increased IL-1β, caspase-1, and NLRP3 levels, which were supportive of pyroptosis. Consistently, the intensities of Masson's trichrome, collagen-1A1, α-SMA, vimentin, and fibronectin all increased. VEGF-A and VEGFR2 levels also increased in the liver and/or sera. The levels of hepatic pigment epithelial-derived factor (PEDF), a physiological antagonist of VEGF-A, decreased with its reciprocal increase in serum. These events were reversed by AZ2 treatment, supporting the role of Gα12 in hyperglycemic stress in the liver. SignificanceChronic hyperglycemia causes hepatic pyroptosis and fibrosis related to ER stress with Gα12/Gα13 and VEGF overexpression, which may be overcome by AZ2 treatments.

Comparative Efficacy of Different Pharmacological Treatments for Pityriasis Rosea: A Network Meta-Analysis.

Background/Objectives: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with the endogenous reactivation of human herpesviruses (HHV)-6 and HHV-7. Classically, the lesions gradually resolve, leaving no sequelae. Therefore, the best treatment is reassuring the patient and suggesting a resting period. However, atypical PR cases characterized by extensive, persistent lesions and systemic symptoms may impact the patient's quality of life, and, therefore, a treatment can be prescribed. There is limited evidence on the comparative effectiveness of pharmacological treatments for PR; therefore, we performed a network meta-analysis to compare these interventions. Methods: Overall, 12 randomized control trials (RCTs) were identified. The outcomes were itch resolution and rash improvement. Results were expressed as risk ratio (RR) and 95% confidence interval (CI). We also calculated the relative ranking of the interventions for achieving the aforementioned outcomes as their surface under the cumulative ranking (SUCRA). Results: On network meta-analysis, only oral steroids and the combination of oral steroids+antihistamine resulted significantly superior to the placebo in terms of itch resolution (RR 0.44, CI 0.27-0.72 and RR 0.47, CI 0.22-0.99). Oral steroids resulted in the best treatment (SUCRA 0.90) for itch resolution. In terms of rash improvement, only acyclovir and erythromycin resulted significantly superior to placebo (RR 2.55, CI 1.81-3.58; and RR 1.69, CI 1.23-2.33), and acyclovir outperformed all the other tested interventions. Consequently, acyclovir ranked as the best intervention (SUCRA score 0.92). Conclusions: Acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms. Steroids and antihistamines seemed the best treatment for itch resolution.

The Effectiveness of Mindfulness-Based Therapy on Quality of Life, Anxiety, and Depression in Individuals with Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

: The primary objective of this systematic review was to determine the efficacy of mindfulness-based therapy in improving the quality of life for individuals diagnosed with Irritable Bowel Syndrome (IBS). Following the PRISMA guidelines, a comprehensive literature search was conducted using major databases, including PubMed, Web of Science, Scopus, PsycInfo, CINAHL, and Cochrane Library, for clinical trial articles published between 2010/01/30 and 2024/05/30. The search strategy incorporated keywords such as "IBS," "Mindfulness," "quality of life," and "anxiety." The systematic review included 20 studies, with sample sizes ranging from 3 to 95 patients. A meta-analysis was subsequently performed on ten articles, focusing on the impact of mindfulness-based therapy on enhancing the quality of life in IBS patients. The Verhagen quality assessment checklist was used to qualitatively evaluate these articles. The study's findings were presented in two main sections using the random-effects model during the meta-analysis. First, the influence of mindfulness-based therapy on patients' quality of life was examined. The results showed a statistically significant improvement in the quality of life following this therapeutic intervention (Standardized Mean Difference [SMD] = -0.683, 95% Confidence Interval [CI] = -1.326, -0.039, P = 0.000). Additionally, mindfulness-based therapy significantly reduced anxiety (SMD = 0.679, 95% CI = 0.354, 1.004) and depression symptoms (SMD = 0.496, 95% CI = 0.284, 0.708) in these individuals. The findings of this systematic review suggest that mindfulness-based therapy is effective in improving the quality of life for individuals with IBS, while also reducing symptoms of depression and anxiety. Given the potentially harmful side effects of pharmacological treatments for these patients, it is essential to prioritize therapeutic and non-pharmacological interventions, such as mindfulness-based therapy.

