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Эффективность комбинированного препарата хондроитина сульфата и глюкозамина гидрохлорида в лечении остеоартрита: систематический обзор исследований
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
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Naumov AV, Khovasova NO, Unkovskiy AV. Efficacy of combination chondroitin sulfate plus glucosamine hydrochloride in osteoarthritis: A systematic review. Terapevticheskii Arkhiv (Ter. Arkh.). 2024;96(12):1223–1229. DOI: 10.26442/00403660.2024.12.203039
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Ключевые слова: остеоартрит, коксартроз, гонартроз, хондроитина сульфат, глюкозамина гидрохлорид, систематический обзор
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Osteoarthritis is the most common musculoskeletal disorder, leading to reduced mobility and disability. Currently, in OA, basic therapy with slow-acting symptomatic drugs for the treatment of osteoarthritis (SYSADOA) is recommended, among which chondroitin sulfate (CS) and glucosamine hydrochloride (HS), as well as their combinations, have the most convincing evidence of effectiveness. The combined drugs of CS and HS include the drug ARTRA®. The purpose of this article was to provide a systematic review of the efficacy studies of the combination drug CS and HS (ARTRA®). Of the 20 publications on the study of the efficacy of ARTRA®, 6 articles with a total of 3683 patients met the inclusion criteria. In patients treated with ARTRA, both Visual Analogue Scale and Western Ontario and McMaster University Osteoarthritis Index pain relief was observed at all time points (3, 4, and 6 months). Functional capacity of patients also had positive dynamics in the intervention groups in all presented studies.
Keywords: osteoarthritis, coxarthrosis, gonarthrosis, chondroitin sulfate, glucosamine hydrochloride, systematic review
2. Shi J, Fan K, Yan L, et al. Cost effectiveness of pharmacological management for osteoarthritis: A systematic review. Appl Health Econ Health Policy. 2022;20(3):351-70. DOI:10.1007/s40258-022-00717-0
3. Наумов А.В., Ткачева О.Н. Применение глюкозамина сульфата у пациентов с остеоартритом и коморбидностью при наличии высокого риска осложнений, связанных с НПВП. Терапевтический архив. 2018;90(5):81-7 [Naumov AV, Tkacheva ON. Use of a glycosamine sulfate for patients with osteoarthritis and a comorbidity with high risk of the side effects from NSAIDS. Terapevticheskii Arkhiv (Ter. Arkh.). 2018;90(5):81-7 (in Russian)]. DOI:10.26442/terarkhiv201890581-87
4. Visser AW, de Mutsert R, le Cessie S, et al.; NEO Study Group. The relative contribution of mechanical stress and systemic processes in different types of osteoarthritis: The NEO study. Ann Rheum Dis. 2015;74(10):1842-7. DOI:10.1136/annrheumdis-2013-205012
5. Leheita O, Abed Elrazek NY, Younes S, Mahmoud AZ. Lymphocytes subsets in osteoarthritis versus rheumatoid arthritis. Egypt J Immunol. 2005;12(2):113-24. PMID:17977216
6. Saito I, Koshino T, Nakashima K, et al. Increased cellular infiltrate in inflammatory synovia of osteoarthritic knees. Osteoarthritis Cartilage. 2002;10(2):156-62. DOI:10.1053/joca.2001.0494
7. Лила А.М., Мазуров В.И., Мартынов А.И., и др. Резолюция консенсуса экспертов Российской Федерации по диагностике и лечению остеоартрита 2022. Современная ревматология. 2022;16(6):106-16 [Lila AM, Mazurov VI, Martynov AI, et al. Resolution of the consensus of the Russian Federation experts on the diagnosis and treatment of osteoarthritis, 2022. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2022;16(6):106-16 (in Russian)]. DOI:10.14412/1996-7012-2022-6-106-116
8. Arden NK, Perry TA, Bannuru RR, et al. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nat Rev Rheumatol. 2021;17(1):59-66. DOI:10.1038/s41584-020-00523-9
9. Safiri S, Kolahi AA, Smith E, et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis. 2020;79(6):819-28. DOI:10.1136/annrheumdis-2019-216515
10. Галушко Е.А., Насонов Е.Л. Распространенность ревматических заболеваний в России. Альманах клинической медицины. 2018;46(1):32-9 [Galushko EA, Nasonov EL. Prevalence of rheumatic diseases in Russia. Almanac of Clinical Medicine. 2018;46(1):32-9 (in Russian)]. DOI:10.18786/2072-0505-2018-46-1-32-39
11. Ткачева О.Н., Воробьева Н.М., Котовская Ю.В., и др. Распространенность гериатрических синдромов у лиц в возрасте старше 65 лет: первые результаты российского эпидемиологического исследования ЭВКАЛИПТ. Российский кардиологический журнал. 2020;25(10):3985 [Tkacheva ON, Vorob’eva NM, Kotovskaya YuV, et al. Prevalence of geriatric syndromes in persons over 65 years: the first results of the EVCALIPT study. Russian Journal of Cardiology. 2020;25(10):3985 (in Russian)].
