Эффективность применения инъекционного препарата хондроитина сульфата в лечении остеоартрита коленного сустава

Abstract

Aim: to evaluate the efficacy of two-month therapy with chondroitin sulfate (CS) (Mucosat®) injections in patients with osteoarthritis and the drug potential in terms of structure-modifying action. Patients and Methods: an open prospective study with participation of 30 patients (mean age 52.5±11.7 years) with osteoarthritis, grade 2 gonarthrosis according to the Kellgren-Lawrence classification, and severe pain syndrome (more than 50 points according to VAS) was conducted. 76.7% of subjects had concomitant pathology. The drug was prescribed according to the standard regimen with a course of up to 25–30 injections. The examination included a clinical assessment of indicators of joint syndrome, life quality, joint function using WOMAC, Lekken, KOOS, EQ-5D scales, cartilage oligomeric matrix protein (COMP) and C-reactive protein (CRP), ultrasound of the knee joints. Results: after a two-month treatment course with Mucosat®, there was a significant (p<0.05) decrease in pain intensity by 1.8 times, the number of tender and swollen joints by 2 or more times, an improvement in indicators of functional activity and life quality of patients. Reactive synovitis of the knee joints, which was present at the beginning of the study in 53.3% of cases, was preserved clinically and according to ultrasound data only in 17% of subjects by the end of treatment. There was a tendency to decrease the levels of CRP and COMP. Ultrasound of the knee joints showed a significant (p=0.000) increase in the average thickness of articular cartilage from 1.55±0.26 mm initially to 1.67±0.27 mm after 2 months of treatment. More significant positive dynamics during therapy was observed in patients without arterial hypertension. In general, no adverse events were registered during treatment. Conclusion: in clinical practice, the use of the CS injections in patients with gonarthrosis is safe and effective. The tendency to decrease the cartilage degradation and increase its thickness suggests a positive effect of CS in the form of slowing the disease progression in the long-term period. KEYWORDS: osteoarthritis, cartilage degradation, synovitis, chondroitin sulfate, bioavailability, structure-modifying effect, Mucosat. FOR CITATION: Lapshina S.A., Mingaleeva G.F. Chondroitin sulfate injection efficacy in the treatment of knee osteoarthritis. Russian Medical Inquiry. 2021;5(5):301–306 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-301-306.