medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-1-86-96medsovet-2274Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYНовые возможности терапии у больных остеоартритом коленных суставов и метаболическим синдромомNEW OPPORTUNITIES THERAPY IN PATIENTS WITH KNEE JOINT OSTEOARTHRITIS AND METABOLIC SYNDROMEАлексееваЛ. И.AlexeevaL. I.

д.м.н., профессор

MD, Prof

ТаскинаЕ. А.TaskinаE. A.

к.м.н.

PhD in medicine

КашевароваН. Г.KashevarovaN. G.

к.м.н.

PhD in medicine

ШараповаЕ. П.SharapovaE. P.

к.м.н.

PhD in medicine

АникинС. Г.AnikinS. G.

к.м.н.

PhD in medicine

СтребковаЕ. А.StrebkovaE. A.

к.м.н.

PhD in medicine

КоротковаТ. А.KorotkovaT. A.

к.м.н.

PhD in medicine

РаскинаТ. А.RaskinaT. A.

д.м.н., профессор

MD, Prof

ЗоноваЕ. В.ZonovaE. V.

д.м.н., профессор

MD, Prof

ОттеваЭ. Н.OtevaE. N.

д.м.н., профессор

MD, Prof

ДилбарянА. Г.DilbaryanA. G.Научно-исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияNasonova Research Institute of Rheumatology, MoscowRussian FederationКемеровский государственный медицинский университетРоссияKemerovo State Medical UniversityRussian FederationНовосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian FederationИнститут повышения квалификации специалистов здравоохранения, ХабаровскРоссияKhabarovsk Institute of Advanced Training of Health ProfessionalsRussian Federation201806022018018696Copyright © Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г., Шарапова Е.П., Аникин С.Г., Стребкова Е.А., Короткова Т.А., Раскина Т.А., Зонова Е.В., Оттева Э.Н., Дилбарян А.Г., 20182018Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г., Шарапова Е.П., Аникин С.Г., Стребкова Е.А., Короткова Т.А., Раскина Т.А., Зонова Е.В., Оттева Э.Н., Дилбарян А.Г.Alexeeva L.I., Taskinа E.A., Kashevarova N.G., Sharapova E.P., Anikin S.G., Strebkova E.A., Korotkova T.A., Raskina T.A., Zonova E.V., Oteva E.N., Dilbaryan A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2274Цель/введение

Цель/введение. Оценка эффективности и безопасности терапии диацереином у пациентов с остеоартритом (ОА) коленных суставов и метаболическим синдромом (МС). Материалы и методы. В исследование было включено 55 амбулаторных больных (50 женщин и 5 мужчин) из 4 субъектов РФ с МС и ОА коленных суставов 2–3 ст. по Келлгрену – Лоуренсу, с интенсивностью болевого синдрома > 40 мм по ВАШ. Средний возраст пациентов составил 59,7 ± 7,3 года, средний ИМТ – 33 ± 5,49 кг/м2, продолжительность болезни – 8 (5–10) лет. Длительность исследования – 9 месяцев (6 месяцев терапии: первый месяц 1 капсула (50 мг) в день, последующие 5 месяцев 2 капсулы (100 мг) в сутки – и 3 месяца наблюдения). Оценка эффективности и безопасности лечения проводилась по обще- принятым критериям. Всем больным в начале и в конце терапии определялись биохимические показатели. Результаты. Результаты исследования продемонстрировали статистически значимое снижение боли при ходьбе по ВАШ уже через 1 месяц от начала лечения, дальнейшее достоверное улучшение наблюдалось на протяжении всей 6 -месячной терапии. При отмене препарата (период наблюдения составил 3 месяца) болевой синдром не нарастал. Идентичная закономерность выявлялась и при оценке индекса Womac. Статистически значимое улучшение качества жизни по EQ-5D тоже отмечено на протяжении всего периода наблюдения. К концу терапии 92,5% больных были ответчиками по критерию OMERACT-OARSI и полностью отказались от приема НПВП 64,2% пациентов. На фоне проведенной терапии отмечено достоверное снижение ИМТ, уровней ЛПНП, ТГ, глюкозы, мочевой кислоты. Заключение. Полученные данные позволяют рекомендовать диацереин в качестве базисной терапии ОА у больных с МС. На фоне терапии у пациентов статистически значимо снижается боль, скованность, потребность в НПВП, улучшается качество жизни и функция суставов. Кроме того, достоверно уменьшается масса тела, улучшаются показатели липидограммы, углеводного и белкового обменов.

 

 

Objective/introduction

Objective/introduction. Evaluation of efficacy and safety of diacerein therapy in patients with knee joint osteoarthritis (OA) and metabolic syndrome (MS). Materials and methods. 55 outpatients (50 women and 5 men) with MS and stage 2-3 OA of knee joint according to Kellgren-Lawrence, with intensity of pain syndrome > 40 mm according to visual analogue scale (VAS) from 4 Russian Federation subjects were enrolled in the study. Average age of patients was 59.7 ± 7.3 years , mean BMI is 33 ± 5,49 kg/m2, the duration of the disease is 8 (5-10 years). Duration of the study was 9 months (6 months of therapy: 1 capsule (50 mg) per day for the first month, 2 capsules (100 mg) per day for the next 5 months, and follow-up for 3 months). Evaluation of the efficacy and safety of the treatment was conducted according to generally accepted criteria. All patients were underwent biochemical tests at the beginning and at the end of therapy. Results. The study resulted in a statistically significant reduction in pain when walking according to VAS as early as in 1 month from the beginning of treatment; the further significant improvement was observed during the entire 6-month therapy. Withdrawal of therapy (the observation period was 3 months) didn’t increase the pain syndrome. Evaluation according to Womac index also revealed identical regularity. A statistically significant improvement in the quality of life according to EQ-5D was also identified during the whole period of observation. By the end of the therapy, 92.5% of the patients were OMERACT - OARSI - responders and 64.2% of patients had completely withdrawn from NSAID. Against the background of the therapy, there was a significant decrease in BMI, LDL, TG, glucose, uric acid levels. Conclusion: The data obtained make it possible to recommend diacerein as a basic therapy for OA in patients with MS. On the background of therapy, the patients showed statistically significantly reduction in pain, stiffness, the need for NSAIDs, improved the quality of life and the function of the joints. In addition, the body weight decreases reliably, the lipidogram, carbohydrate and protein metabolism parameters also improved.

 

 

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The authors declare that there are no conflicts of interest present.