Evaluation of the efficacy and safety of a combination of chondroitin sulfate and glucosamine sulfate for knee and hip osteoarthritis in real clinical practice

2020 ◽  
Vol 14 (4) ◽  
pp. 82-90
Author(s):  
A. E. Karateev ◽  
Yu. V. Barysheva ◽  
Ya. V. Belokon ◽  
T. Yu. Bolshakova ◽  
Yu. Yu. Grabovetskaya ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Chondroitin Sulfate ◽  
Hip Osteoarthritis ◽  
Glucosamine Sulfate ◽  
New Drugs ◽  
Observational Research ◽  
Efficacy And Safety ◽  
Safety Level ◽  
Lequesne Index ◽  
Joint Health

A combination of chondroitin and glucosamine is widely used in clinical practice as both a symptomatic and structure-modifying agent for the treatment of osteoarthritis (OA). The emergence of new drugs based on this combination substantially expands treatment options for OA therapy.Objective: to evaluate the efficacy and safety of Artroflex® that is a combination of chondroitin sulfate 400 mg and glucosamine sulfate 500 mg (CS + GS) to support joint health in patients with knee and/or hip OA.Patients and methods. When implementing an open observational research program, the results of using the CS + GS complex were assessed in 644 OA patients (74.7% women) (mean age, 58.0±14.6 years) who experienced moderate/severe pain and required to continuously take non-steroidal anti-inflammatory drugs (NSAIDs). The CS + GS complex was prescribed in a dose of 2 capsules per day for 3 months. The investigators estimated changes in pain on movement by a 0 to 10 verbal pain scale, general health (GH) by a 0–10 visual analogue scale), the Lequesne index, the need for NSAIDs, and patient satisfaction with treatment and its tolerance.Results and discussion. After 3-month therapy, there were decreases in pain intensity by 49.2±16.8%, GH scores by 45.6±18.1%, the Lequesne index from 9.0 [6.0; 13.0] to 5.0 [3.0; 9.0]; less than half (45.2%) of the patients still needed for NSAIDs. 82.2% of patients were satisfied or completely satisfied with treatment results; 89.6% reported good treatment tolerance.Adverse events (apparently associated with NSAID use) were recorded in 2.2% of cases. There were no serious complications that required CS + GS treatment discontinuation or hospitalization.Conclusion. The findings have indicated that Artroflex® used to support joint health is an effective agent that controls OA symptoms and has a good safety level.

scholarly journals Clinical Relevance of Target Identity and Biology

2013 ◽  
Vol 18 (10) ◽  
pp. 1164-1185 ◽  
Author(s):  
Anand C. Patel
Keyword(s):  
Clinical Practice ◽  
Drug Target ◽  
Target Identification ◽  
New Drugs ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Prescribing Behavior ◽  
Lower Productivity ◽  
Drug Choice ◽  
Significant Factors

Many of the most commonly used drugs precede techniques for target identification and drug specificity and were developed on the basis of efficacy and safety, an approach referred to as classical pharmacology and, more recently, phenotypic drug discovery. Although substantial gains have been made during the period of focus on target-based approaches, particularly in oncology, these approaches have suffered a high overall failure rate and lower productivity in terms of new drugs when compared with phenotypic approaches. This review considers the importance of target identity and biology in clinical practice from the prescriber’s viewpoint. In evaluating influences on prescribing behavior, studies suggest that target identity and mechanism of action are not significant factors in drug choice. Rather, patients and providers consistently value efficacy, safety, and tolerability. Similarly, the Food and Drug Administration requires evidence of safety and efficacy for new drugs but does not require knowledge of drug target identity or target biology. Prescribers do favor drugs with novel mechanisms, but this preference is limited to diseases for which treatments are either not available or suboptimal. Thus, while understanding of drug target and target biology is important from a scientific perspective, it is not particularly important to prescribers, who prioritize efficacy and safety.

scholarly journals Efficacy of Chondroitin Sulfate in Patients with Knee and Hip Osteoarthritis

2021 ◽  
Vol 15 (4) ◽  
pp. 120-125
Author(s):  
E. P. Sharapova ◽  
E. A. Taskina ◽  
N. G. Kashevarova ◽  
L. I. Alekseeva ◽  
A. M. Lila
Keyword(s):  
Back Pain ◽  
Chondroitin Sulfate ◽  
Hip Osteoarthritis ◽  
Rapid Onset ◽  
Nsaid Therapy ◽  
Efficacy And Safety ◽  
Inflammatory Drugs ◽  
Domestic Practice ◽  
Short Time

Currently chondroitin sulfate (CS) is the most studied drug from the group of «chondroprotectors». The article shows the role of CS in the treatment of osteoarthritis (OA): mechanism of action, clinical efficacy and safety in patients with OA with comorbidity. Evidence for the effectiveness and safety of the use of CS has been analyzed. The place of this drug in Russian and international clinical guidelines for the management of patients with OA is discussed.In domestic practice, the parenteral form of CS is often used in patients with OA. The parenteral form of CS for intramuscular and intra-articular administration (Chondroguard®) has a number of advantages, including the rapid onset of the effect. This enables reducing the dose in a short time or completely abandon the use of non-steroidal anti-inflammatory drugs (NSAIDs), which is extremely important for patients with OA with comorbidity. Chondroguard® can be recommended for initial use in exacerbations of chronic joint and back pain in OA, including in patients with relative and absolute contraindications for NSAID therapy.

scholarly journals Therapeutic possibilities of topical corticosteroids in modern clinical practice

