Treatment of osteoarthritis of large and small joints using an injectable complex action chondroprotector
https://doi.org/10.51793/OS.2021.14.17.012
Abstract
The aim of the study was to assess the efficacy and tolerability of slow-acting injectable agent for the treatment of osteoarthritis in the treatment of osteoarthritis of large and small joints. The study group consisted of 49 patients (87,8% women, 12,2% men, whose median age – 63,4 [52,3; 75,2] years, the duration of the disease – 5,86 [3,07; 11.4] years, body mass index – 30,06 [23,1; 41,4] kg/m2): 14,6% – with damage to small joints of the hands (group 1), 62,5% with damage to large joints, who received the drug only intramuscularly (group 2) and 22,9% with lesions of large joints, who received the drug intra-articularly and intramuscularly (group 3). During the year, 2 courses of injections were carried out with an interval of 6 months. 3 months follow-up period was held. The results of treatment were assessed by the dynamics of the VAS of pain, AUSCAN and WOMAC indices, patient and doctor satisfaction on a 5-point scale, and the need for non-steroidal anti-inflammatory drugs (NSAIDs). After 1 course of treatment, there was a statistically significant decrease in pain according to VAS in all groups by 45,4-57,7%, in the AUSCAN index – by 49,3%, in the WOMAC index in group 2 – by 44,9%, in group 3 – by 53,2%. About 1/3 of patients refused to take NSAIDs. By the beginning of the 2nd course, these indicators increased, but not to the initial level. After the 2nd course of therapy, further improvement was noted pain according to VAS – by 20,2-30,8%, AUSCAN index – by 28,4%, WOMAC index in group 2 – by 20,5%, in group 3 – by 22 ,9%. After 3 months of follow-up there was a decrease in comparison with the initial indicators: pain according to VAS – by 60,8-64,8%, AUSCAN index – by 34,3%, WOMAC in group 2 – by 51,3%, in group 3 – by 35,4%. The dynamics of joint stiffness was most pronounced. Half of the patients stopped taking NSAIDs. Adverse reactions (dermatitis at the injection site and synovitis after i/a administration of the drug) were detected in 2 patients.
About the Authors
I. V. Menshikova
FSAЕU HE I. M. Sechenov First Moscow State Medical University
Россия
Россия
Moscow
V. N. Sorotskaya
FSBEI HE State University of Tula
Россия
Россия
Tula
References
1. Алексеева Л. И. Современное лечение остеоартроза // Фарматека. 2012; 1: 22-27. [Alekseeva L. I. Sovremennoe lechenie osteoartroza [Modern treatment of osteoarthritis (in Russ)] // Pharmateka. 2012; 1: 22-27.]
2. Балабанова Р..М., Эрдес Ф. Ш. Распространенность ревматических заболеваний в России в 2012-2013 гг. // Научнопрактическая ревматология. 2015; 53 (2): 120-124. [Balabanova R. M., Erdes Ph. Sh. Rasprosranennost revmaticheskikh zabolevanii v Rossii v 2012-2013 gg. [Prevalence of rheumatic diseases in Russia in 2012-2013] // Nauchnopracticheskaya revmatologiya (Rheumatology Science and Practice). (In Russ). 2015; 53 (2): 120-124.]
3. Buckwalter J. A., Martin J. A. Osteoarthritis // Adv Drug Deliv Rev. 2006; 58: 150-167.
4. Robinson W. H., Lepus C. M., Wang Q., et al. Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis // Nat Rev Rheumatol. 2016; 12 (10): 580-592. DOI: 10.1038/nrrheum.2016.136. Epub 2016 Aug 19.
5. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!) // Osteoarthriris and Cartilage. 2013; 21: 16-21.
6. Bruyere O., Cooper C., Pellitier J. P., et al. An algorithm recommendations for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) // Semin Arthritis Rheum. 2014; 44 (3): 253-263. DOI: 10.1016/j.semarthrit.2014.05.014.
7. Hochberg M. C., Altman R. D., April K. T., et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee // Arthritis Care Res (Hoboken). 2012; 64 (4): 465-474.
8. Денисов Л. Н., Цветкова Е. С., Голубев Г. Ш. и др. Алгоритм лечения остеоартрита коленного сустава Европейского общества по клиническим и экономическим аспектам остеопороза и остеоартрита (ESCEO) применим в российской клинической практике: совместное заключение ведущих российских специалистов и экспертов ESCEO по остеоартриту // Научно-практическая ревматология. 2016; 54 (6): 641-53. [Denisov L. N., Tsvetkova E. S., Golubev G. S., et al. Algoritm lecheniya osteoartrita kolennogo sustava Evropeiskogo obschestva po klinicheskim I ekonomicheskim aspektam osteoporoza I osteoartrita (ESCEO) primenim v rossiiskoi klinicheskoi praktike: sovmestnoe zaklyuchenie veduschikh rossiiskikh spetsialistov i ekspertov ESCEO po osteoartritu [The European society for clinical and economic aspects of osteoporosis and osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis is applicable to russian clinical practice: a consensus statement of leading russian and ESCEO osteoarthritis experts] // Nauchno-prakticheskaya revmatologiya (Rheumatology Science and Practice). 2016; 54 (6): 641-653. (In Russ.)] DOI: 10.14412/1995-4484-2016-641-653.
