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Modern pharmacotherapy for post-traumatic osteoarthritis

DOI: https://doi.org/10.29296/25877305-2022-12-10
Issue: 
12
Year: 
2022

A. Povzun(1, 2); V. Kostenko(1), K. Povzun(1), E. Shmeleva(1), I. Sarvilina(3)
1-I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine
2-Acad. I.P. Pavlov First Saint Petersburg State Medical University
3-OOO “Novomeditsina” Medical Center, Rostov-on-Don

The strategy and tactics for using the drugs that affect the pathobiochemical pathways of inflammation and structural changes in cartilage and synovial tissues in joint functional impairment (JFI) during post-traumatic osteoarthritis (PTOA) are an urgent public health problem. Objective. To study the mechanism of action of and to evaluate the efficacy of parenteral chondroitin sulfate (CS; Chondroguard®, CS-Bioactive© Bioiberica S.A.U., Spain; ZAO Sotex PharmFirm, Russia) in patients with Stage 1 PTOA of the knee and grade 1 JFI. Subjects and methods. A 50-day open-label prospective controlled randomized study was conducted. The study involved 64 patients with Kellgren-Lawrence X-Ray Stage I PTOA of the knee and grade 1 JFI, who were divided into 2 groups. Group 1 included 34 patients who received CS (Chondroguard®, 100 mg/ml) intramuscularly every other day; the first 3 injections were 1 ml each, with a good tolerance; the each dose of the 4th to 25th injections was 2 ml; the treatment cycle was 50 days) and meloxicam (Amelotex®, 15 mg/day); Group 2 consisted of 30 patients who took meloxicam (Amelotex®, 15 mg/day that could be reduced 7.5 mg/day and be discontinued). On study days 0 and 50, the patients underwent assessment of pain intensity using the visual analogue scale (VAS) and the WOMAC index, the functional state of the knee joint and the activity in daily life and active sports life by the Lequesne index; the safety of therapy was evaluated by the WHO and Naranjo scales; standard radiography and MRI of the knee were done evaluating the articular cartilage and calculating the T2 relaxation time. Laboratory testing for blood biomarkers included the determination of the concentration of ultrasensitive C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukins (IL)-1β and IL-6. The data were statistically processed using the Statistica 10.0 program (StatSoft, Inc., USA). Results. CS therapy was well tolerated by patients and was accompanied by a considerable improvement in the pain intensity at rest and during movement according to the VAS (U test=7.79; p

Keywords: 
therapy
post-traumatic osteoarthritis
knee joint
pain
functional impairment
cartilage tissue
chondroitin sulfate
Chondroguard®.



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