Development and validation of a new method by MIR-FTIR and chemometrics for the early diagnosis of leprosy and evaluation of the treatment effect

ObjectiveDevelop a new method for diagnosing leprosy and monitoring the pharmacological treatment effect of patients. Material and methodsPlasma samples from patients diagnosed with leprosy (n = 211) who had not yet received any pharmacological treatment were collected at a basic health unit in Brazil. After treatment, samples were collected from the same patients (n = 125). Plasma samples from healthy volunteers were also collected (n = 179) and used as a control group. All samples were analyzed by Fourier transform mid-infrared spectrophotometry (MIR-FTIR). The spectral data of the samples were subjected to chemometric analysis. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were used to predict diagnosis and monitor pharmacological treatment. ResultsThe PCA model successfully distinguished among three sample classes: healthy individuals, pre-treatment leprosy patients, and post-treatment leprosy patients. The PLS-DA algorithm accurately classified healthy, treated, and diseased samples, facilitating both reliable diagnosis and treatment monitoring for leprosy. The model achieved a sensitivity of 97 %–100 %, specificity of 100 %, and accuracy ranging from 99 % to 100 %. Furthermore, when tested on plasma samples from patients with other conditions—renal failure (n = 1032), hypertriglyceridemia (n = 100), hypercholesterolemia (n = 100), and mixed dyslipidemia (n = 100)—the model correctly classified these as negative for leprosy, with diagnostic specificity between 93 % and 96 %. ConclusionThe MIR-FTIR technique combined with PLS-DA analysis proved to be a highly effective tool for screening leprosy patients and monitoring treatment outcomes. Given its low cost, this method could be easily implemented in laboratories across emerging and low-income countries.

The impact of sleep disturbances on treatment efficacy and prognosis in patients with depressive and anxiety disorders.

Little was known about the relationship between sleep disturbances and depressive and anxiety disorders, as well as the efficacy of treatment regimens. During 2021 to 2023, a total of 417 participants were screened by Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Rating Scale (HAMA-14) for psychological status, and Pittsburgh sleep quality index (PSQI) assessment. 409 participants were finally enrolled, of which 188 (45.97%) were suffered from sleep disorders. All participants were received polysomnography (PSG) followed by six-week pharmacological treatment of escitalopram and zopiclone, and finally assessed by HAMD-17 and HAMA-14 for treatment efficacy. PSG monitoring indicated that participants with depression experienced prolonged rapid eye movement sleep latency (REMSL) and increased wakefulness after sleep onset (WASO) (P=0.030 and P=0.002, respectively). Those with anxiety disorders demonstrated a significantly higher percentage of non-rapid eye movement sleep (NREM%) and reduced WASO (P=0.013 and P=0.001, respectively). After six-weeks pharmacological treatment, participants with or without sleep disorders exhibited with similar efficacy outcomes of depression and anxiety disorders (P>0.05). However, every point of PSQI increment at baseline would decrease 0.78 and 0.85 times of probability of effective pharmacological treatment of depression and anxiety disorders. Moreover, participants with both effective outcomes of depression and anxiety disorders were found significant shorter sleep onset latency (SOL) (P<0.001). The insights gained underscore the necessity of considering sleep disturbances in enhancing the overall effectiveness of pharmacological treatments for depression and anxiety disorders.

Navigating Drug-Induced Lung Disease (DILD): A Comprehensive Review on Management and Prevention Strategies.

Drug-induced lung disease (DILD) is a significant and often overlooked adverse effect of pharmacological treatments, encompassing a range of pulmonary disorders triggered by medications. This review provides a comprehensive overview of DILD, focusing on its definition, pathophysiology, and clinical implications. We explore the epidemiology of DILD, highlighting the prevalence of various drugs associated with pulmonary toxicity and the factors influencing susceptibility. The review details the clinical presentation of DILD, including common symptoms and diagnostic challenges, and outlines diagnostic modalities such as imaging, pulmonary function tests, and invasive procedures. Management strategies are discussed, emphasizing the importance of timely drug discontinuation, supportive care, and the role of corticosteroids and novel therapies. Preventive measures, including pre-treatment evaluations and ongoing monitoring, are also addressed. The review concludes by examining future research directions and emerging therapies, aiming to enhance the understanding and management of DILD. This review is intended to aid healthcare professionals in recognizing, managing, and preventing drug-induced lung diseases, ultimately improving patient outcomes and safety.

Effect of long-term pharmacological treatments on Alzheimer disease: A systematic review and network meta-analysis.

