Features of therapy for gonarthrosis in patients with decreased bone mineral density
DOI:
https://doi.org/10.15674/0030-59872014251-57Keywords:
knee osteoarthritis, osteoporosis, bone mineral density, chondroitin-4, 6-sulfate, nimesulide, diclofenacAbstract
Objective: to determine features of therapy of gonarthrosis in patients with decreased bone mineral density (BMD). Methods: we examined 120 patients with radiological grades II–III of knee osteoarthritis according to Kellgren-Lawrence. 54.2 % of them have had decreased BMD. Depending on therapy performed these patients were divided into four groups: 1 — patients received chondroitine-4, 6-sulfate (C-4, 6-S) 1 g daily for 6 months and nimesulide 200 mg per day up to 15 days; 2 — C-4, 6-S, 1 g daily for 6 months and diclofenac 150 mg daily up to 15 days; 3 — nimesulide 200 mg per day up to 15 days; 4th — diclofenac 150 mg per day up to 15 days. Results: correlations between BMD and clinical and laboratory data were determined. We found such distinctive peculiarities of gonarthrosis in patients with decreased BMD as more pronounced pain and limitation of functional activity as well as increased level of C-reactive protein. After 6 and 12 months of therapy we found significantly less decline in BMD (T-and Z-indices in standard deviations) in patients who has received C-4, 6-S which allows to conclude its positive impact on BMD. In case of nimesulide monotherapy after 6 months we observed significantly less negative dynamics of BMD indicators (Z-index standard deviation) than in cases of diclofenac monotherapy indicating a positive effect of nimesulide on BMD.References
European guidelines for the diagnosis and maintenance of osteoporosis in postmenopausal women / J. A. Kanis, N. Burlet, C. Cooper [et al.] / / Ukrainian Journal of Rheumatology. — 2008. — Vol. 4 (34). — P. 10-32.
Kovalenko V. N. Оsteoarthritis. Practical guidance / V. M. Kovalenko, A. P. Bortkiewicz. — 3rd ed. report, as amended. — Kyiv: Morion, 2010. — 608 p.
Kovalenko V. N. National textbook of rheumatology / V. M. Kovalenko, N. M. Shuba. — Kyiv: Morion, 2013. — 672 p.
Guidelines for diagnosis, prevention and treatment of systemic osteoporosis in women with postmenopausal / V. M. Kovalenko, V. V. Povoroznyuk, O. P. Bortkevych [et al.] // Ukrainian Journal of Rheumatology. — 2009. - № 3 (37). — P. 23-39.
Berenbaum F. Osteoarthritis, inflammation and obesity / F. Berenbaum, F. Eymard, X. Houard // Curr. Opin. Rheumatol. — 2013. — Vol. 25 (1). — P. 114–118.
Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study / S. K. Tat, J. P. Pelletier, J. Vergés [et al.] // Arthritis Res. Ther. — 2007. — Vol. 9 (6). — P. R117.
Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI / L. M. Wildi, J. P. Raynauld, J. Martel-Pelletier [et al.] // Ann. Rheum. Dis. — 2011. — Vol. 70 (6). — P. 982–989.
Circulating levels of inflammatory markers predict change in bone mineral density and resorption in older adults: a longitudinal study / C. Ding, V. Parameswaran, R. U U dayan, G. Jones // J. Clin. Endocrinol. Metab. — 2008. — Vol. 93 (5). — P. 1952–1958.
Comparative effect of nimesulide and ibuprofen on the urinary levels of collagen type II C-telopeptide degradation products and on the serum levels of hyaluronan and matrix metalloproteinases-3 and -13 in patients with flare-up of osteoarthritis / D. H. Manicourt, M. Bevilacqua, V. Righini [et al.] // Drugs. — 2005. — Vol. 6 (5). — P. 261–271.
Comparative efficacy and safety study of two chondroitin sulfate preparations from different origin (avian and bovine) in symptomatic osteoarthritis of the knee / P. Fardellone, M. Zaim, A. Saurel, E. Maheu // Open Rheumatol J. — 2013. — Vol. 7. — P. 1–12.
Findlay D. M. Vascular pathology and osteoarthritis / D. M. Findlay // Rheumatology. — 2007. — Vol. 46 (12). — P. 1763–1768.
Goldring M. B. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis / M. B. Goldring, S. R. Goldring // Ann. NY Acad. Sci. — 2010. — Vol. 1192. — P. 230–237.
Herman S. Molecular mechanisms of inflammatory bone damage: emerging targets for therapy / S. Herman, G. Kronke, G. Schett // Trends Mol. Med. — 2008. — Vol. 14 (6). — P. 245–253.
Immunomodulatory and anti-inflammatory effects of chondroitin sulphate / P. Du Souich, A. G. Garcia, J. Verges [et al.] // J. Cell. Mol. Med. — 2009. — Vol. 13 (8A). — P. 1451–1463.
Iovu M. Anti-inflammatory activity of chondroitin sul-fate / M. Iovu, G. Dumais, P. du Souich // Osteoarthritis Cartilage. — 2008. — Vol. 16. — P. S14–S8.4.
Kullich W. Effect of nimesulide on metalloproteinases and matrix degradation in osteoarthritis: a pilot clinical study / W. Kullich, F. Niksic, G. Klein // J. Clin. Pract.— 2002. — Vol. 28. — P. 24–30.
Mahjoub M. Why subchondral bone in osteoarthritis? The importance of the cartilage bone interface in osteoarthritis / M. Mahjoub, F. Berenbaum, X. Houard // Osteoporos Int. — 2012. — Vol. 23 (Suppl. 8). — P. 841–846.
Metabolic syndrome meets osteoarthritis / Q. Zhuo, W. Yang, J. Chen, Y. Wang // Nat. Rev. Rheumatol. — 2012. — Vol. 8 (12). — P. 729–737.
Downloads
Issue
Section
License
Copyright (c) 2014 Neonila Shuba, Tatiana Tarasenko
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available after 6 months from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.
Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.
The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).
