It has been established that osteoarthritis (OA) refers to diseases with high comorbidity. According to available data, OA is most often combined with arterial hypertension (AH) and other cardiovascular diseases (CVD). The combination of OA and CVD causes certain difficulties when choosing drug therapy. Traditionally, with pain syndrome, the choice falls on NSAIDs, since this allows in most cases to get a quick response to treatment. However, the use of NSAIDs may be accompanied by an increase in average blood pressure by 5 mm Hg or more in patients with arterial hypertension (AH) and significantly reduces the antihypertensive effectiveness of beta-blockers and ACE inhibitors. Symptomatic effect of the use of symptom-modifying drugs of delayed action (SYSADOA - Symptomatic slow acting drugs for osteoarthritis) develops approximately 8-12 weeks after the start of administration. Limitations in the use of NSAIDs in patients with OA and CVD due to increased cardiovascular risk and a long waiting period for the onset of the effect when using drugs of the SYSADOA group dictate the need to search for new approaches in the treatment of OA, on the one hand, with rapid effectiveness, and on the other - meeting all the requirements of cardiovascular safety. It is known that local injection therapy with the use of different groups of drugs has high efficiency in OA: glucocorticosteroids (GCS), hyaluronic acid, chondroitin, etc. Currently, microinduction collagen preparations with a high safety profile have joined them. Special attention in OA deserves the drug Plexatron, which has in its composition a type 1 tropocollagen with a molecular weight of 300 kD and calcium phosphate 1 mcg, and is intended for intra-articular and periarticular administration. Injectable collagen preparations are capable of inducing the regeneration of damaged collagen fibers by stimulating the migration of fibroblasts to the sites of damage, the release of growth factors and the activation of a key enzyme for the induction of endogenous collagen synthesis - lysine hydroxylase

The review examines the effect of symptomatic delayed-acting drugs, nonsteroidal anti-inflammatory drugs, hyaluronic acid on the course and progression of osteoarthritis.

Knee osteoarthritis (KOA) is a chronic disease that leads to a significant deterioration in the quality of life and disability. In the treatment of OA, hyaluronic acid (HA) drugs have an important place.Objective: to compare the effectiveness of ROA treatment with different HA drugs with different physicochemical properties and molecular weight.Patients and methods. A 12-week prospective randomized study of the comparative efficacy of a single intra-articular injection of three HA drugs – Armaviscon Forte (AF), Flexotron Cross (FCr) and Flexotron Ultra (FUL) was carried out. The study group consisted of 90 patients with knee osteoarthritis, aged from 43 to 50 years (the majority were women – 63.3%) with an initial severity of pain >40 mm according to the visual analogue scale (VAS). The result of therapy was assessed by the dynamics of pain (VAS), WOMAC index, and subjective assessment of the effect 3 months after intra-articular administration of HA.Results and discussion. Eight patients dropped out of the study: in the AF group – 3, FCr – 4, FUL – 1. After 90 days, the decrease in pain compared to baseline values in the AF group was 30%, in FCr – 46% and in FUL – 57% (p ≤0,05), and the dynamics of the WOMAC index – 27, 36, and 42%, respectively. After 90 days, 85.0, 93.4 and 96.5% of patients noted improvement and significant improvement in the AF, FCr and FUL groups, respectively. No serious adverse events were recorded.Conclusion. All investigated drugs demonstrated high analgesic potential, but the best clinical effect was observed with FUL.