[Modern therapy of osteoarthrosis--pathogenetic substantiation].
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Biomedical subjects
Publications and source records attributed to E S Tsvetkova.
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AIM: Response and tolerance study of a novel nonspecific antiinflammatory drug meloxikam (movalis) in patients with osteoarthrosis (OA). MATERIALS AND METHODS: 630 OA patients entered a multicenter trial in 29 hospitals. Movalis was given in a dose 7.5 mg or 15 mg (groups 1 and 2, respectively). In poor response the dose 7.5 mg was raised to 15 mg. The course of treatment took 2-4 weeks. The effect was assessed in scores by changes in the complaints. RESULTS: Movalis has a significant antiinflammatory and analgetic effect, improved joint function, diminished severity of arthralgia and synovitis. Side effects were occasional. CONCLUSION: Movalis introduction in wide rheumatological practice will raise effectiveness of OA treatment and reduce the risk of side effects.
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A 2-week clinical trial of cream dolgit efficacy and tolerance in 76 patients with primary osteoarthritis in 8 rheumatological centers showed this preparation to reduce local pain syndrome in 70.1%, palpation pain sensitivity in 79.2%, joint swelling in 75.5% of patients. Unwanted reactions in the form of skin itch at the site of application were reported in 7.8% of cases.
Diclonate P (sodium diclofenac, Pliva, Zagreb) was used in the treatment of 74 patients with rheumatoid arthritis as the basic antirheumatic drug. Analgesic and antiinflammatory activity and good tolerance of three dosage forms (tablets, suppositories, ampoules) of diclonate P were established on a statistically significant basis. In some parameters the drug compares very favourably with its chemical analogs.
Based on an analysis of the current data on the pathogenesis of osteoarthrosis, the authors provide evidence for the importance of chondroprotective therapy. Present comparative experimental and clinical (tentative) data on the efficacy of chondroprotective drugs.
A study was made of a possibility of estimating the efficacy of hospital therapy of patients suffering from rheumatoid arthritis (RA) using the modified Stanford health assessment questionnaire. The general functional index (GFI) derived on the basis of the questionnaire was found to be in good agreement with a number of the commonly accepted indicators in rheumatology: Richi's articular index, the swelling index, the power of pain in accordance with the visual analog scale, hand force as well as with the psychological and social characteristics. The GFI was shown to decrease significantly after the treatment carried out under hospital conditions together with a decrease of pain and the articular index (p less than 0.001) both in grave RA patients with an unfavorable functional and work fitness prognosis and in patients with milder RA, having a favourable prognosis. It is recommended that the GFI may be used for estimating the efficacy of the treatment in addition to other indicators and measurements.
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Study of the comparative efficacy of the basic slow-acting drugs for the treatment of rheumatoid arthritis permits considering randomization as necessary for obtaining objective data. It has been established that gold salts (chrisanol and myochrysin) are the most efficacious drugs for the treatment of RA. D-Penicillamine and delagil, in particular, are less efficacious. Administration of levamisole is rather dangerous because of the frequency and intensity of side effects.
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