ГИАЛУРОНОВАЯ КИСЛОТА ДЛЯ ВНУТРИСУСТАВНОГО ВВЕДЕНИЯ: ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ

DOI: https://doi.org/10.29296/25877305-2019-03-17
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Номер журнала: 
3
Год издания: 
2019

В. Привольнев(1), кандидат медицинских наук, О. Агафонов(2), кандидат медицинских наук, А. Родин(3), кандидат медицинских наук, Р. Федоров(4), кандидат медицинских наук, А. Шилина(3) 1-Медицинский департамент АО «Р-Фарм», Смоленск 2-1409 Военно-морской клинический госпиталь Минобороны России, Черняховск 3-Смоленский государственный медицинский университет 4-Федеральный центр травматологии, ортопедии и эндопротезирования Минздрава России, Смоленск E-mail: doc82@yandex.ru

Препараты гиалуроновой кислоты (ГК) известны достаточно давно. Более 20 лет назад Food and Drug Administration (США) было разрешено их клиническое применение. За это время накоплен огромный опыт, отраженный в многочисленных высокоуровневых исследованиях и метаанализах. Приводятся данные по патогенетическому обоснованию клинического применения препаратов ГК, его результатам, в том числе – в сравнении с другими препаратами для терапии остеоартроза (ОА). Отдельно рассмотрены показания к их использованию, эффективность, безопасность при внутрисуставном введении. На основании приведенных данных определена роль препаратов ГК в лечении ОА.
Ключевые слова: 
ревматология
остеоартроз
гонартроз
гиалуроновая кислота
Для цитирования
Привольнев В., Агафонов О., Родин А., Федоров Р., Шилина А. ГИАЛУРОНОВАЯ КИСЛОТА ДЛЯ ВНУТРИСУСТАВНОГО ВВЕДЕНИЯ: ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ . Врач, 2019; (3): 76-82 https://doi.org/10.29296/25877305-2019-03-17

