REMEDIUMREMEDIUM1561-59362658-3534Joint-Stock Company Chicot94510.21518/1561-5936-2020-4-5-6-42-52Original ArticleUpdated recommendations of the American College of rheumatology for the management of patients with osteoarthritisShavlovskayaO. A.noemail@neicon.ruNaumovA. V.noemail@neicon.ruFirst Moscow State Medical University named after I.M. Sechenov (Sechenov University)N.I. Pirogov Russian National Research Medical UniversityRussian Clinical and Research Center of Gerontology N.I. Pirogov Russian National Research Medical University041220204-6425218032022Copyright © 2020,2020In the complex therapy of osteoarthritis (OA), both medicinal and non-medicinal methods are used. In Russia, they are guided by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). According to the recommendations of the American College of Rheumatology American College (ACR) in 2019, new approaches to OA therapy are proposed. Each of the methods of treatment, non-drug (changes in physical activity, body weight correction, kinesiotaping, wearing orthoses, acupuncture) and medication (non-steroidal anti-inflammatory drugs (NSAIDs), chondroprotectors), was evaluated. The appointment of chondroprotetcors (CP) - SYmptomatic Slow Acting Drugs for OsteoArthritis (SYSADOA) is being actively discussed. To chondroprotectors are preparations of chondroitin sulfate (CS) and glucosamine sulfate (GS). Proponents of CS and GS prescribing rely on numerous clinical studies that confirm the clinical efficacy and safety of CP. A randomized blind multicenter placebo-controlled clinical trial was conducted to study the efficacy and safety of Sustagard Artro for patients with parenteral knee OA (400 mg every other day for 6 weeks). An open randomized multicenter study to evaluate the effectiveness and safety of Chondrogard in various administration methods in patients with knee OA. The advantages were noted in the group of combined treatment (intravenous administration + subsequent intravenous administration). With any method of administration, the drug quickly and effectively reduced pain and stiffness, improved the functional state of the joints and with a high safety profile. There was a decrease in the need for NSAIDs.GRADESYSADOAosteoarthritisrecommendationsGRADEpain syndromeSYSADOAchondroprotectorschondroitin sulfateChondroguardglucosamine sulfateSustaguard Artroостеоартритрекомендацииболевой синдромхондропротекторыхондроитина сульфатХондрогардглюкозамина сульфатСустагард Артро1.Cisternas M.G., Murphy L., Sacks J.J., Solomon D.H., Pasta D.J., Helmick C.G. Alternative methods for defining osteoarthritis and the impact on estimating prevalence in a US population-based survey. Arthritis Care Res (Hoboken). 2016;68(5):574-580. doi: 10.1002/acr.22721.2.Forget P. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603-1658. doi: 10.1016/S0140-6736(16)31460-X.3.Murphy L., Schwartz T.A., Helmick C.G., Renner J.B., Tudor G., Koch G. et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207-1213. doi: 10.1002/art.24021.4.Murphy L.B., Helmick C.G., Schwartz T.A., Renner J.B., Tudor G., Koch G.G. et al. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010;18(11):1372-1379. doi: 10.1016/j.joca.2010.08.005.5.Qin J., Barbour K.E., Murphy L.B., Nelson A.E., Schwartz T.A., Helmick C.G. et al. Lifetime risk of symptomatic hand osteoarthritis: the Johnston County Osteoarthritis Project. Arthritis Rheumatol. 2017;69(6):1204-1212. doi: 10.1002/art.40097.6.Nuesch E., Dieppe P., Reichenbach S., Williams S., Iff S., Juni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ. 2011;342(2):1165. doi: 10.1136/bmj.d1165.7.