Topical issues concerning the choice of basic therapy for osteoarthritis

L.N. Eliseeva, M.I. Bocharnikova, A.Yu. Blednova, O.A. Zhikhareva

Kuban State Medical University, Krasnodar

Aim: to retrospectively evaluate the efficacy and safety of diacerein in the treatment of patients with osteoarthritis.

Patients and Methods: the study involved 28 patients with gonarthrosis and 25 with grade 3–4 coxarthrosis included in the waiting list for total endoprosthesis replacement with an expected surgical intervention period of more than 3–4 months. Diacerein was prescribed at a dose of 50 mg once a day for the first 3–4 weeks, followed by an increase up to 50 mg 2 times a day. Analgesic efficacy was evaluated using a 100 mm visual analog scale (VAS). Safety was assessed by the presence of side effects (including from the gastrointestinal tract) and changes in laboratory parameters.

Results: the average age of patients with coxarthrosis was 62.2±3.4 years, patients with gonarthrosis — 60±4.6 years. The intensity of the pain syndrome, estimated by VAS in the initial state, was 68.3±11.3 mm in patients with coxarthrosis and 70.6±8.8 mm in patients with gonarthrosis. During therapy, the pain severity decreased to 56.0±10.2 and 42.1±9.3 mm, respectively. At the same time, the need for the use of nonsteroidal anti-inflammatory drugs (NSAIDs) decreased from 92.0 to 64.0 % in patients with coxarthrosis and 92.86 to 85.71 % in patients with gonarthrosis. No side effects of diacerein were detected during the pre- and postoperative follow-up. When assessing glycemic and creatinine control with glomerular filtration rate, no changes were found during therapy.

Conclusion: the inclusion of diacerein in complex therapy makes it possible to refuse NSAIDs intake or significantly reduce their dosages while maintaining analgesic and anti-inflammatory effects. The absence of significant side effects and adverse events ensures the safety of diacerein in patients with osteoarthritis and comorbid conditions.

Keywords: osteoarthritis, comorbidity, diabetes me llitus, diacerein, SYSADOA, chondroprotectors.

For citation: Eliseeva L.N., Bocharnikova M.I., Blednova A.Yu., Zhikhareva O.A. Topical issues concerning the choice of basic therapy for osteoarthritis. RMJ. 2021;10:36–40.