Pharmacotherapy of pain in musculoskeletal diseases: evolution and revolution of views

Osteoarthritis (OA) is a painful and disabling disease affecting millions of people worldwide. OA is the most common form of arthritis which is characterized by joint pain and stiffness, leading to a decrease in functional activity and loss of life quality. Various approaches to OA therapy are constantly being revised, as new molecules appear, data concerning drugs/molecules that are already in use, appear as well, including data on adverse events. At last, new randomized controlled trials results, new methods of adjunctive therapy become available. OA therapy and prevention, drugs with chondroprotective properties are prescribed (according to the opinion of European experts (2019)) that are as follows: chondroitin sulfate (CS), glucosamine sulfate (GS), diacerein, avocado soybean unsaponifiables, hyaluronic acid (HA) for intra-articular administering. Only effectiveness and the A1 level of recommendations of CS and GS have been proven, therefore, they are included in clinical recommendations and standards of the Ministry of Health of the Russian Federation (MHRF), as well as the international recommendations according to which CS and GS are to be used for a long time (up to 6 months). The article focuses on the analysis of erroneous statements regarding the classification, composition and mechanisms of action of different drugs of this group. Differences in terminology of drug groups are given, such as chondroprotectors, symptomatic slow acting drugs for osteoarthritis (SYSADOAs), disease-modifying osteoarthritis drugs, between which an equal sign cannot be placed. According to this analysis, a conclusion was made concerning the erroneous attitudes towards some SYSADOAs: 1) according to the Anatomical Therapeutic Chemical Classification, the active substances CS, GS, diacerein and HA are classified as nonsteroidal anti-inflammatory drugs due to their anti-inflammatory activity; 2) quite often, drugs based on bioactive concentrate of small sea fish and glycoaminoglycan-peptide complex do not belong to SYSADOAs according to any of the existing generally recognized classifications. Therefore, they do not contain a sufficient amount of active substances (CS or peptides), there is no proper level of evidence, they are not included in the recommendations of international medical communities and MHRF clinical recommendations and standards. In Russia, physicians are to follow MHRF clinical guidelines and standards for OA therapy.

show abstract

From misconceptions to reasonable osteoarthritis patients therapy

Shavlovskaya

Gromova

Torshin

et al. 2023

Farmakoèkonomika

View full text Add to dashboard Cite

show abstract

Aseptic necrosis of the femoral head

Filatova,

Solovyov,

Gruzdev

et al. 2024

Medicinskij sovet

View full text Add to dashboard Cite

The article discusses the historical aspects of the study of aseptic necrosis, as well as the issues of therapy and early diagnosis of aseptic necrosis of the femoral head. The authors raise the issues of pathogenesis and discuss the factors influencing its development. So it is believed that the leading factors are excessive alcohol consumption, deep-sea diving and some autoimmune diseases. Attention is also paid to the long-term consequences of COVID-19 infection, in which significant complications from the musculoskeletal system are observed, including aseptic necrosis of the femoral head. The consequences of infection can be triggered both by the inflammatory process itself and as a high risk of complications during glucocorticosteroid therapy. The article focuses on the clinic of aseptic necrosis of the femoral head and its difference from the clinic of osteoarthritis. As well as the importance of early diagnosis of aseptic necrosis of the femoral head. The article discusses the issues of drug therapy, indications for it and the choice of drugs. The article provides a clinical example that demonstrates the importance of careful collection of complaints and anamnesis in a young patient with atypical hip pain, as well as the effectiveness of prescribed therapy according to clinical recommendations. A specific example demonstrates not only the importance of using magnetic resonance imaging in the diagnosis of aseptic necrosis of the femoral head, but also the effectiveness and safety of therapy. The possible synergism and pleiotropic effects of the prescribed therapy are also discussed. The emphasis is on the importance of further research to develop indications and criteria for the effectiveness of therapy for aseptic necrosis of the femoral head.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Pharmacotherapy of pain in musculoskeletal diseases: evolution and revolution of views

Cited by 2 publications

References 40 publications

From misconceptions to reasonable osteoarthritis patients therapy

From misconceptions to reasonable osteoarthritis patients therapy

Aseptic necrosis of the femoral head

Contact Info

Product

Resources

About