Хитров Н.А. Остеоартроз. Медицинский совет. 2011;(11-:132-139. Режим доступа: https://www.elibrary.ru/item. asp?id=18751359&.8.Bruyere O., Honvo G., Veronese N., Arden N.K. et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019;49(3):337-350. doi: 10.1016/j.semarthrit.2019.04.008.9.Kolasinski S.L., Neogi T., Hochberg M.C., Oatis C. et al. 2019 American College of Rheumatology / Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi: 10.1002/acr.24131.10.Martel-Pelletier J., Farran A., Montell E. et al. Discrepancies in composition and biological effects of different formulations of chondroitin sulfate. Molecules. 2015;20(3):4277-4289. doi: 10.3390/ molecules20034277.11.Jerosch J. Effects of Glucosamine and Chondroitin Sulfate on Cartilage Metabolism in OA: Outlook on Other Nutrient Partners Especially Omega-3 Fatty Acids. International Journal of Rheumatology. 2011;2011:969012. doi:10.1155/2011/969012.12.Honvo G., Bruyère O., Geerinck A., Veronese N., Reginster J.-Y. Efficacy of chondroitin sulfate in patients with knee osteoarthritis: a comprehensive meta-analysis exploring inconsistencies in ran- domized, placebo-controlled trials. Adv Ther. 2019;36(5):1085. doi: 10.1007/s12325-019-00921-w.13.Bruye`re O., Cooper C., Pelletier J.P. et al. A consensus statement on the european society for clinical and economic aspects of osteo- porosis and osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-from evidence-based medicine to the real- life setting. Semin Arthritis Rheum. 2016;45(4):S3-11. doi: 10.1016/j. semarthrit.2015.11.010.14.Bruye`re O., Cooper C., Al-Daghri N.M., Dennison E.M., Rizzoli R., Reginster J.Y. Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res. 2018;30(2):111-117. doi: 10.1007/s40520-017-0861-1.15.Алексеева Л.И., Шарапова Е.П., Кашеварова Н.Г. и др. Сравнительное исследование эффективности и безопасности препарата Хондрогард® при комбинированном (внутрисуставное и внутримышечное) и внутримышечном введении у пациентов с остеоартритом коленных суставов. Современная ревматология. 2018;12(2):44-49. doi: 10.14412/1996- 7012-2018-2-44-49.16.Наумов А.В., Шаров М.Н., Ховасова Н.О., Прокофьева Ю.С. Результаты применения интермиттирующей схемы парентерального введения хондроитина сульфата и глюкозамина сульфата в старт-терапии хронической боли в суставах и спине у коморбидных пациентов. РМЖ. 2018;4(II):47-54. Режим доступа: https://www.rmj.ru/articles/nevrologiya/Rezulytaty_primen- eniya_intermittiruyuschey_shemy_parenteralynogo_vvedeniya_ hondroitina_sulyfata_i_glyukozamina_sulyfata_v_start-terapii_ hronicheskoy_boli_v_sustavah_i_spine_u_komorbidnyh_pacien- tov/.17.Zhang W., Nuki G., Moskowitz R.W. et al. OARSI recommenda- tions for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil. 2010;18(4):476-499. doi: 10.1016/j.joca.2010.02.011.18.Bjordal J.M., Klovning A., Ljunggren A.E. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a meta-analysis of randomised placebo-controlled trials. Eur J Pain. 2007;11(2):125-138. doi: 10.1016/j.ejpain.2006.02.013.19.Herrero-Beaumont G., Ivorra J.A., Del Carmen Trabado M. et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007;56(2):555-567. doi: 10.1002/art.22371.20.Reginster J.Y., Deroisy R., Rovati L.C. et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001;357(9252):251-256. doi: 10.1016/s0140-6736(00)03610-2.21.Pavelka K. Gatterova J., Olejarova M. et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, ran- domized, placebo-controlled, double-blind study. Arch Intern Med. 2002;162(18):2113-2123. doi: 10.1001/archinte.162.18.2113.22.Pontes C., Marsal J.R., Elorza J.M., Aragón M., Prieto-Alhambra D., Morros R. Analgesic use and risk for acute coronary events in patients with osteoarthritis: a population-based, nested case-con- trol study. Clinical Therapeutics. 