Clinical Manifestations Of Osteoarthritis Research Articles

Risk factors for osteoarthritis: a literature review of historical and current perspectives

Risk factors for osteoarthritis: a literature review of historical and current perspectives

A prospective comparative randomized trial of the efficacy and safety of topical tenoxicam and diclofenac in knee osteoarthritis

Local forms of non-steroidal anti-inflammatory drugs (NSAIDs) are characterized by a high safety profile due to low systemic absorption. They do not increase the risk of developing class-specific gastrointestinal, cardiovascular and kidney adverse events (AEs), which makes it possible to prescribe them even in severe comorbid pathology, which is typical for patients with osteoarthritis (OA).Objective: to evaluate the efficacy and safety of Artoxan gel (tenoxicam) 1% in comparison with Diclofenac gel 1% in patients with knee OA in a prospective comparative randomized trial.Material and methods. The study included 60 patients with Kellgren–Lawrence stages II–III knee OA, aged 41 to 78 years. The patients were randomly divided into two groups: the 1st group received Artoxan gel 1%, 5 cm 2 times a day for 14 days; 2nd – Diclofenac gel 1% according to the same scheme. During therapy, we assessed pain using a visual analog scale, the WOMAC index, quality of life using the EQ-5D questionnaire, satisfaction with therapy, and time to effect.Results and discussion. It has been demonstrated that local forms of NSAIDs have a positive effect on all clinical manifestations of OA: effectively reduce pain, stiffness, improve the functional state of the joints and quality of life. They also have a good safety profile and a fast symptomatic response. Comparison of the two groups showed that in patients receiving the local form of tenoxicam, there was a tendency to a more rapid and pronounced analgesic effect.Conclusion. The results of the study confirm the good efficacy and safety of local forms of NSAIDs.

Strategic application of imaging in DMOAD clinical trials: focus on eligibility, drug delivery, and semiquantitative assessment of structural progression.

Despite decades of research efforts and multiple clinical trials aimed at discovering efficacious disease-modifying osteoarthritis (OA) drugs (DMOAD), we still do not have a drug that shows convincing scientific evidence to be approved as an effective DMOAD. It has been suggested these DMOAD clinical trials were in part unsuccessful since eligibility criteria and imaging-based outcome evaluation were solely based on conventional radiography. The OA research community has been aware of the limitations of conventional radiography being used as a primary imaging modality for eligibility and efficacy assessment in DMOAD trials. An imaging modality for DMOAD trials should be able to depict soft tissue and osseous pathologies that are relevant to OA disease progression and clinical manifestations of OA. Magnetic resonance imaging (MRI) fulfills these criteria and advances in technology and increasing knowledge regarding imaging outcomes likely should play a more prominent role in DMOAD clinical trials. In this perspective article, we will describe MRI-based tools and analytic methods that can be applied to DMOAD clinical trials with a particular emphasis on knee OA. MRI should be the modality of choice for eligibility screening and outcome assessment. Optimal MRI pulse sequences must be chosen to visualize specific features of OA.

Clinical efficacy of nutraceuticals in the management of osteoarthritis

Background: Osteoarthritis (OA) is a degenerative disorder affecting all joints & due to aphelia. The clinical manifestations of OA are swelling, pain & dysfunction of joints. Current non-pharmacological therapy mainly focuses on symptomatic treatment and may carry cardiovascular and gastrointestinal adverse effects. Nutraceuticals are preferred now a days owing to their safety and efficacy. TriNyros capsule consist of mixture of Rosa canina L. (Rosehip), Boswellia serrata and Harpagophytum procumbens (Devil`s claw) extract. These nutraceuticals are found to be effective as an anti-inflammatory, antioxidant, chondroprotective agent. Aim: Current post marketing phase IV surveillance study was conducted to investigate the effectiveness of TriNyros capsule in OA patient with and without comorbidity. Methods: Total 151 patients were enrolled in the study. All patients received cap. TriNyros containing [Rosehip 275 mg, IridoForceTM (Devil`s claw extract) 100 mg and Aflapin® 50 mg] twice daily for 90 days. Clinical assessment of symptoms included palpation tiredness, limitation of mobility, joint crepitus, swelling and redness. Osteoarthritis symptoms were measured using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Total European Quality of Life–5 Dimensions and visual analogue scale (VAS). Results: After 90 day’s treatment with Cap. TriNyros, WOMAC score reduced significantly from 39.62 + 11.95 to 13.36 + 4.82 (p