DOI:10.15829/1560-4071-2020-3985
12. Lin T, Zhao Y, Xia X, et al. Association between frailty and chronic pain among older adults: A systematic review and meta-analysis. Eur Geriatr Med. 2020;11(6):945-59. DOI:10.1007/s41999-020-00382-3
13. Saraiva MD, Suzuki GS, Lin SM, et al. Persistent pain is a risk factor for frailty: A systematic review and meta-analysis from prospective longitudinal studies. Age Ageing. 2018;47(6):785-93. DOI:10.1093/ageing/afy104
14. Brabant T, Stichtenoth D. [Pharmacological treatment of osteoarthritis in the elderly]. Z Rheumatol. 2005;64(7):467-72 (in German). DOI:10.1007/s00393-005-0778-5
15. Стрижаков Л.А., Гуляев С.В., Бабанов С.А., Моисеев С.В. Остеоартроз в клинике внутренних и профессиональных болезней: дифференциально-диагностические аспекты. Терапевтический архив. 2020;92(6):89-92 [Strizhakov LA, Guliaev SV, Babanov SA, Moiseev SV. Osteoarthrosis in the clinic of internal and occupational diseases: differential diagnostic aspects. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(6):89-92 (in Russian)]. DOI:10.26442/00403660.2020.06.000620
16. Bruyère O, Cooper C, Pelletier JP, et al. A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis – From evidence-based medicine to the real-life setting. Semin Arthritis Rheum. 2016;45(Suppl. 4):S3-11. DOI:10.1016/j.semarthrit.2015.11.010
17. National Center For Complimentary And Alternative Medicine National Institutes Of Health. The NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). J Pain Palliat Care Pharmacother. 2008;22(1):39-43. DOI:10.1080/15360280801989351
18. Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: A randomized, controlled trial. Arthritis Rheum. 2005;52(3):779-86. DOI:10.1002/art.20867
19. Volpi N. Analytical aspects of pharmaceutical grade chondroitin sulfates. J Pharm Sci. 2007;96(12):3168-80. DOI:10.1002/jps.20997
20. Liu X, Machado GC, Eyles JP, et al. Dietary supplements for treating osteoarthritis: A systematic review and meta-analysis. Br J Sports Med. 2018;52(3):167-75. DOI:10.1136/bjsports-2016-097333
21. Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16(2):137-62. DOI:10.1016/j.joca.2007.12.013
22. Кашеварова Н.Г., Таскина Е.А., Алексеева Л.И., и др. Изменения минеральной плотности кости при прогрессировании остеоартрита коленных суставов. Терапевтический архив. 2019;91(5):61-7 [Kashevarova NG, Taskina EA, Alekseeva LI, et al. The сhanges of bone mineral density on the risk of progression of osteoarthritis of the knee. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(5):61-7 (in Russian)]. DOI:10.26442/00403660.2019.05.000194
23. Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop. 2023;14(6):443-57. DOI:10.5312/wjo.v14.i6.443
24. Minoretti P, Santiago Sáez A, Liaño Riera M, et al. Efficacy and safety of two chondroprotective supplements in patients with knee osteoarthritis: A randomized, single-blind, pilot study. Cureus. 2024;16(4):e57579. DOI:10.7759/cureus.57579
