Objective: to study the specific features of the symptomatic effect and tolerability of acetaminophen, glucosamine sulfate (GS), chondroitin sulfate (CS), and meloxicam in patents with knee osteoarthritis (OA). Subjects and methods. An 18-month open-label randomized prospective parallel-group trial enrolled 80 patients with knee OA who fulfilled the American College of Rheumatology criteria and signed the informed consent. They had Kellgren and Lawrence grades O-III OA with visual analogue scale pain intensity of ≥ 40 mm in the target knee, a body mass index of ≤ 35 kg/m2, and no clinical dysfunctions of vital organs and systems. The patients were randomized into 4 groups: 1) acetaminophen 2 g daily; 2) a standard GS regimen; 3) a standard CS regimen; 4) meloxicam 15 mg daily. The patients were followed up for 18 months. The effectiveness was evaluated by the WOMAC questionnaire, Leguesne index, and OMERACT-OARSI (D scenario) during 8 visits. Laboratory and clinical examination as well as electrocardiography were performed. Adverse events were recorded during each visit.Results. After 4 weeks of treatment, symptomatic improvement was noted in all groups; however, the best effect was achieved by the use of meloxicam that ensured an obvious improvement in all patients. According to the OMERACT-OARSI criteria and changes in the WOMAC and Leguesne indices, the total efficacy of meloxicam was also highest. 20, 10, and 15% of the patients failed to respond to treatment in the acetaminophen, GS, and CS groups, respectively. Conclusion. The results of this trial suggest that it is expedient to use GS, CS, and meloxicam long, support the recent guidelines of the European Society for Clinical and Economic Aspects of Osteoporosis and OA (ESCEO), and can give proofs of the efficiency and safety of GS, CS, and meloxicam used in the treatment of knee OA.

Objective: to analyze changes of serum calprotectin (CP) concentration, its relationship to the clinical and laboratory parameters of rheumatoid arthritis (RA) activity, and the significance of baseline CP level for predicting therapeutic response in RA patients treated with etanercept (ETC).Subjects and methods. A total of 84 patients with moderate and high RA activity (mean DAS28 6.35±0.92) who had been ineffectively treated with disease-modifying antirheumatic drugs were examined. The patients received ETC 50 mg/week subcutaneously for 34 weeks. To assess RA activity, tender and swollen joint count, pain, patient’s and physician’s assessment of global disease activity on 100-mm visual analogue scale and DAS28 were used. Functional status was evaluated by HAQ and RAPID3. Treatment efficacy was assessed according to the European League against Rheumatism (EULAR) criteria and the American College of Rheumatology (ACR) criteria. Serum concentration of CP was tested before, 12 and 25 weeks after start of therapy.Results and discussion. There was a statistically significant (p < 0.0001) decrease in CP concentrations after 12 weeks of ETC therapy. Later (after 25 weeks) CP level remained essentially unchanged. CP concentration correlated with erythrocyte sedimentation rate, C-reactive protein level, swollen joint count, and DAS28. Baseline CP level was not a predictor for achieving the therapeutic response according to the EULAR and ACR criteria. In a group of patients unresponsive to treatment according to the EULAR criteria, CP levelrose at 25 weeks whereas it fell during clinical improvement. In the patients achieving ACR 50 and 70% response, changes of CP level were significantly better than those in the other patients.Conclusion. ETC therapy caused a considerable reduction of CP level, clinical and laboratory parameters of RA activity. The baseline concentration of CP was not a predictor for achieving the response to ETC treatment.

Objective. To study efficacy and safety of the knee osteoarthritis treatment with hyaluronic acid preparation “Ostenil administered according to two dosing regimens 3 or 5 intra-articular injections performed with weekly intervals in a randomized controlled masked multicenter one year study. Material and methods. 140 pts with primary knee osteoarthritis of l-lll radiological stage were included in 7 centers of Russia. Group 1 pts received 5 Ostenil injections and group 2 pts 3 Ostenil injections with subsequent 2 masked injections of lidokain 2%. An independent investigator assessed efficacy with WOMAK skale before the treatment, in 1,5, 3,6, 9 and 12 months after treatment course completion. Results. 3 and 5 Ostenil intra-articular injections provided fast and significant improvement in 65-70% of pts with knee osteoarthritis. Effect of a single treatment course was lasted for at least one year in 45-50% of pts. Wfe did not reveal any differences in degree and duration of clinical improvement in pts received 3 and 5 injections. Our pts did not have serious adverse events connected with Ostenil administration. Conclusion. The study confirmed high efficacy of Ostenil in the treatment of knee osteoarthritis. Difference in improvement duration after 5 and 3 Ostenil injections was not revealed

Objective. To compare efficacy and tolerability of two glucosamin sulfate (GS) therapy schemes 1500 mg/day orally (group I) and combination of 1500 mg/day orally with 400 mg/day intramuscularly trice a week during the first 3 weeks (group II) in an open randomized prospective study in 60 pts with knee joint osteoarthritis (KJOA). Material and methods. Pts were followed up during 6 weeks of treatment and 2 weeks afterwards. Following parameters were recorded: pain intensity on Likert scale, overall activity assessment (separately by pt and physician), pain intensity, morning stiffness duration and functional activity on WOMAC questionnaire in mm on visual analog scale (VAS), pain intensity at rest, start up pain at week 3, 6 and 8, synovitis activity, time of therapy effect achieving. Results. Knee joint pain decrease was noted during treatment in both groups. In group II significant improvement was achieved after 3 weeks and in group I at week 6. Aftereffect of DONA was noted in both groups. Significant decrease of WOMAC index was noted after 3 weeks in group II and only at week 6 in group I, Combined administration of GS two forms allowed to decrease stiffness and improve functional activity to a greater extent than isolated treatment with sachet. Fast analgesic and antiinflammatory effect of combined treatment with DONA was showed to be superior to isolated oral treatment. GS dose elevation did not cause increase of frequency and degree of adverse events. High efficacy and good tolerability of oral and intramuscular DONA administration was proved. Conclusion. Administration of DONA different forms (ampoules and sachet) contributes to fast clinical effect achievement in pts with KJOA.