Tula, Tula, Russian Federation
Russian Federation
Tula, Tula, Russian Federation
UDK 61 Медицина. Охрана здоровья
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
osteoarthritis, cardiovascular pathology, comorbidity, pain syndrome, collagen, plexatron
1. Kadam U.T. Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales / U.T. Kadam, K. Jordan, P.R. Croft // Ann Rheum Dis. - 2004. - Vol. 63. 408-414.
2. Comorbid Conditions in the AMICA Study Patients: Effects on the Quality of Life and Drug Prescriptions by General Practitioners and Specialists. / Caporali R. [et al.] // Sem Arthr Rheum. - 2005. - Vol. 35. - Issue 1. - Suppl. 1. - P. 31-37.
3. Comorbidity of chronic diseases in general practice / Schellevis FG [et al.] // J Clin Epidemiol. - 1993.-Vol. 46.-№5.-P. 469-473.
4. Osteoartroz v praktike vracha terapevta // L.I. Alekseeva [i dr.] // RMZh. -2008. - T.16, №7. - S.476.
5. Johnson A., Nguyen T., Day R. Do nonsteroidal anti-inflammatory drugs affect blood pressure? Ann Intern Med 1994;121:289-300.
6. Sowers J.R., White W.B., Pitt B. et al.; Celecoxib Rofecoxib Efficacy and Safety in Comorbidities Evaluation Trial (CRESCENT) Investigators. The effects of cyclooxygenase-2 inhibitors and nonsteroidal anti-inflammatory therapy on 24-hour blood pressure in patients with hypertension, osteoarthritis, and type 2 diabetes mellitus. Arch Intern Med 2005;165(2):161-8.
7. Schwartz J.I., Thach C., Lasseter K.C. et al. Effects of etoricoxib and comparator nonsteroidal anti-inflammatory drugs on urinary sodium excretion, blood pressure, and other renal function indicators in elderly subjects consuming a controlled sodium diet. J Clin Pharmacol 2007;47(12):1521-31.
8. Anichkov D.A., Shostak N.A. Sutochnyy profil' arterial'nogo davleniya u bol'nyh metabolicheskim sindromom i osteoartrozom na fone terapii nesteroidnymi protivovospalitel'nymi preparatami. //Klin med 2004;82(12):27-30.
9. Reitblat T., Zamir D., Estis L. et al. The different patterns of blood pressure elevation by rofecoxib and nabumetone. J Hum Hypertens 2002;16:431-4.
10. Mukherjee D. Nonsteroidal anti-inflammatory drugs and the heart: what is the danger? Congest Heart Fail 2008;14(2):75-82.
11. Patrignani P., Capone M.L., Tacconelli S. NSAIDs and cardiovascular disease. Heart 2008;94(4):395-7.
12. Alekseeva L.I. Sovremennye podhody k lecheniyu osteoartroza. // Russkiy medicinskiy zhurnal. - 2003. - № 11 (4). - S. 201-205.
13. Branco JC, Rodrigues AM, Gouveia N, et al. Prevalence of rheumatic and musculoskeletal diseases and their impact on healthrelated quality of life, physical function and mental health in Portugal: results from EpiReumaPt - a national health survey. RMD Open. 2016 Jan 19;2(1):e000166. doi:https://doi.org/10.1136/rmdopen-2015-000166.
14. Revmatologiya: nacional'noe rukovodstvo. Pod red. E.L. Nasonova, V.A. Nasonovoy. M.: GEOTAR-Media, 2008;573-88.
15. Jordan K. M., Arden N. K., Doherty M., Bannwarth B., et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT) Ann Rheum Dis 2003; 62:1145-1155.
16. Zhang W., Doherty M., Arden N., Bannwarth B., et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) Ann Rheum Dis 2005; 64:669-681.
17. Karpov Yu.A., Kulikova T.Yu. Nesteroidnye protivovospalitel'nye preparaty: voprosy serdechnososudistoy bezopasnosti. //Aktual'nye voprosy bolezney serdca i sosudov. 2010; 4: 60-65.
18. Osteoartroz kak faktor riska kardiovaskulyarnyh katastrof // O.I. Mendel' [i dr.] // RMZh, Nevrologiya 2007. - Tom 15, № 23. -S. 1 -5.
19. Nasonov E.J1. Kardiovaskulyarnye problemy v revmatologii // E.L. Nasonov, T.V. Popkova // Nauchno-prakticheskaya revmatologiya - 2004. -№4.- S. 4-9.
20. Randelli F., Menon A. i dr. Vliyanie MD-COLLAGEN na morfofunkcional'nye svoystva kul'tiviruemyh tenocitov cheloveka.//Pleksatron. Sbornik nauchnyh materialov, 2021. - S. 53-64.
