CHANGES IN THE ACTIVITY OF ARTICULAR SYNDROME IN PATIENTS WITH COMORBID COURSE OF OSTEOARTHRITIS AND OBESITY, DEPENDING ON THE PRESCRIBED NONSTEROIDAL ANTI-INFLAMMATORY DRUG
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i2.8642Keywords:
articular syndrome, osteoarthritis, obesity, NSAIDs.Abstract
The aim – establishing the activity of articular syndrome in patients with osteoarthritis and obesity depending on the prescribed NASID.
Material and Methods. In order to find out the features of the articular syndrome in patients with osteoarthrosis (OA) with reactive synovitis, depending on the degree of obesity against the background of the prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) (nimesulide, meloxicam, diclofenac, paracetamol, ibuprofen), 96 patients with I-III degree of obesity and OA knee joints were examined.
Results. Visual analogue scale indexes, individual pain level, pain severity, joint stiffness, functional capacity of WOMAC enquirer in the examined groups have significantly (p<0.05) improved after allocated therapy. It was established that with the increase of body mass index (BMI), the activity of the articular syndrome is more difficult to control.
Conclusion. Obtained results confirm negative influence of obesity on the course of OA. The use of anti-inflammatory therapy in order to eliminate the pain syndrome showed significantly lower efficacy in patients with comorbid OA and obesity of ΙΙΙ degree compared with those with less weight.
All NSAIDs showed high anti-inflammatory and analgesic activity in patients with comorbid OA and obesity during two weeks of treatment. Ibuprofen and diclofenac demonstrated the highest efficacy in reducing articular syndrome in these patients.
References
Balabanova, R.M. (2013). Novyy podkhod k lecheniyu osteoartroza kak khronicheskogo vospalitelnogo zabolevaniya [A new approach to the treatment of osteoarthritis as a chronic inflammatory disease]. Sovremennaya revmatologiya – Modern Rheumatology, 2, 95-98 [in Russian].
Golovach, I.Yu. (2014). Osteoartrit: fundamentalnye i prikladnye aspekty etiopatogeneza zabolevaniya. Nichego ne stoit na meste [Osteoarthritis: the fundamental and applied aspects of the etiopathogenesis of the disease. Nothing stands still]. Ukrainskyi revmatolohichnyi zhurnal – Ukrainian Rheumatology Journal, 2, 4-11 [in Russian].
Kovalenko, V.M., & Bortkevych, O.P. (2010). Osteoartroz. Praktychna nastanova [Osteoarthritis. Practical guidance]. 3-tie vyd., dopov., zi zminamy. Kyiv: Morion [in Ukrainian].
Chichasova, N.V., Mendel, O.N., & Nasonov, E.L. (2010). Osteoartroz kak obshcheterapevticheskaya problema [Osteoarthritis as a general therapeutic problem]. Russkiy meditsinskiy zhurnal – Russian Medical Journal, 11, 729-734 [in Russian].
Kovalenko, V.M., & Shuba, N.M. (Eds.). (2013). Natsionalnyi pidruchnyk z revmatolohii [National textbook on Rheumatology]. Kyiv: Morion [in Ukrainian].
Smiian, S.I. (2011). Osteoartroz kolinnykh suhlobiv: suchasnyi stan problemy [Osteoarthritis of the knee joints: the present state of the problem]. Hostri ta nevidkladni stany v praktytsi likaria – Acute and Emergencies in the Practice of a Doctor, 3, 12-15 [in Ukrainian].
Tanas, O.V., & Khukhlina, O.S. (2014). Dynamika pokaznykiv tsytokinovoho ta oksydantnoho homeostazu pry likuvanni diatsereinom patsiientiv z osteoartrozom ta komorbidnymy zakhvoriuvanniamy [Dynamics of indicators of cytokine and oxidative homeostasis in the treatment of diacerein in patients with osteoarthritis and comorbid diseases]. Visnyk problem biolohii i medytsyny – Journal of Biology and Medicine Problems, 2 (3), 241-244 [in Ukrainian].