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Список литературы: 
  1. Balazs E., Denlinger J. Viscosupplementation: a new concept in the treatment of osteoarthritis // J. Rheum. – 1993; 39: 3–9.
  2. Conduah A., Baker C., Baker Jr C. Managing joint pain in osteoarthritis: safety and efficacy of hylan G-F 20 // J. Pain Res. – 2009; 2: 87–98.
  3. Goldberg V., Buckwalter J. Hyaluronans in the treatment of osteoarthritis of the knee: evidence for disease-modifying activity // Osteoarthritis Cartilage. – 2005; 31: 216–24. DOI: 10.1016/j.joca.2004.11.010
  4. Moreland L. Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: mechanisms of action // Arthritis Res. Ther. – 2003; 5 (2): 54–67. DOI: 10.1186/ar623.
  5. Brockmeier S., Shaffer B. Viscosupplementation therapy for osteoarthritis // Sports Med. Arthrosc. Rev. – 2006; 14 (3): 155–62. DOI: 10.1097/00132585-200609000-00007.
  6. Miyakoshi N., Kobayashi M., Nozaka K. et al. Effects of intra-articular administration of basic fibroblast growth factor with hyaluronic acid on osteochondral defects of the knee in rabbits // Arch. Orthop. Trauma Surg. – 2005; 125 (10): 683–92. DOI: 10.1007/s00402-005-0052-y.
  7. Ghosh P. The role of hyaluronic acid (hyaluronan) in health and disease: interactions with cells, cartilage and components of synovial fluid // Clin. Exper. Rheumatol. – 1994; 12 (1): 75–82.
  8. Goldberg V., Goldberg L. Intra-articular hyaluronans: the treatment of knee pain in osteoarthritis // J. Pain Res. – 2010; 3: 51–6. DOI: 10.2147/JPR.S4733.
  9. Lussier A., Cividino A., McFarlane C. et al. Viscosupplementation with hylan for the treatment of osteoarthritis: findings from clinical practice in Canada // J. Rheumatol. – 1996; 23 (9): 1579–85.
  10. Bellamy N., Campbell J., Robinson V. et al. Viscosupplementation for the treatment of osteoarthritis of the knee // Cochrane Database Syst. Rev. – 2006; 2: CD005321. DOI: 10.1002/14651858.CD005321.pub2.
  11. Wang C., Lin J., Chang C. et al. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials // J. Bone Joint Surg. Am. – 2004; 86 (3): 538–45.
  12. Brzusek D., Petron D. Treating knee osteoarthritis with intra-articular hyaluronans // Curr. Med. Res. Opin. – 2008; 24 (12): 3307–22. DOI: 10.1185/03007990802490124.
  13. Dickson D., Hosie G., English J. A double-blind, placebo-controlled comparison of hylan G-F 20 against diclofenac in knee osteoarthritis // J. Clin. Res. – 2001; 4: 41–52.
  14. Caborn D., Rush J., Lanzer W. et al. A randomized, single-blind comparison of the efficacy and tolerability of hylan G-F 20 and triamcinolone hexacetonide in patients with osteoarthritis of the knee // J. Rheumatol. – 2004; 31 (2): 333–43.
  15. Wang S., Wu D., Chang Q. et al. Intra-articular, single-shot co-injection of hyaluronic acid and corticosteroids in knee osteoarthritis: A randomized controlled trial // Exp. Ther. Med. – 2018; 16 (3): 1928–34. DOI: 10.3892/etm.2018.6371.
  16. Karlsson J., Sjogren S., Lohmander L. Comparison of two hyaluronan drugs and placebo in patients with knee osteoarthritis: a controlled, randomized, double-blind, parallel-design multicentre study // Rheumatology (Oxford). – 2002; 41 (11): 1240–8. DOI: 10.1093/rheumatology/41.11.1240.
  17. Kotevoglu N., Iyibozkurt P., Hiz O. et al. A prospective randomized controlled clinical trail comparing the efficacy of different molecular weight hyaluronan solutions in the treatment of knee osteoarthritis // Rheumatol. Int. – 2006; 26 (4): 325–30. DOI: 10.1007/s00296-005-0611-0.
  18. Raynauld J., Goldsmith C., Bellamy N. et al. Effectiveness and safety of repeat courses of hylan G-F 20 in patients with knee osteoarthritis // Osteoarthritis Cartilage. – 2005; 13 (2): 111–9. DOI: 10.1016/j.joca.2004.10.018.
  19. Webber T., Webber A., Matzkin E. Rate of adverse reactions to more than 1 series of viscosupplementation // Orthopedics. – 2012; 35 (4): e514–9. DOI: 10.3928/01477447-20120327-26.
  20. Altman R., Rosen J., Bloch D. et al. Safety and efficacy of retreatment with a bioengineered hyaluronate for painful osteoarthritis of the knee: results of the open-label Extension Study of the FLEXX Trial // Osteoarthritis Cartilage. – 2011; 19 (10): 1169–75. DOI: 10.1016/j.joca.2011.07.001.
  21. Pagnano M., Westrich G. Successful nonoperative treatment of chronic osteoarthritis pain of the knee: safety and efficacy of retreatment with intra-articular hyaluronans // Osteoarthritis Cartilage. – 2005; 13 (9): 751–61. DOI: 10.1016/j.joca.2005.04.012.
  22. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines // Arthritis Rheum. – 2000; 43 (9): 1905–15. DOI: 10.1002/1529-0131(200009)43:93.0.CO;2-P.
  23. Hammesfahr J., Knopf A., Stitik T. Safety of intra-articular hyaluronates for pain associated with osteoarthritis of the knee // Am. J. Orthop. – 2003; 32 (6): 277–83.
  24. Waddell D. Viscosupplementation with hyaluronans for osteoarthritis of the knee // Drugs Aging. – 2007; 24 (8): 629–42.
  25. Goldberg V., Coutts R. Pseudoseptic reactions to hylanviscosupplementaion: diagnosis and treatment // Clin. Orthop. Relat. Res. – 2004; 419: 130–7.
  26. Jackson D., Evans N., Thomas B. Accuracy of needle placement into the intra-articular space of the knee // J. Bone Joint Surg. Am. – 2002; 84 (9): 1522–7. DOI: 10.2106/00004623-200209000-00003.
  27. Goomer R., Leslie K., Maris T. et al. Native hyaluronan produces less hypersensitivity than cross-linked hyaluronan // Clin. Orthop. Relat. Res. – 2005; 434: 239–45. DOI: 10.1097/01.blo.0000152443.04202.43.
  28. Leopold S., Warme W., Pettis P. et al. Increased frequency of acute local reaction to intra-articular hylan GF-20 (synvisc) in patients receiving more than one course of treatment // J. Bone Joint Surg. Am. – 2002; 84-A (9): 1619–23. DOI: 10.2106/00004623-200209000-00015.
  29. Ottaviani R., Wooley P., Song Z. et al. Inflammatory and immunological responses to hyaluronan preparations. Study of a murine biocompatibility model // J. Bone Joint Surg. Am. – 2007; 89 (1): 148–57. DOI: 10.2106/JBJS.E.01135.
  30. Monfort J., Lisbona M., Gimenez-Arnau A. et al. Immunoallergic reaction following intraarticular injection of high molecular weight hyaluronic acid // Joint Bone Spine. – 2013; 80 (5): 551–2. DOI: 10.1016/j.jbspin.2013.02.010.
  31. Guidelines for the diagnosis, investigation and management of osteoarthritis of the hip and knee. Report of a Joint Working Group of the British Society for Rheumatology and the Research Unit of the Royal College of Physicians // J. R. Coll. Physicians Lond. – 1993; 27: 391–6.
  32. Allen E., Krohn K. Adverse reaction to hylan GF-20 // J. Rheumatol. – 2000; 27 (6): 1572.
  33. Kahan A., Lleu P., Salin L. Prospective randomized study comparing the medico-economic benefits of hylan G-F 20 vs conventional treatment in knee osteoarthritis // Joint Bone Spine. – 2003; 70 (4): 276–81.
  34. Waddell D., Bricker D. Total knee replacement delayed with hylan G-F 20 use in patients with grade IV osteoarthritis // J. Manag. Care Pharm. – 2007; 13 (2): 113–21. DOI: 10.18553/jmcp.2007.13.2.113.
  35. Altman R., Lim S., Steen R. et al. Hyaluronic acid injections are associated with delay of total knee replacement surgery in patients with knee osteoarthritis: evidence from a large U.S. health claims database // PLoS One. – 2015; 10 (12): e0145776. DOI: 10.1371/journal.pone.0145776.