To analyze and compare the pharmacological treatments for Alzheimer disease (AD), we will conduct a systematic review and network meta-analysis focusing on their efficacy and safety over a duration exceeding 1 year. We searched the databases of PubMed, Scopus, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and CNKI until July 30, 2023, for randomized controlled trials (RCTs) evaluating pharmacological treatments for AD. Seventeen RCTs, comprising 7214 participants, investigated the efficacy of the following drugs: Donepezil, Rivastigmine, Galantamine, Memantine, Ginkgo biloba extract (EGb), Atorvastatin-calcium and Vitamin B in the treatment of AD. The network meta-analysis resulted indicated that placebo demonstrated greater effectiveness compared to Atorvastatin-calcium 80 mg (mean different [MD] = -6.93, confidence interval [CI] -11.57, -2.29) and Rivastigmine 12 mg (MD = -3.33, CI -6.56, -0.09). EGb120 mg exhibited a greater improvement in cognition compared to Atorvastatin-calcium 80 mg (MD = 7.77, CI 2.07, 13.46) and Rivastigmine 12 mg + EGb120 mg (MD = 9.92, CI 1.32, 17.22). EGb 120 mg emerged as the most efficient intervention for cognition, while placebo demonstrated the least harm over a period exceeding 1 year. In this network meta-analysis of studies of patients with AD and a follow-up period of at least 1 year, EGb 120 mg demonstrated cognitive benefits, while placebo posed the least harm for AD. More RCTs are required to address the uncertainty surrounding the efficacy of medication.

Effect of pharmacological treatment of attention-deficit/hyperactivity disorder on later psychiatric comorbidity: a population-based prospective long-term study

BackgroundPsychiatric comorbidity is frequent among persons with attention-deficit/hyperactivity disorder (ADHD). Whether pharmacological treatment of ADHD influences the incidence of psychiatric comorbidity is uncertain.ObjectiveTo investigate associations and causal relations between pharmacological...

Real-life effects of pharmacological osteoporosis treatments on bone mineral density by quantitative computed tomography.

Monitoring of bone mineral density (BMD) is used to assess pharmacological osteoporosis therapy. This study examined the real-life effects of antiresorptive and osteoanabolic treatments on volumetric BMD (vBMD) of the spine by quantitative computed tomography (QCT). Patients aged ≥ 50years with a vBMD < 120mg/ml had ≥ 2 QCT. For analysis of therapy effects, the pharmacological treatment and the duration of each therapy were considered. Identical vertebrae were evaluated in all vBMD measurements for each patient. A linear mixed model with random intercepts was used to estimate the effects of pharmacological treatments on vBMD. A total of 1145 vBMD measurements from 402 patients were analyzed. Considering potential confounders such as sex, age, and prior treatment, a reduction in trabecular vBMD was estimated for oral bisphosphonates (-1.01mg/ml per year; p < 0.001), intravenous bisphosphonates (-0.93mg/ml per year; p = 0.015) and drug holiday (-1.58mg/ml per year; p < 0.001). Teriparatide was estimated to increase trabecular vBMD by 4.27mg/ml per year (p = 0.018). Patients receiving denosumab showed a statistically non-significant decrease in trabecular vBMD (-0.44mg/ml per year; p = 0.099). Compared to non-treated patients, pharmacological therapy had positive effects on trabecular vBMD (1.35mg/ml; p = 0.001, 1.43mg/ml; p = 0.004, 1.91mg/ml; p < 0.001, and 6.63mg/ml; p < 0.001 per year for oral bisphosphonates, intravenous bisphosphonates, denosumab, and teriparatide, respectively). An increase in trabecular vBMD by QCT was not detected with antiresorptive agents. Patients treated with teriparatide showed increasing trabecular vBMD. Non-treatment led to a larger decrease in trabecular vBMD than pharmacological therapy.

Differential Efficacy of Weight Loss Interventions in Patients with Versus Without Diabetes.

Obesity is both a major risk factor for diabetes and a serious comorbidity of the condition. The twin epidemics of obesity and diabetes have spread globally over the past few decades. Treatment of obesity in patients with diabetes provides a host of clinical benefits that encompass virtually all body systems. Despite this, multiple lines of evidence suggest that the efficacy of most therapies for weight loss is significantly reduced among patients with diabetes. With this background, we summarize the evidence of a differential effect of lifestyle, pharmacological, and surgical treatments for obesity in patients with existing diabetes, and explore the potential mechanisms involved in this phenomenon. This information is then used to formulate strategies to improve weight loss outcomes for patients with diabetes.

Pathogenesis and New Pharmacological Approaches to Noise-Induced Hearing Loss: A Systematic Review.

