Therapy of osteoarthritis in combination with assymptomatic hyperuricemia: results of a pilot study

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Abstract

Combination of osteoarthritis (OA) with hyperuricemia (HU) in patient is a common clinical situation.

The aim of the study was to evaluate the symptom-modifying effect of combination therapy, including an injection course of bioactive concentrate of small marine fish (Alflutop®) and complex urate-lowering therapy (ULT) in OA patients with asymptomatic HU.

Material and methods. The study included 55 patients: complex therapy of 30 of them included an injection course of Alflutop®, 25 others received a standard course of medicines from the oral SYSADOA group. At the second stage, a comparative estimation of the efficacy of combination therapy depending on the duration of observation was performed.

Results. As a result of the performed therapy in both groups, there was a positive development of OA clinical course. At the same time, in patients of the first group, there was fixed a significant pain decrease according to VAS (p=0,000071), while in the second group, the decrease in this index did not reach any statistical significance (p=0,055927). Use of Alflutop® as a component of combination therapy by patients with OA with asymptomatic HU caused a decrease in the need for NSAIDs by 73,7% (p=0,000183). At the same time, in the group of patients treated with oral SYSADOA, NSAID dose reduction was achieved only in 58,8% (p=0,001566) of cases. Use of complex therapy contributed to a significant decrease in the level of uric acid (UA) in the blood serum of the observed individuals from both groups. Along with this, the achievement or preservation of the target values of UA in the blood serum was significantly (p=0,022438) more often observed in the participants of the first group. During an intragroup analysis of patients who received an injection course of Alflutop®, it was found that the reduction in VAS of pain did not reach statistical significance at the observation point corresponding to the 7–9th months of the study (p=0,065288).

Conclusion. Combination therapy, including an injection course of Alflutop® and a complex ULT, leads to decrease of pain syndrome and the need of NSAIDs use in OA patients with asymptomatic HU. At the same time, the efficacy of therapy is more significant in the first 6 months after the start of treatment.

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About the authors

Vadim I. Mazurov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25

Author for correspondence.
Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051

MD, professor, academician of RAS, chief scientific consultant, director of the Research Institute of Rheumatology, head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, head of the Center for autoimmune diseases, Honored Worker of Science of the Russian Federation

Russian Federation, Saint Petersburg; 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

Roman A. Bashkinov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25

Email: bashkinov-roman@mail.ru
ORCID iD: 0000-0001-9344-1304
SPIN-code: 5169-5066

postgraduate student of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, rhemautologist

Russian Federation, Saint Petersburg; 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

Oksana V. Inamova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25

Email: ovig74@mail.ru
ORCID iD: 0000-0001-9126-3639
SPIN-code: 8841-5496

PhD in Medical Sciences, deputy director of the Research Institute of Rheumatology, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, chief physician

Russian Federation, Saint Petersburg; Saint Petersburg

Marianna S. Petrova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25

Email: podagra@bk.ru
ORCID iD: 0000-0001-5261-6614

PhD in Medical Sciences, associate professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, deputy chief physician

Russian Federation, Saint Petersburg; 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

Kira P. Morozova

Clinical Rheumatological Hospital No. 25

Email: kiramorozoba@mail.ru
ORCID iD: 0000-0002-4113-3104

rheumatologist

Russian Federation, 190068, Saint Petersburg, 30 Bol`shaya Pod`yacheskaya Str.

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