Effective reduction of need for non-steroid anti-inflammatory drugs on background of intra-artular introduction of sodium hyauloranate in patients with gonarthrosis

Introduction. Osteoarthritis (OA) in the Russian Federation is still not included in the list of socially significant diseases, despite the fact that this pathology limits the level of physical activity of the population more than diseases of the cardiovascular system, visual impairment and diabetes. European experts emphasize the relevance of research to develop methods to improve the effectiveness of viscosupplementary therapy in OA. The purpose of the study. To evaluate the efficacy, safety and long-term results of treatment of gonarthrosis with sodium hyaluronate.

Materials and methods. The study included 180 patients with gonarthrosis with insufficient efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) on demand and oral symptomatic slow-acting drugs against osteoarthritis (SYSADOA). The patients were randomized into three groups. Group 1: 50 patients who received sodium hyaluronate (Ripart®; Ingal, Russia) intra-articularly. Group 2: 30 patients received intra-articular SYSADOA (bioactive concentrate of small marine fish). The control group consisted of 100 patients who received drugs of the SYSADOA group intramuscularly.

Results. An effective reduction in pain both at rest and during movement was achieved in most patients of all groups, but the treatment groups differed statistically significantly in the speed of achieving the clinical effect and its duration. In the 1st group, a significant decrease in the VAS pain index was observed already at the 1st week and by the 3rd month it was –49.1 % (p < 0.001). In the comparison and control groups, the indicators of speed, the degree of pain reduction, and the duration of the effect of therapy were also significant (p ≤ 0.050). But the effectiveness of therapy in these groups was statistically significantly lower than in patients of group 1 (p ≥ 0.050). It should be emphasized that the intra-articular administration of sodium hyaluronate provided a significant reduction in the need for patients to additionally take NSAIDs. After 3 months of therapy, only 5 patients (10 %) of this group continued to take NSAIDs (p < 0.001); 20 – completely stopped taking NSAIDs (40 %) and 25 (50 %) reduced the dose of NSAIDs taken, the duration of the effect lasted up to 12 months.

Conclusions. In our study, sodium hyaluronate demonstrated high efficiency in reducing pain in patients with gonarthrosis and contributed to a significant decrease in the need for patients to take NSAIDs for 12 months.

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