25. Meng Z, Liu J, Zhou N. Efficacy and safety of the combination of glucosamine and chondroitin for knee osteoarthritis: A systematic review and meta-analysis. Arch Orthop Trauma Surg. 2023;143(1):409-21. DOI:10.1007/s00402-021-04326-9
26. Родионова С.С., Еськин Н.А. Комбинация хондроитина сульфата и глюкозамина (препарат АРТРА) для купирования боли и снижения потребления нестероидных противовоспалительных препаратов у пациентов с I–II стадиями остеоартроза коленных суставов. Хирургия. Журнал им. Н.И. Пирогова. 2016;(1):67‑72 [Rodionova SS, Es'kin NA. The combination of chondroitin sulfate and glucosamine (ARTRA) for pain relief and to reduce the consumption of NSAIDs in patients with I–II stages of osteoarthritis of the knee. Pirogov Russian Journal of Surgery. 2016;(1):67-72 (in Russian)]. DOI:10.17116/hirurgia2016167-72
27. Шалтабаева А.Б., Шевалье А.Н., Шаймерденова А.Б. Эффективность применения препарата «АРТРА» при лечении остеоартроза коленных суставов в амбулаторных условиях. Сборник статей XI Международного научно-практического конкурса. Пенза: Наука и просвещение (ИП Гуляев Г.Ю.), 2017. С. 324-7 [Shaltabaeva AB, Sheval'e AN, Shaimerdenova AB. Effektivnost' primeneniia preparata "ARTRA" pri lechenii osteoartroza kolennykh sustavov v ambulatornykh usloviiakh. Sbornik statei XI Mezhdunarodnogo nauchno-prakticheskogo konkursa. Penza: Nauka i prosveshchenie (IP Guliaev G.Iu.), 2017. P. 324-7 (in Russian)].
28. Меньшикова Л.В., Храмцова Н.А., Меньшиков М.Л. Применение препарата АРТРА у женщин с остеоартрозом коленных суставов. Современные проблемы ревматологии. 2005;(2):192-8 [Men'shikova LV, Khramtsova NA, Men'shikov ML. Use of the medication ARTRA in women with knee osteoarthrosis. Sovremennyye Problemy Revmatologii. 2005;(2):192-8 (in Russian)].
29. Алексеева Л.И., Чичасова Н.В., Мендель О.И. Результаты применения препарата АРТРА® при гонартрозе. Научно-практическая ревматология. 2004;2:45-7 [Alekseeva LI, Chichasova NV, Mendel OI. Results of using the medication ARTRA® in gonarthrosis. Nauchno-Prakticheskaya Revmatologiya. 2004;2:45-7 (in Russian)].
30. Алексеева Л.И., Чичасова Н.В., Мендель О.И., и др. Рациональный выбор базисной терапии при остеоартрозе. Результаты открытого рандомизированного многоцентрового исследования препарата АРТРА® в России. РМЖ. 2005;24:1637 [Alekseeva LI, Chichasova NV, Mendel OI, et al. Rational choice of basic therapy for osteoarthrosis. Results of an open randomized multicenter study of the medication ARTRA® in Russia. Russian Medical Journal. 2005;24:1637 (in Russian)].
31. Наумов А.В., Верткин А.Л., Мендель О.В., и др. Как повысить безопасность и эффективность «антиартрозной» терапии у пациентов с соматической патологией. РМЖ. 2007;26:2012 [Naumov AV, Vertkin AL, Mendel OI, et al. How to improve the safety and effectiveness of "antiarthrosis" therapy in patients with somatic pathology. Russian Medical Journal. 2007;26:2012 (in Russian)].
32. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. DOI:10.1136/bmj.n71
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1. Hunter DJ, Schofield D, Callander E. The individual and socioeconomic impact of osteoarthritis. Nat Rev Rheumatol. 2014;10(7):437-41. DOI:10.1038/nrrheum.2014.44
2. Shi J, Fan K, Yan L, et al. Cost effectiveness of pharmacological management for osteoarthritis: A systematic review. Appl Health Econ Health Policy. 2022;20(3):351-70. DOI:10.1007/s40258-022-00717-0
3. Naumov AV, Tkacheva ON. Use of a glycosamine sulfate for patients with osteoarthritis and a comorbidity with high risk of the side effects from NSAIDS. Terapevticheskii Arkhiv (Ter. Arkh.). 2018;90(5):81-7 (in Russian). DOI:10.26442/terarkhiv201890581-87
4. Visser AW, de Mutsert R, le Cessie S, et al.; NEO Study Group. The relative contribution of mechanical stress and systemic processes in different types of osteoarthritis: The NEO study. Ann Rheum Dis. 2015;74(10):1842-7. DOI:10.1136/annrheumdis-2013-205012
5. Leheita O, Abed Elrazek NY, Younes S, Mahmoud AZ. Lymphocytes subsets in osteoarthritis versus rheumatoid arthritis. Egypt J Immunol. 2005;12(2):113-24. PMID:17977216
6. Saito I, Koshino T, Nakashima K, et al. Increased cellular infiltrate in inflammatory synovia of osteoarthritic knees. Osteoarthritis Cartilage. 2002;10(2):156-62. DOI:10.1053/joca.2001.0494
7. Lila AM, Mazurov VI, Martynov AI, et al. Resolution of the consensus of the Russian Federation experts on the diagnosis and treatment of osteoarthritis, 2022. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2022;16(6):106-16 (in Russian). DOI:10.14412/1996-7012-2022-6-106-116
8. Arden NK, Perry TA, Bannuru RR, et al. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nat Rev Rheumatol. 2021;17(1):59-66. DOI:10.1038/s41584-020-00523-9
9. Safiri S, Kolahi AA, Smith E, et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis. 2020;79(6):819-28. DOI:10.1136/annrheumdis-2019-216515
10. Galushko EA, Nasonov EL. Prevalence of rheumatic diseases in Russia. Almanac of Clinical Medicine. 2018;46(1):32-9 (in Russian). DOI:10.18786/2072-0505-2018-46-1-32-39
11. Tkacheva ON, Vorob’eva NM, Kotovskaya YuV, et al. Prevalence of geriatric syndromes in persons over 65 years: the first results of the EVCALIPT study. Russian Journal of Cardiology. 2020;25(10):3985 (in Russian). DOI:10.15829/1560-4071-2020-3985
12. Lin T, Zhao Y, Xia X, et al. Association between frailty and chronic pain among older adults: A systematic review and meta-analysis. Eur Geriatr Med. 2020;11(6):945-59. DOI:10.1007/s41999-020-00382-3
13. Saraiva MD, Suzuki GS, Lin SM, et al. Persistent pain is a risk factor for frailty: A systematic review and meta-analysis from prospective longitudinal studies. Age Ageing. 2018;47(6):785-93. DOI:10.1093/ageing/afy104
14. Brabant T, Stichtenoth D. [Pharmacological treatment of osteoarthritis in the elderly]. Z Rheumatol. 2005;64(7):467-72 (in German). DOI:10.1007/s00393-005-0778-5
15. Strizhakov LA, Guliaev SV, Babanov SA, Moiseev SV. Osteoarthrosis in the clinic of internal and occupational diseases: differential diagnostic aspects. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(6):89-92 (in Russian). DOI:10.26442/00403660.2020.06.000620
16. Bruyère O, Cooper C, Pelletier JP, et al. A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis – From evidence-based medicine to the real-life setting. Semin Arthritis Rheum. 2016;45(Suppl. 4):S3-11. DOI:10.1016/j.semarthrit.2015.11.010
