The Comparative Efficacy and Safety of Long- and Short-Term Continuous Use of Non-Steroidal Anti-Inflammatory Drugs for the Treatment of Knee Osteoarthritis

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Abstract

Objective. To compare the efficacy and tolerability of long-term and short-term continuous NSAIDs in patients with knee osteoarthritis with insufficient efficacy “on demand” NSAIDs and SYSADOA.

Study design. 12-week, prospective, comparative, randomized, single-center study.

Materials and Methods. 180 patients with primary knee osteoarthritis aged 40 to 85 years with insufficient efficacy of “on demand” NSAIDs and SYSADOA were examined. Anti-inflammatory drugs were recommended for everyone: 56 people took Naproxen (31.11%), 63 — Etoricoxib (35%), 61 — Ketoprofen (33.89%). Patients were randomized into two groups: 1st group — with 8-week continuous intake of NSAIDs, 2nd group — with a 2-week continuous course of NSAIDs.

Results. There was a positive dynamics of pain syndrome according to VAS and decrease in the level of the WOMAC index in both groups after 2 weeks of therapy. The pain level (VAS) and WOMAC indices in 1st group achieved after 8 weeks significantly differed from the ones after 2 weeks of therapy (VAS dynamics —10.93±2.43 mm, t = 42.64; p<0.001). In both groups we noted gradual significant increase in the average pain level according to VAS and WOMAC indices after NSAIDs cancellation. However, there was better control of pain in 1st group with long-term NSAID than in 2nd one. Safety profile of drug therapy was similar in both groups.

Conclusion. The long-term 8-week use of NSAIDs in patients with knee osteoarthritis with insufficient efficacy “on demand” NSAIDs and SYSADOA provides better dynamics of the pain syndrome than with 2-week therapy. After treatment is canceled longer prior NSAID therapy contributes to better control of the pain syndrome. Continuous use of NSAIDs demonstrated good tolerance and safety, did not require dose reduction and/or discontinuation of therapy. Thus, anti-inflammatory therapy of osteoarthritis in this group of patients may be prescribed for a longer period with continuous use of NSAIDs.