9. Гроппа Л., Мынзату И., Карасева М. и др. Эффективность Алфлутопа у больных с деформирующим артрозом // Клиническая ревматология. 1995; (3): 20-22. [Groppa L., Mynzatu I., Karaseva M., et al. Effektivnost Alflutopa u bolnykh s deformiruyuschim artrozom [Efficiency of Alflutop in patients with deforming arthrosis] // Klinicheskaya revmatologiya. 1995; (3): 20-22. (In Russ.)]
10. Алексеева Л. И., Шарапова Е. П., Таскина Е. А. и др. Многоцентровое слепое рандомизированное плацебо-контролируемое исследование симптом- и структурно-модифицирующего действия препарата Aлфлутоп у больных остеоартрозом коленных суставов. Сообщение 1 – оценка симптом-модифицирующего действия препарата // Научнопрактическая ревматология. 2013; 51 (5): 532-538. [Alekseeva L. I., Sharapova E. P., Taskina E. A., et al. Mnogotsentrovoe slepoe randomizirovannoe platsebo-kontroliruemoe issledovanie simptom- i strukturno-modifitsiruyuschego deistviya preparata Alflutop u bolnykh osteoartrozom kolennykh sustavov. Soobschenie 1 – otsenka simptom-modifitsiruyuschego deisviya preparata [Multicenter double-blind randomized placebo-controlled trial of the symptom- and structure-modifying effect of Alflutop in patients with knee osteoarthrosis. communication 1. evaluation of the symptom-modifying effect of the drug] // Nauchno-prakticheskaya revmatologiya (Rheumatology Science and Practice). 2013; 51 (5): 532-528. (In Russ.)] DOI: 10.14412/1995-4484-2013-1545.
11. Алексеева Л. И., Шарапова Е. П., Таскина Е. А. и др. Многоцентровое слепое рандомизированное плацебо-контролируемое исследование симптом- и структурно-модифицирующего действия препарата алфлутоп у больных остеоартрозом коленных суставов. Сообщение 2 – оценка структурно-модифицирующего действия препарата. Научно-практическая ревматология. 2014; 52 (2): 174-177. [Alekseeva L. I., Sharapova E. P., Taskina E. A., et al. Mnogotsentrovoe slepoe randomizirovannoe platsebokontroliruemoe issledovanie simptom- i strukturnomodifitsiruyuschego deistviya preparata Alflutop u bolnykh osteoartrozom kolennykh sustavov. Soobschenie 2 – otsenka s strukturno-modifitsiruyuschego deisviya preparata[Multicenter double-blind randomized placebo-controlled trial of the symptom- and structure-modifying effect of alflutop in patients with knee osteoarthrosis. Communication 2. evaluation of the symptom-modifying effect of the drug] // Nauchnoprakticheskaya revmatologiya (Rheumatology Science and Practice). 2014; 52 (2): 174-177. (In Russ.)] DOI: 10.14412/1995-4484-2014-174-177.
12. Отчет по сравнительному исследованию фармакологической активности и местно-раздражающего действия препарата АМБЕНЕ®Био и зарегистрированного в РФ референтного препарата Алфлутоп, ФГБУН ИТ ФМБА России, Санкт-Петербург, 2016. Otchet po sravnitelnomu issledovaniyu farmakologicheskoi aktivnosti i mestno-razdrazhayuschego deistviya preparata AMBENE®Bio i zaregistriroannogo v RF referentnogo preparata Alflutop] [Report on a comparative study of the pharmacological activity and local irritant effect of AMBENE®Bio and the reference drug Alflutop registered in the Russian Federation, FSBUN IT FMBA of Russia, Sankt-Petersburg, 2016.]
13. Денисов Л. Н., Платова А. И., Меншикова И. В., Лила А. М. Остеоартрит – аспекты фармакотерапии // Современная ревматология. 2018; 12 (2): 97-102. [Denisov L. N., Platova A. I., Menshikova I. V., Lila A. M. Osteoartit – aspekty farmakoterapii [Osteoarthritis – aspects of pharmacotherapy]. Sovremennaya revmatologiya (Modern Rheumatology). 2018; 12 (2): 97-102.]
14. Pham T., van der Heijde D., Altman R. D., Anderson J. J., Bellamy N., Hochberg M., et al. OMERACTeOARSI initiative: OsteoarthritisResearch Society International set of responder criteria for osteoarthritis clinicaltrials revisited // Osteoarthritis Cartilage. 2004; 12: 389-399.
15. Pavelka K., Bruyere O., Cooper C., et al. Diacerein: benefits, risks and place in the management of osteoarthritis. An opinionbased report from the ESCEO // Drugs Aging. 2016; 33 (2): 75-85. DOI: 10.1007/s40266-016-0347-4.
Review
For citations:
Menshikova I.V., Sorotskaya V.N. Treatment of osteoarthritis of large and small joints using an injectable complex action chondroprotector. Lechaschi Vrach. 2021;(4):66-71. (In Russ.) https://doi.org/10.51793/OS.2021.14.17.012
Views:
280
JATS XML
Email this article 
