Features of therapy for gonarthrosis in patients with decreased bone mineral density

Authors

  • Neonila Shuba
  • Tatiana Tarasenko

DOI:

https://doi.org/10.15674/0030-59872014251-57

Keywords:

knee osteoarthritis, osteoporosis, bone mineral density, chondroitin-4, 6-sulfate, nimesulide, diclofenac

Abstract

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

  1. 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.
  2. Kovalenko V. N. Оsteoarthritis. Practical guidance / V. M. Kovalenko, A. P. Bortkiewicz. — 3rd ed. report, as amended. — Kyiv: Morion, 2010. — 608 p.
  3. Kovalenko V. N. National textbook of rheumatology / V. M. Kovalenko, N. M. Shuba. — Kyiv: Morion, 2013. — 672 p.
  4. 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.
  5. Berenbaum F. Osteoarthritis, inflammation and obesity / F. Berenbaum, F. Eymard, X. Houard // Curr. Opin. Rheumatol. — 2013. — Vol. 25 (1). — P. 114–118.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. Findlay D. M. Vascular pathology and osteoarthritis / D. M. Findlay // Rheumatology. — 2007. — Vol. 46 (12). — P. 1763–1768.
  12. 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.
  13. 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.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. Metabolic syndrome meets osteoarthritis / Q. Zhuo, W. Yang, J. Chen, Y. Wang // Nat. Rev. Rheumatol. — 2012. — Vol. 8 (12). — P. 729–737.

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How to Cite

Shuba, N., & Tarasenko, T. (2014). Features of therapy for gonarthrosis in patients with decreased bone mineral density. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 51–57. https://doi.org/10.15674/0030-59872014251-57

Issue

No. 2 (2014)

Section

ORIGINAL ARTICLES

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Copyright (c) 2014 Neonila Shuba, Tatiana Tarasenko

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