Вплив метаболічних порушень на клінічні прояви остеоартрозу та спосіб прогнозування його перебігу

Мета дослідження: вивчення впливу показників метаболічного синдрому на клінічні прояви остеоартрозу та розробка способу прогнозування тяжкості перебігу остеоартрозу залежно від компонентів метаболічного синдрому. Матеріали та методи. Були обстежені 84 хворі з остеоартрозом (20 чоловіків та 64 жінки), середній вік 57,03 ± 0,70 року. Результати. Встановлений зв’язок показників вуглеводного, ліпідного обміну, індексу маси тіла та абдомінального ожиріння з клінічними проявами остео-артрозу. Побудована модель дерева регресії для прогнозування сумарного бала за шкалою WOMAC залежно від характеристик метаболічного синдрому. Висновки. Отримані дані дозволяють зробити висновки про вплив інсулінорезистентності, дисліпідемії, артеріальної гіпертензії та абдомінального ожиріння на вираженість больового синдрому, обмеження рухливості та прояви фізичної активності у хворих на остеоартроз.

Roles of long non‑coding RNA in osteoarthritis (Review).

Osteoarthritis (OA) is a chronic bone and joint disease characterized by articular cartilage degeneration and joint inflammation and is the most common form of arthritis. The clinical manifestations of OA are chronic pain and joint activity disorder, which severely affect the patient quality of life. Long non-coding RNA (lncRNA) is a class of RNA molecules >200 nucleotides long that are expressed in animals, plants, yeast, prokaryotes and viruses. lncRNA molecules lack an open reading frame and are not translated into protein. The present review collated the results of recent studies on the role of lncRNA in the pathogenesis of OA to provide information for the prevention, diagnosis and treatment of OA.

Association between osteoarthritis-related serum biochemical markers over 11 years and knee pain in middle-aged adults

Purpose: In most cases, by the time clinical or radiographic evidence of osteoarthritis (OA) is established, significant and irreversible disease progression has already occurred, impairing the disease prognosis. Serum levels of cartilage and joint-specific biochemical markers such cartilage oligomeric matrix protein (COMP), matrix metalloproteinase (MMP)-3, and hyaluronan (HA) are associated with cartilage degradation, joint tissue degradation, and synovitis in patients with OA. Change in these OA-related biomarkers may precede the morphological and clinical manifestations of OA and therefore have been explored as predictive markers in OA.

The efficacy and safety of glycosaminoglycan-peptide complex in patients with knee osteoarthritis and comorbidity: a multicenter prospective study

Objective: to evaluate the efficacy and safety of glycosaminoglycan-peptide complex (GPC, Rumalon) used in patients with knee osteoarthritis (OA) and comorbidities (hypertension and/or type 2 diabetes mellitus (T2DM).Patients and methods: A 10-month multicenter (13 centers from 10 subjects of the Russian Federation) prospective study included 179 patients with Stages II–III primary tibiofemoral knee OA and comorbidity, a walking pain intensity of ≥40 mm on a visual analogue scale (VAS), and a need for nonsteroidal anti-inflammatory drugs (for at least 30 days in the previous 3 months). The efficiency of treatment was evaluated from the changes in VAS scores for knee pain intensity during walking, the overall WOMAC score and scores of its individual indicators, laboratory parameters, and ultrasound data. All the patients received 2 cycles of GPC treatment with 25 injections, by following the manufacturer's instructions.Results and discussion. Even at 2 months after starting the treatment, there was a statistically significant reduction in pain during walking from 60 (50–69) to 40 (27–53.5) mm on the VAS (p< 0.05), which persisted during the follow-up period. A similar pattern was found when assessing the WOMAC index and its components. The drug demonstrated an anti-inflammatory effect: a decrease in the number of patients with synovitis from 55.7 to 39.2% (p=0.02), the level of high-sensitivity C-reactive protein (hsCRP) from 3.2 (1.3–6.2) to 2.6 (1.2–5.7) mg/l (p< 0.05). GPC was ascertained to have a safety profile.Conclusion. The data of this study confirm the good therapeutic effect and safety of GPC Rumalon in knee OA patients with hypertension and/or T2DM. The drug is shown to have a rapid analgesic and anti-inflammatory effect, as well as a positive influence on all clinical manifestations of OA.

