Grounding optimal choice of the drugs for the treatment of osteoarthritis with hyperuricemia
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Abstract
The objective: differentiated approach to the treatment of OA depending of presence of hyperuricemia.
Patients and methods. Was exanimated 176 patients (144 women, 32 men), aged (59,71±0,86) years with confirmed radiographic OA according to Kellgren and Lawrence scale. Division into groups was performed depending on treatment. For 14 days group 1 (n=30) had been received nimesulide 100 mg twice daily, and group 2 (n=30) – meloxicam 15 mg 1 time a day. For 6 months 3rd group (n=54) had been received diacerein 50 mg twice a day and the 4th group (n=32) – chondroitine sulfate (CS) 500 mg twice daily. 5th group (n=30) had been received glucosamine sulfate (GS) 400 mg 3 times per week for 1,5 months. Was estimated dynamics of VAS, WOMAC, Lequesne, uric acid (UA), CRP, IL-1β, ESR, biochemical indicators. Statistical analysis – SPSS Statistics.
Results. The article presents the current data on the combination of hyperuricemia and osteoarthritis. Was analyzed stage lesions by radiographic characteristics, clinical features articular syndrome in patients with osteoarthritis and hyperuricemia. The article presents the characteristics of the most common drugs in the treatment of osteoarthritis – NSAIDs (nimesulide, meloxicam) and symptomatic anti inflammatory drugs (including diacerein, chondroitin sulfate, glucosamine sulfate). Was investigated efficacy by indicators of articular syndrome, such as VAS, indices Lequesne, WOMAC. As well as effects on uric acid levels and the opportunity of use in patients with hyper uricemia.
Conclusions. Was showed that nimesulide is more effective than meloxicam during first 14 days, and reduces IL 1, an important proinflammatory factor. The presence of hyperuricemia in 63,63% patients with OA, resulted in a more severe OA. Diacerein decreases UA, given an advantage in treatment these patients, which isn`t presented with CS (which increased the level of UA
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References
Алексеева Л.И. Симптоматические препараты замедленного действия при лечении ОА. / Л.И. Алексеева //Consiliummedicus. – 2009. – No 11 (9). – С. 100–104.
Барскова В.Г., Насонова В.А. Цапина Т.Н. и др. Эффективность и безопасность применения нимесулида (нимесил) у больных подагрическим артритом. Клин мед. – 2004. – No 12. – С. 49–54.
Первичный (возрастзависимый, инволюционный) остеоартроз / В.К. Казимирко, В.Н. Коваленко, В.И. Мальцев. – K.: Морион, 2006. – 176 с.
Проценко Г. О. Застосування інгібіторів ІЛ-1 у хворих на подагру та остеоартроз / Г.О. Проценко, Н.С. Бойчук, Т.І. Гавриленко // Український ревматологічний журнал. – 2009. – No 2. – С. 75–78.
Шуба Н.М., Крилова А.С. Ефективність структурно модифікувальних препаратів у пацієнтів з остеоартрозом і гіперурикемією./ Н.М. Шуба, А.С. Крилова // Ортопедия, травматология и протезирование. – 2015. – No 4. – С. 69–73.
Ashton Acton Q. Metabolic disorders: new insights for the healthcare professional / Q. Ashton Acton. //Scholarly Paper. – 2013. – P. 57–58.
Bruyere O. 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 Economic 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.
Burt H.M. Growth of monosodium urate monohydrate crystals: effect of cartilage and synovial fluid components on in vitro growth rates / H.M. Burt, Y.C. Dutt // Ann Rheum Dis. – 1986. – Vol. 45. – P. 858–864.
Challa S. Association of hyperuricemia and osteoarthritis knee in costal indian population / S. Challa, M.S. Sudhir, N. Alavalapati, J. Satyaprasad // International Journal of Recent Trends in Science And Technology. – 2013. – Vol. 7 (3). – Р. 129–131.
Cronstein B.N. The inflammatory process of gout and its treatment / B.N. Cronstein, R. Terkeltaub //Arthritis Res Ther. – 2006. – Vol. 8 (1). – P. 3.
Denoble A.E. Uric acid is a danger signal of increasing risk for osteoarthritis through inflammasome activation / A.E. Denoble, K.M. Huffman, T.V. Stabler [et al.]// Proc Natl Acad Sci USA. – 2011. – Vol. 108. – Р. 2088–2093.
Ding X, Zeng C The associations of serum uric acid level and hyperuricemia with knee osteoarthritis. / X. Ding, C. Zeng //Rheumatol Int. – 2016. – Vol. 36 (4). – Р. 567–73.
Inokuchi T. Plasma interleukin (IL) 18 (interferon gamma inducing factor) and other inflammatory cytokines in patients with gouty arthritis and monosodium urate monohydrate crystal induced secretion of IL-18 / T. Inokuchi, Y. Moriwaki, H. Tsutsui // Cytokine. – 2006. – Vol. 33 (1). – Р. 21–27.
Klumb E. The treatment of acute gout arthritis. Double blind randomized comparative study between nimesulid and indomethacin. / E. Klumb //Revista Brasileira De Medicine.– 1996. – Vol. 53. – Р. 540–546.
Laurent T.C. Solubility of sodium urate in the presence of chondroitin 4 sulphate / T.C. Laurent // Nature. – 1964. – Vol. 202. – P. 1334.
Martinon F. Gout: new insights into an old disease / F. Martinon, L.H. Glimcher //J Clin Invest. – 2006. – Vol. 116. – P. 2073–2075.
Plotnikoff R. Osteoarthritis prevalence and modifiable factors: a population study / R. Plotnikoff // BMC Public Health.– 2015. – Vol. 15. – Р. 1195.
Sellam J, Berenbaum F. Is osteoarthritis a metabolic disease? / J Sellam, F Berenbaum //Joint Bone Spine. Dec. – 2013. – Vol. 80 (6). – Р. 568–73.
Shaoxian H.U. Diacerein combined with febuxostat relieves symptoms of gout / H.U. Shaoxian// 2014. – Режим доступу до ресурсу: http://www.clinicaltrials.gov./ct2/show/NCT02060552.htm.
Sharma L. (2016) Osteoarthritis year in review 2015: clinical. / Sharma L. // Osteoarthritis Cartilage. – 2016. – Vol. 24 (1). – Р. 36–48.
Sun Y. Serum uric acid and patterns of radiographic osteoarthritis – the Ulm osteoarthritis study /Y. Sun, H. Brenner, S. Sauerland [et al.] //Scand J Rheumatol. – 2000. – Vol. 29. – Р. 380–386.
