The use of anticonvulsant pregabalin in rheumatologist practice: therapy of knee osteoarthritis
Filatova E.S., Turovskaya E.F., Alekseeva L.I.

Scientific Research Institute of Rheumatology named after V.A. Nasonova, Moscow
The main manifestation of osteoarthritis (OA) of the knee joints is chronic pain syndrome. It reduces the quality of life of patients, forcing them to seek treatment.
Aim: To evaluate the efficacy of pregabalin in patients with knee osteoarthritis.
Patients and Methods: 60 patients with OA of knee joints with a neuropathic pain component (DN4> 4) were included in the study. The patients are divided by the random numbers method into two groups: 1-st group – received therapy with aceclofenac; 2nd group - received aceclofenac + pregabalin for 5 weeks. All the patients included in the study had clinical and neurological examination with assessment of WOMAC functional index, pain intensity at movement, the diagnosis of neuropathic pain (NP) (by questionnaire DN4 and Pain DETECT), pain intensity according to the VAS at rest.
Results: the patients of group 1 had a more severe and prolonged course of the disease, a more pronounced neuropathic component of the pain syndrome (NCPS), however, radiologic changes in the joints, pain intensity according to the VAS (both at rest and at movement), quality of life, the severity of anxiety and depression on the hospital scale were the same in both groups. The study showed a positive dynamics in both groups regarding the NCPS, but complex therapy with the use of a drug from the group of anticonvulsants (pregabalin) showed a more significant positive effect not only in relation to NCPS, but also with respect to functional activity (according to WOMAC) and the severity of pain according to the VAS.
Conclusion: patients with OA of knee joints should be examined before beginning the therapy for central sensitization using questionnaires of neuropathic pain (DN4). Complex therapy with anticonvulsants in patients with OA of knee joints with signs of NP allows not only to effectively reduce the severity of the pain syndrome, but also to improve the functional activity of patients, and therefore, the quality of life.

Key words: osteoarthritis of knee joints, chronic articular pain, neuropathic pain component, pregabalin, aceclofenac.
For citation: Filatova E.S., Turovskaya E.F., Alekseeva L.I. The use of anticonvulsant pregabalin in rheumatologist practice: therapy of knee osteoarthritis // RMJ. 2017. № 25. P. 1893–1897.