ОПТИМІЗАЦІЯ КОМПЛЕКСНОГО ЛІКУВАННЯ ІЗ ЗАСТОСУВАННЯМ ПРЕФОРМОВАНИХ ФАКТОРІВ У ЖІНОК У ПОСТМЕНОПАУЗАЛЬНОМУ ПЕРІОДІ, ХВОРИХ НА ОСТЕОАРТРОЗ КОЛІННИХ СУГЛОБІВ


 
 
 The article presents the issues of complex treatment of osteoarthritis of the knee with the use of preformed factors in postmenopausal women compared to standard drug therapy. The study included 60 women aged 50 to 75 years with clinical manifestations of osteoarthritis of the knee joints in the postmenopausal period. Complex treatment with preformed factors has been found to be an effective treatment for this category of patients, improving the clinical course of osteoarthritis by 53% and improving quality of life.
 
 

Clinical and molecular interrelations of dislipidemia and metabolic phenotype of osteoarthritis

The work purpose: analysis of lipid parameters and inflammation markers in metabolic phenotype (MPh) osteoarthritis (OA) in correlation with the clinical manifestations of the disease. The study involved 90 patients with OA of the knee (average age of 64.66±8.43 year), of which 37 patients were with Diabetes mellitus type 2 (group MPh OA). 25 comparable volunteers were a control group. Lipid levels, interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α), vasculo-endothelial growth factor A (VEGF-A), atherosclerotic changes of the common carotid artery by ultrasound were determined for all patients. It is shown that when MPh OA patients have a higher atherogenic index (as compared with the control group and patients with OA without the MPh), a greater thickness of the intima-media complex of the common carotid artery and the imbalance of cytokines in favor of increased pro-inflammatory molecules. In MPh OA group there was correlation of atherogenic lipids with proinflammatory cytokines (IL-1β, TNF-α), a marker of endothelial damage (VEGF-A) and clinical manifestations of OA. Thus, the results of the analysis confirm the important role of dyslipidemia and atherosclerosis in the pathogenesis of MPh OA, in particular indicate the possibility of integrating factors of cardiovascular comorbidity via molecular patterns IL-1β, TNF-α, VEGF-A.

WHAT INFLUENCE ON EARLY POSTOPERATIVE PAIN INTENSITY AFTER TOTAL KNEE ARTHROPLASTY?

Purpose – to describe the relationship of selected socio-demographic, clinical, and surgical factors with the severity and patterns of postoperative pain during the first three days following total knee arthroplasty.Material and methods. The sample included 100 patients (93 women and 7 men; mean age 63.5±7.8 years) with osteoarthritis admitted for primary total knee arthroplasty. Prior to surgery, standard measures were used to assess preoperative pain and other symptoms, clinical manifestations of osteoarthritis, functional status of the knee, comorbidities, functional abilities, quality of life, and other patient characteristics. Physical, biochemical and surgical parameters of the perioperative period were also recorded. Patterns of daily changes in postoperative pain characteristics were investigated with the use of individual diaries. Results. All the analyzed indicators of postoperative pain progressively decreased during the three days after surgery (р0,001), including the number of daily hours of moderate to severe pain (р0,001). Pain levels were generally higher among women than among men (р = 0,009). Of the analyzed preoperative factors, higher levels postoperative pain were correlated with higher levels of anxiety (р = 0,029) and preoperative pain intensity (р = 0,029). Among the perioperative factors, surgery duration longer than 90 minutes was associated with higher levels of postoperative pain in activity (р = 0,012) and more hours of moderate/severe pain (р = 0,008). Characteristics of postoperative pain were unrelated to level of patient education, social or family status, employment, lifestyle, or any other clinical or laboratory variables.Conclusion. Of the many factors previously associated with postoperative pain, only gender, anxiety and level of preoperative pain confirmed their importance in this study. Among the perioperative factors, surgery duration, which varied by the type of implant, was significantly associated with postoperative pain levels.

