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We characterized pharmacological treatment patterns across safety strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We used Japanese health insurance claims database (2014\u20132024). Adults aged \u226540\u00a0years with incident knee or hip osteoarthritis were classified as having oral NSAID contraindications, precautions, or neither. Outcomes were receipt of oral NSAIDs within 90\u00a0days of osteoarthritis diagnosis. Adjusted risk differences (RDs) were estimated with identity-link binomial models and facility-clustered standard errors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For knee osteoarthritis, oral NSAIDs were prescribed to 49.0%, 44.0%, and 30.2% of patients in the no contraindications or precautions, precaution, and contraindication groups, respectively, and to 53.4%, 48.6%, and 34.5% of patients with hip osteoarthritis. Compared with patients with no contraindications or precautions, the adjusted RDs for receiving oral NSAIDs were \u22122.0 (95% confidence interval [CI], \u22122.6 to \u22121.4) and \u221212.9 (95% CI \u221214.1 to \u221211.7) for knee osteoarthritis, and \u22121.9 (95% CI \u22123.3 to \u22120.5) and \u221213.0 (95% CI \u221215.7 to \u221210.3) for hip osteoarthritis, for the precaution and contraindication groups, respectively. Adjusted RDs for receiving non-NSAID treatments were 0.5 (95% CI \u22120.1 to 1.1) and \u22122.0 (95% CI \u22123.4 to \u22120.6) for knee osteoarthritis, and 1.1 (95% CI \u22120.2 to 2.3) and 3.1 (95% CI 0.3 to 5.8) for hip osteoarthritis, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oral NSAID use was less frequent among patients classified as having oral NSAID precautions or contraindications than among those without such classifications in both cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00774-026-01762-8","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:38:05Z","timestamp":1790559485000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacological management of knee and hip osteoarthritis stratified by oral nonsteroidal anti-inflammatory drugs safety status"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7096-5604","authenticated-orcid":false,"given":"Masaki","family":"Hatano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1649-0596","authenticated-orcid":false,"given":"Yuya","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6480-3388","authenticated-orcid":false,"given":"Akira","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6317-6087","authenticated-orcid":false,"given":"Hisatoshi","family":"Ishikura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2040-6345","authenticated-orcid":false,"given":"Takeyuki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-9414","authenticated-orcid":false,"given":"Sakae","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-469X","authenticated-orcid":false,"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"1762_CR1","doi-asserted-by":"publisher","first-page":"e508","DOI":"10.1016\/S2665-9913(23)00163-7","volume":"5","author":"GBD 2021 Osteoarthritis Collaborators","year":"2023","unstructured":"GBD 2021 Osteoarthritis Collaborators (2023) Global, regional, and national burden of osteoarthritis, 1990\u20132020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. 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YK is a member of the Department of Health Services Research, Graduate School of Medicine, which is a cooperative program between The University of Tokyo and Tsumura & Co. TT has a collaborative research agreement with Amgen Inc. for a project involving the development and validation of hip and vertebral fractures using a claims database. ST received lecture fees, outside the submitted work, from Asahi Kasei Pharma Corporation, Chugai Pharmaceutical Co., Ltd., Teijin Healthcare Limited, Amgen K.K., and Daiichi Sankyo Co., Ltd. MH, AO, and HI declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board of the University of Tokyo (approval number: 2021010NI [April 23, 2021]). The requirement for informed consent was waived because the data were appropriately anonymized so that no specific individual could be identified.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}