17. National Center For Complimentary And Alternative Medicine National Institutes Of Health. The NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). J Pain Palliat Care Pharmacother. 2008;22(1):39-43. DOI:10.1080/15360280801989351
18. Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: A randomized, controlled trial. Arthritis Rheum. 2005;52(3):779-86. DOI:10.1002/art.20867
19. Volpi N. Analytical aspects of pharmaceutical grade chondroitin sulfates. J Pharm Sci. 2007;96(12):3168-80. DOI:10.1002/jps.20997
20. Liu X, Machado GC, Eyles JP, et al. Dietary supplements for treating osteoarthritis: A systematic review and meta-analysis. Br J Sports Med. 2018;52(3):167-75. DOI:10.1136/bjsports-2016-097333
21. Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16(2):137-62. DOI:10.1016/j.joca.2007.12.013
22. Kashevarova NG, Taskina EA, Alekseeva LI, et al. The сhanges of bone mineral density on the risk of progression of osteoarthritis of the knee. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(5):61-7 (in Russian). DOI:10.26442/00403660.2019.05.000194
23. Lila AM, Alekseeva LI, Baranov AA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: A long-term observational study in Russia. World J Orthop. 2023;14(6):443-57. DOI:10.5312/wjo.v14.i6.443
24. Minoretti P, Santiago Sáez A, Liaño Riera M, et al. Efficacy and safety of two chondroprotective supplements in patients with knee osteoarthritis: A randomized, single-blind, pilot study. Cureus. 2024;16(4):e57579. DOI:10.7759/cureus.57579
25. Meng Z, Liu J, Zhou N. Efficacy and safety of the combination of glucosamine and chondroitin for knee osteoarthritis: A systematic review and meta-analysis. Arch Orthop Trauma Surg. 2023;143(1):409-21. DOI:10.1007/s00402-021-04326-9
26. Rodionova SS, Es'kin NA. The combination of chondroitin sulfate and glucosamine (ARTRA) for pain relief and to reduce the consumption of NSAIDs in patients with I–II stages of osteoarthritis of the knee. Pirogov Russian Journal of Surgery. 2016;(1):67-72 (in Russian). DOI:10.17116/hirurgia2016167-72
27. Shaltabaeva AB, Sheval'e AN, Shaimerdenova AB. Effektivnost' primeneniia preparata "ARTRA" pri lechenii osteoartroza kolennykh sustavov v ambulatornykh usloviiakh. Sbornik statei XI Mezhdunarodnogo nauchno-prakticheskogo konkursa. Penza: Nauka i prosveshchenie (IP Guliaev G.Iu.), 2017. P. 324-7 (in Russian).
28. Men'shikova LV, Khramtsova NA, Men'shikov ML. Use of the medication ARTRA in women with knee osteoarthrosis. Sovremennyye Problemy Revmatologii. 2005;(2):192-8 (in Russian).
29. Alekseeva LI, Chichasova NV, Mendel OI. Results of using the medication ARTRA® in gonarthrosis. Nauchno-Prakticheskaya Revmatologiya. 2004;2:45-7 (in Russian).
30. Alekseeva LI, Chichasova NV, Mendel OI, et al. Rational choice of basic therapy for osteoarthrosis. Results of an open randomized multicenter study of the medication ARTRA® in Russia. Russian Medical Journal. 2005;24:1637 (in Russian).
31. Naumov AV, Vertkin AL, Mendel OI, et al. How to improve the safety and effectiveness of "antiarthrosis" therapy in patients with somatic pathology. Russian Medical Journal. 2007;26:2012 (in Russian).
32. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. DOI:10.1136/bmj.n71
ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*nanton78@gmail.com
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Anton V. Naumov*, Natalia O. Khovasova, Aleksey V. Unkovskiy
Pirogov Russian National Research Medical University, Moscow, Russia
*nanton78@gmail.com