EVALUATION OF THE ROLE OF ALFLUTOP IN THE OSTEOARTHRITIS TREATMENT: INDICATIONS, CLINICAL EFFICACY, TOLERABILITY AND IMPACT ON QUALITY OF LIFE

The main clinical manifestations of osteoarthritis (OA) are a painful articular syndrome of varying intensity accompanied by loss of functionality and impaired quality of life. The pathogenetic links of the degradation are related to violations of the hyaline cartilage structure. Collagen defects are practically not restored, worsening the dysfunction of joints. Alflutop is the cartilage protector, including chondroitin sulfate. In the literature its symptom - and the structure-modifying effect is shown. In the study we conducted in 60 patients the dynamics of painful articular syndrome, functional features and the quality of life of patients in case of complex treatment with alflutop were studied.

Influence of weight loss on the clinical manifestations of osteoarthritis of the knee-joints.

Obesity consistently associated with the development of a number of chronic diseases, leading to a decrease in quality of life, disability and death. The article examines the connection between obesity and disease of the musculoskeletal system, describes the mechanisms by means of which obesity leads to the development of osteoarthritis. It is evident that reduction of body mass can slow the progression of osteoporosis. The own experience of non-pharmacological and pharmacological treatment of obesity with the use of orlistat in 50 obese patients with osteoarthritis of the knee II–III stage is presented. Treatment has resulted in a decrease in body weight, waist circumference, accompanied by a decrease in symptoms osteoarthritis among all the patients. Our results showed that the addition of orlistat to standard osteoarthritis scheme leads to significant reduction in weight and reduction of clinical manifestations of osteoarthritis. According to the above, the drugs that have impact on weight loss, should be included in the treatment regimen of patients with osteoarthritis and obesity.

Clinical manifestations of osteoarthritis of the knee joints

Osteoarthritis of joints is a degenerative disease whose main characteristics are damage and loss of articular cartilage, thickening of the bone just beneath the cartilage (subchondral bone) and hypertrophy of bone at the edges of the joint. Clinically, OA of joints knees, depending on the stage of the disease, manifested by pain in degenerative altered joint, stiffness, restricted range of motion, precipitation, joint effusion within deformations, and varying degrees of inflammation. In this research were involved 100 patients and presented the results of the clinical manifestations of the disease, including amnesics and objective parameters, demographics status, radio-logical findings and the presence of co morbid conditions.

CORRELATION BETWEEN CLINICAL MANIFESTATIONS OF OSTEOARTHRITIS AND FLUCTUATING BLOOD LEVELS OF INTERLEUKIN 6

Objective — to evaluate associations between fluctuating interleukin 6 (IL6) levels and clinical manifestations of osteoarthritis (OA). Material and methods. Totally 81 patients aged 47—73 y.o. with OA diagnosis, meeting ACR criteria, were evaluated. Anthropometric measurements, duration of the disease, degree of functional disability, IL6 levels and joints radiographs were assessed in all patients. Correlation between different IL6 secretion levels and the severity of OA clinical course and of pain syndrome was also analyzed. Results and discussion. Elevated IL6 levels were associated with more pronounced radiographic structural damage, greater degree of functional disability, presence of synovitis and more severe pain syndrome. Therefore, elevated IL6 levels are associated with unfavorable clinical course of OA.