The efficacy of structure-modified drugs in the treatment of patient with osteoarthritis and hyperuricemia

Neonila Shuba, Anna Krylova

Abstract


The goal: to investigate the efficacy of chondroitin-4,6-sulfate (as a monotherapy and combined with potassium-sodium-hydrocitrate complex) in the patients with osteoarthritis (OA) and concomitant hyperuricemia and its influence on the dynamics of indices of inflammation process, purine, carbohydrates, lipidic metabolism. Methods: 78 patients with OA (62 females, 16 males) at the age from 35 to 75 years were included in the investigation. All patients were divided on 3 groups. The patients of I group (30 patients with OA but without concomitant hyperuricemia) and II group (32 patients with OA and concomitant hyperuricemia) took chondroitin-4,6-sulfate; III group (16 patients with OA and concomitant hyperuricemia) took chondroitin-4,6-sulfate and potassium-sodium-hydrocitrate complex. The dynamics of different indices (VAS, WOMAC, Lequesne, uric acid, IL-1β, IGF-1, NO, CRP, general clinical) on the background of therapy were assessed. Statistical analysis was performed wsing SPSS Statistics. Results: significant pain relief according to VAS, decrease of indices WOMAC and Lequesne after 6 months of therapy were revealed in all groups. However, more significant (0,05) decrease of VAS score while walking and WOMAC index were observed in III patient group comparing with
I and II groups. After 6 moths of treatment the statistically significant decrease of IL-1, NO, and statistically significant increase of IGF-1 were observed. Patients of III groups had decrease of IL-1 (p < 0.05) more substantial than patients of I and II groups. The tendency towards increase of uricemia in I group, its statistically significant increase in II group and decrease in III group were revealed. Conclusion: the usage of medication with chondroitin-4,6-sulfate to treat the patients with OA and concomitant hyperuricemia is pathogeneticaly grounded and clinically promising, however, its influence on the uricemia level should be taken into consideration and differential approach to the treatment of patients with OA and concomitant hyperuricemia should be planned prescribing structure modifying agents combined with medication lowering hyperuricemia.

Keywords


osteoarthritis; hyperuricemia; structure modifying agents; chondroitin sulfate; citrate complex

References


EULAR evidence based recommendations for the manage¬ment of hand osteoarthritis: Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) / W. Zhang, M. Doherty, B. F. Leeb [et al.] // Ann. Rheum. Dis. — 2007. — Vol. 66. — P. 377–388, doi:10.1136/ard.2006.062091.

EULAR evidence based recommendations for the management of hip osteoarthritis: report of task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutic (ESCISIT) / W. Zhang, M. Doherty, N. Arden [et al.] //Ann. Rheum. Dis. — 2005. — Vol. 64 (5). — P. 669–681, doi:10.1136/ard.2004.028886.

EULAR Recommendation 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT) / K. M. Jor¬dan, N. K. Arden, M. Doherty [et al.] // Ann. Rheum. Dis. — 2003. — Vol. 62 (12). — P. 1145–1155, doi:10.1136/ard.2003.011742.

An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: A report from a task force of the European Society for Clinical and Eco¬nomic Aspects of Osteoporosis and Osteoarthritis (ESCEO) / O. Bruyere, C. Cooper, J. P. Pelletier [et al.] // Semin. Arthritis Rheum. — 2014. — Vol. 44 (3). — Р. 253–263, doi: http://dx.doi.org/10.1016/j.semarthrit.2014.05.014.

OARSI recommendations for the management of hip and knee osteoarthritis : part III: Changes in evidence following systematic cumulative update of research published through January 2009 / W. Zhang, G. Nuki, R. W. Moskowitz [et al.] // Osteoarthritis Cartilage. — 2010. — Vol. 18 (4). — P. 476–499, doi: 10.1016/j.joca.2010.01.013.

Antioxidant, anti-inflammatory and neuroprotective actions of chondroitin sulfate and proteoglycans / J. Egea, A. G. Garsia, J. Verges [et al.] // Osteoarthritis and Cartilage. — 2010. — Vol. 18, Suppl. 1. — P. 24–27, doi: 10.1016/j.joca.2010.01.016.

Effect of chondroitin sulphate in a rabbit model of atherosclerosis aggravated by chronic arthritis / G. Herrero-Beaumont, M. E. Marcus, O. Sanchez-Pernaute [et al.] // Br. J. Pharmacol. — 2008. — Vol. 154 (4). — P. 843–851, doi: 10.1038/bjp.2008.113.

Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee / R. Altman, E. Asch, D. Bloch [et al.] // Arthritis Rheum. — 1986. — Vol. 29 (8). — P. 1039–1049.

2011 recommendations for the diagnosis and management of gout and hyperuricemia / M. Hamburger, H. S. Baraf, T. C. Ad¬amson, [et al.] // Phys. Sportsmed. — 2011. — Vol. 39 (4). — P. 98–123, doi: 10.3810/psm.2011.11.1946.

Kellgren J. H., Lawrence J. S Radiological assessment of osteoarthrosis / J. H. Kellgren, J. S. Lawrence // Annals of The Rheumatic Diseases. — 1957. — Vol. 16. — Р. 494–450.




DOI: https://doi.org/10.15674/0030-59872015469-73

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