2018;40(2): 270-283. doi: 10.1016/j. clinthera.2017.12.011.23.Васильева Л.В., Евстратова Е.Ф., Никитин А.В. Эффективность лечения глюкозамин сульфатом (Сустагард Артро) больных остеоартритом в поликлинических условиях. Фарматека. 2016;(13):21-25. Режим доступа: https://elibrary.ru/item. asp?id=27182436.24.Громова О.А., Торшин И.Ю., Лила А.М., Наумов А.В., Рудаков К.В. О безопасности применения глюкозамина сульфата у пациентов с резистентностью к инсулину. Consilium Medicum. 2019;21(4):75-83. doi: 10.26442/20751753.2019.4.190309.25.Bruyere O., Cooper C., Al-Daghri N.M., Dennison E.M. et al. Inappropriate claims from non-equivalent medications in osteo- arthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res. 2017;30(2):111-117. doi: 10.1007/s40520-017-0861-1.26.Bruyere O., Cooper C., Pelletier J.P., Branco J. et al. An algo- rithm recommendation for the management of knee osteoar- thritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum. 2014;44(3):253-63. doi: 10.1016/j.semarthrit.2014.05.014.27.Maheu E., Rannou F., Reginster J.Y. Efficacy and safety of hyaluronic acid in the management of osteoarthritis: evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016;45(4):28-33. doi: 10.1016/j.semarthrit.2015.11.008.28.Cooper C., Rannou F., Richette P., Bruyere O., Al-Daghri N. et al., Use of intraarticular hyaluronic acid in the management of knee osteoarthritis in clinical practice. Arthritis Care Res (Hoboken). 2017;69(9):1287-1296. doi: 10.1002/acr.23204.29.Pelletier J.P., Raynauld J.P., Abram F., Dorais M., Delorme P., Martel-Pelletier J. Exploring determinants predicting response to intra-articular hyaluronic acid treatment in symptomatic knee osteoarthritis: 9-year follow-up data from the Osteoarthritis Initiative. Arthritis Res Ther. 2018;20(1):40. doi: 10.1186/s13075-018- 1538-7.30.Rutjes A.W., Jüni P., da Costa B.R., Trelle S., Nüesch E., Reichenbach S. Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Ann Intern Med. 2012;157(3):180-191. doi: 10.7326/0003-4819-157-3-201208070-00473.31.Алексеева Л.И. Обновление клинических рекомендаций по лечению больных остеоартритом 2019 года. РМЖ. 2019;(4):2-6. Режим доступа: https://elibrary.ru/item.asp?id=38502084.32.Лила А.М., Алексеева Л.И., Таскина Е.А. Современные подходы к терапии остеоартрита с учетом обновленных международных рекомендаций. РМЖ. Медицинское обозрение. 2019;11(II):48-52. Режим доступа: https://www.rmj.ru/articles/ revmatologiya/Sovremennye_podhody_k_terapii_osteoartrita_s_ uchetom_obnovlennyh_meghdunarodnyh_rekomendaciy/33.Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г. Остеоартрит: эпидемиология, классификация, факторы риска и прогрессирования, клиника, диагностика, лечение. Современная ревматология. 2019;13(2):9-21. doi: 10.14412/1996- 7012-2019-2-9-21.34.Шавловская О.А., Романов И.Д., Артеменко А.Р. Лечение неспецифической боли в спине и остеоартрита комбинацией инъекционных форм хондропротекторов. РМЖ. Медицинское обозрение. 2019;11(I):6-12. Режим доступа: https://www.rmj.ru/ articles/bolevoy_sindrom/Lechenie_nespecificheskoy_boli_v_ spine_i_osteoartrita_kombinaciey_inyekcionnyh_form_hondro- protektorov/.35.Наумов А.В., Ховасова Н.О., Мороз В.И., Ткачева О.Н., Шавловская О.А. Клиническое значение и возможности терапии остеоартрита у пациентов со старческой астенией. Терапевтический архив. 2019;91(12):42-48. doi: 10.26442/0040366 0.2019.12.000487.