Khukhlina, O.S., Kanovska, L.V., & Tanas, O.V. (2011). Rol oksydantno-protyoksydantnoho homeostazu u patohenezi osteoartrozu, arterialnoi hipertenzii ta ozhyrinnia [The role of oxidant-antioxidant homeostasis in the pathogenesis of osteoarthritis, arterial hypertension and obesity]. Zdobutky klinichnoi ta eksperymentalnoi medytsyny – Achievements of Clinical and Practical Medicine, 1, 132-134 [in Ukrainian].
Chichasova, N.V. (2011). Meloksikam v lechenii khronicheskikh zabolevaniy oporno-dvigatelnogo apparata [Meloksikam in the treatment of chronic diseases of the musculoskeletal system]. Lechashchiy vrach – Attending Doctor, 4, 26 [in Russian].
Shuba, N.M., Voronova, T.D., Pilipenko, A.V., & Litvinenko, S.V. (2016). Effektivnost nimesulida i ego vliyanie na otdelnye katabolicheskie i anabolicheskie faktory u bolnykh osteoartrozom [The effectiveness of nimesulide and its effect on individual catabolic and anabolic factors in patients with osteoarthritis]. Ukrainskyi revmatolohichnyi zhurnal – Ukrainian Rheumatology Journal, 1, 57-60 [in Russian].
Shuba, N.M., Voronova, T.D., Tarasenko, T.M., & Krylova, A.S. (2012). Novi aspekty patohenezu osteoartrozu ta shliakhy yoho korektsii [New aspects of pathogenesis of osteoarthritis and ways of its correction]. Ukrainskyi medychnyi chasopys – Ukrainian Medical Journal, 2, 113-119 [in Ukrainian].
Yaremenko, O.B. (2014). Sovremennaya terapiya osteoartroza na osnovanii novykh rekomendatsiy i dokazatelstv: novye podkhody i perspektivy [Modern therapy of osteoarthritis based on new recommendations and evidence: new approaches and perspectives]. Zdorovia Ukrainy – Health of Ukraine. – Retrieved from: http://health-ua.com/pics/pdf/ZU_2014_Xirurg_2/40-41.pdf [in Russian].
Bennet, A., & Villa, G. (2000). Nimesulid: an NSAID that preferentially inhibits COX-2, and has various unique pharmacological activities. Expert Opin. Pharmacother., 1 (2), 277-286. doi: 10.1517/14656566.1.2.277.
Bruyere, O., Cooper, C., Pelletier, J.P., Branco, J., Luisa Brandi, M., & Guillemin, F. (2014). 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., 44 (3), 253-263. doi: 10.1016/j.semarthrit.2014.05.014.
Castaňeda, S., Roman-Blas, J.A., Largo, R., & Herrero-Beaumont, G. (2014). Osteoarthritis: a progressive disease with changing phenotypes. Rheumatology (Oxford), 53 (1), 1-3. doi: 10.1093/rheumatology/ket247.
Gabriel, S.E., & Michaud, K. (2009). Epidemiological studies in incidence, prevalence, mortality and comorbidity of the rheumatic diseases. Arthritis Res. Ther., 11 (3), 229. doi: 10.1186/ar2669.
Lane, N.E., Brandt, K., Hawker, G., Peeva, E., Schreyer, E., & Tsuji, W. (2011). OARSI-FDA initiative: defining the disease state of Osteoarthritis. Osteoarthritis Cartilaqe, 19 (5), 478-482. doi: 10.1016/j.joca.2010.09.013.
Leite, A.A., Coste, A.J., Lima, B.A., Padilha, A.V., Albuquerque, E.C., & Marques, C.D. (2011). Comorbidities in patients with osteoarthritis: frequency and impact on pain and physical function. Rev. Bras. Rheumatol., 51 (2), 118-123.
Zhuo, Q., Yang, W., Chen, J., & Wang, Y. (2012). Metabolic syndrome meets osteoarthritis. Nat. Rev. Rheumatol., 8 (12), 729-737. doi: 10.1038/nrrheum.2012.135.
