ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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The Effect of Various Multi-Drug Regimens on Clinical Manifestations of Osteoarthritis of the Knee and Parameters of T2 Mapping of the Knee Cartilage

For citation: Mazurov V. I., Trofimov E. A., Trofimova A. S. The Effect of Various Multi-Drug Regimens on Clinical Manifestations of Osteoarthritis of the Knee and Parameters of T2 Mapping of the Knee Cartilage. Doctor.Ru. 2017. 10(139): 53–56.
20 October 00:00

Study Objective: To evaluate the effects of various groups of medications on the clinical course of osteoarthritis of the knee and develop a treatment decision tree based on clinical and X-ray findings.

Study Design: This was a single-center comparative randomized prospective study.

Materials and Methods: One hundred and twenty-two patients, aged 30 to 70, with unilateral radiographic grade I or II osteoarthritis of the knee were examined. The study subjects were divided into four groups. Group I patients (n = 30) received oral chondroitin sulfate (CS) and glucosamine sulfate (GS). Group II patients (n = 31) received oral CS and GS in combination with oral strontium ranelate. Group III patients (n = 30) received oral CS and GS in combination with oral diacerein. Group IV patients (n = 31) received oral CS and GS in combination with intraarticular administration of sodium hyaluronate.

All participants in this experiment were examined three times: Before treatment and at six and twelve months of treatment. They underwent magnetic resonance imaging (MRI) with color mapping of the knee cartilage and measurement of T2 relaxation time. The patients assessed pain intensity and the course of their disease on a 100-mm visual analogue scale. Joint function was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Study Results: In all groups, changes from the baseline WOMAC score at months 6 and 12 were statistically significant, as were the differences between the six- and twelve-month values (p < 0.05 for all comparisons). T2 relaxation time at month 12 was also significantly higher than at baseline in all treatment groups (p < 0.05 for all comparisons). Oral supplementation of CS and GS combined with intraarticular administration of sodium hyaluronate, however, achieved the most significant clinical improvement as assessed by questionnaire data, as well as slowing the progression of cartilage degeneration.

Conclusion: This study showed that the early stages of osteoarthritis are marked not only by bone marrow edema (osteitis) but also by a loss of collagen, proteoglycan, and water content as reflected by altered T2 relaxation time, an important marker detected by T2 mapping. A combination of oral CS and GS coupled with intraarticular administration of sodium hyaluronate was the most effective approach.

V. I. Mazurov — I. I. Mechnikov Northwestern State Medical University, St. Petersburg. E-mail: maz.nwgmu@yandex.ru

E. A. Trofimov — I. I. Mechnikov Northwestern State Medical University, St. Petersburg. E-mail: Evgeniy.trofimov@szgmu.ru

A. S. Trofimova — I. I. Mechnikov Northwestern State Medical University, St. Petersburg. E-mail: bukatsel_anna@mail.ru

Доктор.ру
20 October 00:00
LITERATURE
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  2. Трофимова А. С., Кахели М. А., Трофимов Е. А. Лучевая диагностика остеоартроза. Лучевая диагностика и терапия. 2016; 7(3): 25–32. [Trofimova A. S., Kakheli M. A., Trofimov E. A. Luchevaya diagnostika osteoartroza. Luchevaya diagnostika i terapiya. 2016; 7(3): 25–32. (in Russian)]
  3. Трофимова Т. Н., Мищенко А. В., Минько Б. А., Амосов В. И., Лукина О. В., Сперанская А. А. и др.; Трофимова Т. Н., ред. Современные стандарты анализа лучевых изображений. СПб.: Балтийский медицинский образовательный центр; 2017. 300 с. [Trofimova T. N., Mishchenko A. V., Min’ko B. A., Amosov V. I., Lukina O. V., Speranskaya A. A. i dr.; Trofimova T. N., red. Sovremennye standarty analiza luchevykh izobrazhenii. SPb.: Baltiiskii meditsinskii obrazovatel’nyi tsentr; 2017. 300 s. (in Russian)]
  4. Лила А. М., Трофимова А. С., Трофимов Е. А. Остеоартрит. СПб.: Изд-во СЗГМУ; 2017. 48 с. [Lila A. M., Trofimova A. S., Trofimov E. A. Osteoartrit. SPb.: Izd-vo SZGMU; 2017. 48 s. (in Russian)]
  5. Мазуров В. И., Лесняк О. М., Трофимов Е. А. и др. Ревматология. Фармакотерапия без ошибок. М.: Е-ното; 2017. 528 с. [Mazurov V. I., Lesnyak O. M., Trofimov E. A. i dr. Revmatologiya. Farmakoterapiya bez oshibok. M.: E-noto; 2017. 528 s. (in Russian)]
  6. Денисов Л. Н., Цветкова Е. С., Голубев Г. Ш., Бугрова О. В., Дыдыкина Е. С., Дубиков А. И. и др. Алгоритм лечения остеоартрита коленного сустава Европейского общества по клиническим и экономическим аспектам остепороза и остеоартрита (ESCEO) применим в Российской клинической практике: совместное заключение ведущих российских специалистов и экспертов ESCEO по остеоартриту. Науч.-практ. ревматология. 2016; (54)6: 641–53. [Denisov L. N., Tsvetkova E. S., Golubev G. Sh., Bugrova O. V., Dydykina E. S., Dubikov A. I. i dr. Algoritm lecheniya osteoartrita kolennogo sustava Evropeiskogo obshchestva po klinicheskim i ekonomicheskim aspektam osteporoza i osteoartrita (ESCEO) primenim v Rossiiskoi klinicheskoi praktike: sovmestnoe zaklyuchenie vedushchikh rossiiskikh spetsialistov i ekspertov ESCEO po osteoartritu. Nauch.-prakt. revmatologiya. 2016; (54)6: 641–53. (in Russian)]
  7. Bruyere O., Cooper C., Pelletier J. P., Branco J., Luisa Brandi M., Guillemin F. et al. 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). Semin. Arthritis Rheum. 2014; 44(3): 253–63.
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