Noise-induced hearing loss (NIHL) is responsible for significant adverse effects on cognition, quality of life and work, social relationships, motor skills, and other psychological aspects. The severity of NIHL depends on individual patient characteristics, sound intensity, and mainly the duration of sound exposure. NIHL leads to the production of a reactive oxygen (ROS) inflammatory response and the activation of apoptotic pathways, DNA fragmentation, and cell death. In this situation, antioxidants can interact with free radicals as well as anti-apoptotics or anti-inflammatory substances and stop the reaction before vital molecules are damaged. Therefore, the aim of this study was to analyze the effects of different pharmacological treatments, focusing on exogenous antioxidants, anti-inflammatories, and anti-apoptotics to reduce the cellular damage caused by acoustic trauma in the inner ear. Experimental animal studies using these molecules have shown that they protect hair cells and reduce hearing loss due to acoustic trauma. However, there is a need for more conclusive evidence demonstrating the protective effects of antioxidant/anti-inflammatory or anti-apoptotic drugs' administration, the timeline in which they exert their pharmacological action, and the dose in which they should be used in order to consider them as therapeutic drugs. Further studies are needed to fully understand the potential of these drugs as they may be a promising option to prevent and treat noise-induced hearing loss.

Novel Therapeutic Approaches in Alzheimer's Disease

Alzheimer's disease (AD) is a neurological condition associated with a decrease in levels of acetylcholine and diminished cholinergic functions. This may be caused by the degeneration of cholinergic neurons in the brain, leading to cognitive deficits. Due to the difficulty and invasiveness of collecting cerebrospinal fluid (CSF) required for assessing conventional biomarkers, researchers are currently exploring less intrusive, less expensive, and more straightforward methods for diagnosing AD. Additionally, conventional interventions such as cholinesterase inhibitors like rivastigmine, donepezil, and galantamine are US FDA-approved drugs that are still effective for managing AD. The goal of this therapy is to increase acetylcholine levels in the brain by inhibiting the enzymes that degrade acetylcholine. Therefore, this therapeutic approach is useful for treating mild-to-moderate AD. However, only symptomatic treatment is currently available, and it can lead to serious adverse effects from conventional therapy. Thus, novel therapies for AD are needed in a growing global population. This manuscript provides information on various biomarkers with possible pathogenesis mechanisms, novel treatment strategies such as microalgae, HupA, cannabinoids, and the beneficial effects of coenzyme Q10, bacterial probiotics, omega-3 fatty acids, vitamin B12, and D3 in memory impairment for managing AD. Non-pharmacological treatments such as music therapy, Electroacupuncture (EA), or manual acupuncture (MA) also play an important role in enhancing the effectiveness of conventional pharmacological treatments for AD.

Empowerment of Augmented Reality (AR) for Patient Education and Engagement: Medication Adherence Programs' Impact on Public Health Outcomes

The entire effectiveness of pharmacological treatment depends on patients taking their medications as prescribed. Patient education is a vital component of the endeavours to enhance adherence to medications. However, many people still fail to take their prescription pills as prescribed. In addition to having access to healthcare, those who follow their doctors' orders greatly improve their chances of a positive outcome. The unfortunate reality is that many people do not take their medications as prescribed, which has led to deteriorating health, higher healthcare costs, and more overall costs. Hence, this paper presents the Smart Augmented Reality-based Patient Medication Adherence Program (SAR-PMAP) model for effective patient education and engaging medication. The augmented reality spectacles help those with trouble keeping track of their medication, and the model encourages patients to take their prescriptions as prescribed. Users may easily go to their homes with the aid of the navigation functions, and patients with impaired eyesight can benefit from the audio option that gives out the date and time. Given all this data, the Medication Coach Intelligent Agent (MCIA) takes the lead in making comprehensive decisions so patients can get autonomous, individualized, and unobtrusive treatments.

A Review of Current Approaches to Pain Management in Knee Osteoarthritis with a Focus on Italian Clinical Landscape.

The global cases of knee osteoarthritis (KOA) are projected to increase by 74.9% by 2050. Currently, over half of patients remain dissatisfied with their pain relief. This review addresses unmet needs for moderate-to-severe KOA pain; it offers evidence and insights for improved management. Italian experts from the fields of rheumatology, physical medicine and rehabilitation, orthopedics, primary care, and pain therapy have identified several key issues. They emphasized the need for standardized care protocols to address inconsistencies in patient management across different specialties. Early diagnosis is crucial, as cartilage responds better to early protective and structural therapies. Faster access to physiatrist evaluation and reimbursement for physical, rehabilitative, and pharmacological treatments, including intra-articular (IA) therapy, could reduce access disparities. Concerns surround the adverse effects of oral pharmacological treatments, highlighting the need for safer alternatives. Patient satisfaction with corticosteroids and hyaluronic acid-based IA therapies reduces over time and there is no consensus on the optimal IA therapy protocol. Surgery should be reserved for severe symptoms and radiographic KOA evidence, as chronic pain post-surgery poses significant societal and economic burdens. The experts advocate for a multidisciplinary approach, promoting interaction and collaboration between specialists and general practitioners, to enhance KOA care and treatment consistency in Italy.