About the authors

B. V. Zavodovskiy

Zborovsky Research Institute of Clinical and Experimental Rheumatology

Email: fake@neicon.ru

Boris V. Zavodovsky — Dr. Sci. (Med.), Professor, Head of Laboratory

Volgograd

Russian Federation

E. V. Papichev

Zborovsky Research Institute of Clinical and Experimental Rheumatology

Email: fake@neicon.ru

Eugene V. Papichev — Researcher

Volgograd

Russian Federation

L. E. Sivordova

Zborovsky Research Institute of Clinical and Experimental Rheumatology

Author for correspondence.
Email: seeword@mail.ru

Larisa E. Sivordova — Cand. Sci. (Med.), Leading Researcher

Volgograd

Russian Federation

Yu. V. Polyakova

Zborovsky Research Institute of Clinical and Experimental Rheumatology

Email: fake@neicon.ru

Julia V. Polyakova — Cand. Sci. (Med.), Senior Researcher

Volgograd

Russian Federation

Yu. R. Akhverdyan

Zborovsky Research Institute of Clinical and Experimental Rheumatology

Email: fake@neicon.ru

Yuri R. Akhverdyan — Cand. Sci. (Med.), Senior Researcher

Volgograd

Russian Federation

References

  1. Hochberg M.C., Martel-Pelletier J., Monfort J., Möller I., Castillo J.R., Arden N. et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. 2016;75(1):37-44. doi: 10.1136/annrheumdis-2014-206792.
  2. Балабанова Р.М., Эрдес Ш.Ф. Динамика распространенности ревматических заболеваний, входящих в XIII класс МКБ-10, в популяции взрослого населения Российской Федерации за 2000-2010 гг. Научно-практическая ревматология. 2012;50(3):10-12. doi: 10.14412/1995-4484-2012-702.
  3. Галушко Е.А., Большакова Т.В., Виноградова И.Б., Ivanova O.N., Лесняк О.М., Menshikova L.V. и др. Структура ревматических заболеваний среди взрослого населения России по данным эпидемиологического исследования. Научно-практическая ревматология. 2009;47(1):11-17. doi: 10.14412/1995-4484-2009-136.
  4. Murray C.J., Vos T., Lozano R., Naghavi M., Flaxman A.D., Michaud C. et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-2223. doi: 10.1016/S0140-6736(12)61689-4.
  5. Comas M., Sala M., Roman R., Hoffmeister L., Castells X. Impact of the distinct diagnostic criteria used in population-based studies on estimation of the prevalence of knee osteoarthritis. Gac Sanit. 2010;24(1):28-32. doi: 10.1016/j.gaceta. 2009.06.002.
  6. Алексеева Л.И., Таскина Н.Г., Кашеварова Е.А. Остеоартрит: эпидемиология, классификация, факторы риска и прогрессирования, клиника, диагностика лечение. Современная ревматология. 2019;13(2): 9-21. doi: 10.14412/1996-7012-2019-2-9-21.
  7. Каратеев А.Е., Лила А.М. Остеоартрит: современная клиническая концепция и некоторые перспективные терапевтические подходы. Научно-практическая ревматология. 2018;56(1):70-81. doi: 10.14412/1995-4484-2018-70-81.
  8. Ахвердян Ю.Р., Заводовский Б.В. Полякова Ю.В. Сивордова Л.Е. Зборовская И.А. Никотинамидфосфорибозилтрансфераза как маркёр системного воспаления при остеоартрозе. Клиническая лабораторная диагностика. 2017;62(10):606-610. doi: 10.18821/0869-2084-2017-62-10-606-610.
  9. Симакова Е.С., Заводовский Б.В., Сивордова Л.Е., Полякова Ю.В., Кравцов В.И., Зборовский А.Б. Прогностическое значение нарушений липидного обмена в патогенезе остеоартроза. Вестник Российской военно-медицинской академии. 2013;42(2):29-32.
  10. Reginster J.Y., Dudler J., Blicharski T., Pavelka K. Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT). Ann Rheum Dis. 2017;76(9):1537-1543. doi: 10.1136/annrheumdis-2016-210860.
  11. Scott D.L., Berry H., Capell H., Coppock J., Daymond T., Doyle D.V. et al. The long-term effects of non-steroidal anti-inflammatory drugs in osteoarthritis of the knee: a randomized placebo-controlled trial. Rheumatology (Oxford). 2000;39(10):1095-1101.
  12. Гайдукова И.З., Ребров А.П. Эффективность и безопасность различных режимов назначения эторикоксиба у пациентов c аксиальным спондилоартритом, включая анкилозирующий спондилит. Терапевтический архив. 2015;87(3):77-82. doi: 10.17116/terarkh201587377-82.
  13. Polyakova Yu.V., Sivordova L.E., Papichev E.V., Akhverdyan Yu.R., Zavodovsky B.V., Korolik O.D. Application of avocado/soybean unsaponifiables in osteoarthritis in real clinical practice. Osteoporosis Int. 2018;29(S1):305.
  14. Полякова Ю.В., Сивордова Л.Е., Симакова Е.С., Кравцов В.И., Кравцова Е.Г., Заводовский Б.В. Опыт применения препарата Немулекс в лечении суставного синдрома при остеоартрозе. РМЖ. 2013;21(6):310-312.
  15. Заводовский Б.В., Сивордова Л.Е., Полякова Ю.В., Ахвердян Ю.Р., Кузнецова М.И., Зборовская И.А. Сравнительная эффективность и безопасность эторикоксиба и мелоксикама в лечении больных гонартрозом. Терапевтический архив. 2016;88(12):78-81. doi: 10.17116/terarkh2016881278-81.
  16. Сивордова Л.Е., Заводовский Б.В., Полякова Ю.В., Ахвердян Ю.Р. Доказательства целесообразности применения эторикоксиба в терапии остеоартроза у пациентов старших возрастных групп. Успехи геронтологии. 2016;29(2):286-290.
  17. Pelletier J.P., Martel-Pelletier J., Rannou F., Cooper C. Efficacy and safety of oral NSAIDs and analgesics in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016;45(4 Suppl):S22-27. doi: 10.1016/j.semarthrit.2015.11.009.

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