Are We Using Slow-Acting Symptomatic Chondroprotective Drugs Conscious Enough?

Abstract

Background:Osteochondral injuries constitute an entity that is widespread and can be seen in patients of all ages. Actual treatment modalities aim to relieve pain, obtain full range of movement of the joint, and improve the quality of life. There are many slow-acting chondroprotective agents prevalently used in the United States that are classified as nutritional support but not as medicines . This study presents the importance of clinical adverse effect profiles as well as the pharmacological mechanism of action and application of combinations of drugs that are widely prescribed and not subjected to control.Methods:Electronic databases were searched with keywords about the chondroprotective drugs without any language restriction. Evaluations of the descriptive statistics were represented via Microsoft Office Excel 2010 lists in the form of a mean±standard deviation or frequency (%). The first evaluation showed that 1502 studies were potentially relevant. Following exclusion of the 1277 studies which were not clinical, full versions of the remaining 225 studies were subjected to further evaluation. No controlled, blinded, randomized and/or comparative studies met the inclusion criteria of the study, and no studies evaluated the comparative clinical results of the hyaluronan of different molecular weights.Results:The findings of this study concluded that especially when prescribing drugs with ingredients like GS and CS, many patients’ pre-existing conditions must be considered, such as whether the patient has a glucose intolerance or not. Additionally, mineral toxication should be considered since the drugs contain minerals, and after the application of injected hyaluronan, complications should be considered.Conclusion:Clinical, controlled and comparative studies about the use of chondroprotective drugs must be performed to define the benefits of these drugs, if any, in order to determine the most suitable time for operative intervention.

The Cultural Evolution of Medical Technologies

“…Yet there exist many alternative and complementary treatments in the market (Nahas & Balla, 2011). Relatedly, genuinely effective yet slow-acting drugs may sometimes fail to be recognized, as in the case of osteoarthritis (Bruyère et al, 2008;Gumustas et al, 2017). 7 My model also indicates that when one treatment is significantly superior to alternatives in speeding up recovery, it is nonetheless likely to reach fixation, especially with the help of conformity.…”

Systematic evaluation of promising clinical trials—gene silencing for the treatment of glioblastoma

“…Accordingly, the evidence levels of randomized clinical trials or multiple clinical trials with significant treatment effects were as follows: We excluded studies with a level of evidence of "F" and which were performed on animals, and mechanical models, since we were interested only in clinical trials. While creating a flow chart revealing the number and reasons of excluded and included studies at each stage of the selection process, the standards for reporting the results of a systematic review, the transparency in the presentation of the results, and determining the common issues amongst the reviews were provided by "the Transparent Reporting of the Systematic Review (PRISMA)" (10,19,20,38,39,46). In this way, all the articles were examined during the design phase and the form of reporting was determined.…”

“…Frequently cited articles were identified in Web of Science and Scopus databases. The references and citations of all articles were examined to avoid possible repetitions (Figure 1) (10,44,46).…”