2020 ◽  
pp. 36-45
Author(s):  
T. A. Belousova ◽  
M. V. Kail
Keyword(s):  
Clinical Practice ◽  
Subcutaneous Tissue ◽  
Import Substitution ◽  
New Drugs ◽  
Advanced Technology ◽  
Efficacy And Safety ◽  
Topical Corticosteroids ◽  
Number Of Patients ◽  
History Of ◽  
History Of Use

Over the past decade, dermatological practice has seen an increase in the number of patients suffering from skin and subcutaneous tissue diseases. Annually, 6.4-6.9 million new cases of this group of diseases are registered, which encourages the constant search for new drugs and the continuous improvement of methods and schemes of application of proven drugs. Topical corticosteroids, despite more than 65 years of history of use in the treatment of patients with steroid-sensitive dermatoses, have not lost their relevance. At present, they have no therapeutic alternative in terms of speed of onset and anti-inflammatory activity, so they are essential in the treatment of many skin pathologies. One of the trends in modern pharmacology is not so much the production of new active molecules of TCS or their modifications, as the creation of new pharmacological forms of known molecules - micronized, nanonized, which give the drug the most important property -increased bioavailability. This advanced technology is actively used in the production of domestic topical drugs of Akriderm lines, which make a major contribution to the program of import substitution and drug availability for the population. The optimal combination of ingredients of the foundation of these drugs complements and potentiates the therapeutic effect of steroid. For more than 30 years in clinical practice, a combination of 0.05% betamethasone dipropionate, 0.1% gentamicin sulfate and 1% clotrimazole (Triderm, Akriderm GK) is used. Many years of positive clinical experience of dermatologists using this fixed combination proves the validity of its use in many clinical situations when bacterial and fungal infection is involved. An open randomized comparative study conducted by Russian dermatologists on the efficacy and safety of Akriderm GK (cream) and Triderm (cream) in the complex treatment of eczema showed similar profiles of high clinical efficacy and safety of both drugs.

Molecular Weight of Hyaluronic Acid Has Major Influence on Its Efficacy and Safety for Viscosupplementation in Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Cartilage ◽  
2021 ◽  
pp. 194760352110219
Author(s):  
Yen-Zung Wu ◽  
Hsuan-Ti Huang ◽  
Cheng-Jung Ho ◽  
Chia-Lung Shih ◽  
Chung-Hwan Chen ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Adverse Effects ◽  
High Molecular Weight ◽  
Meta Analysis ◽  
Hip Osteoarthritis ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Lequesne Index

Background This study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA). Methods A systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3. Results A total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%). Conclusion Among different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.

scholarly journals Initial Experience of the Levodopa–Entacapone–Carbidopa Intestinal Gel in Clinical Practice

2021 ◽  
Vol 11 (4) ◽  
pp. 254
Author(s):  
Mezin Öthman ◽  
Erik Widman ◽  
Ingela Nygren ◽  
Dag Nyholm
Keyword(s):  
Cardiac Arrest ◽  
Clinical Practice ◽  
Observational Study ◽  
Prospective Studies ◽  
Infusion Rate ◽  
Treatment Duration ◽  
Initial Experience ◽  
Morning Dose ◽  
Efficacy And Safety ◽  
User Friendliness

Patients in fluctuating stages of Parkinson’s disease (PD) require device-aided treatments. Continuous infusion of levodopa–carbidopa intestinal gel (LCIG) is a well-proven option in clinical practice. We now report the first clinical experience of levodopa–entacapone–carbidopa intestinal gel (LECIG) therapy. An observational study of the first patients to start LECIG in our clinic was performed. Twenty-four patients (11 females, 13 males) were included. The median age was 71.5 years, and the median duration since PD diagnosis was 15.5 years. The median treatment duration was 305 days. Median doses were: 6.0 mL as morning dose, 2.5 mL/h as infusion rate, and 1.0 mL as extra dose. Half of the patients were switched directly from LCIG. These patients express improvements in the size and weight of the pump. Furthermore, most of them considered the new pump to be improved regarding user-friendliness. Six patients discontinued LECIG, three due to diarrhea, one due to hallucinations and two deceased (one cardiac arrest and one COVID-19). LECIG has shown to be possible to use in patients with PD, efficacy and safety as expected. Patients are generally happy with the size and usability of the pump, but some technical improvements of the software are warranted, as well as larger, prospective studies.

scholarly journals Current and Emerging Pharmacotherapeutic Options for Smoking Cessation

2013 ◽  
Vol 7 ◽  
pp. SART.S8108 ◽  
Author(s):  
Kristin V. Carson ◽  
Malcolm P. Brinn ◽  
Thomas A. Robertson ◽  
Rachada To-A-Nan ◽  
Adrian J. Esterman ◽  
...  
Keyword(s):  
Developing Countries ◽  
Smoking Cessation ◽  
Clinical Practice ◽  
Chronic Disease ◽  
Developed Countries ◽  
Mental Illnesses ◽  
Current Clinical Practice ◽  
Efficacy And Safety ◽  
First Line ◽  
Marginalized Groups

Tobacco smoking remains the single most preventable cause of morbidity and mortality in developed countries and poses a significant threat across developing countries where tobacco use prevalence is increasing. Nicotine dependence is a chronic disease often requiring multiple attempts to quit; repeated interventions with pharmacotherapeutic aids have become more popular as part of cessation therapies. First-line medications of known efficacy in the general population include varenicline tartrate, bupropion hydrochloride, nicotine replacement therapy products, or a combination thereof. However, less is known about the use of these products in marginalized groups such as the indigenous, those with mental illnesses, youth, and pregnant or breastfeeding women. Despite the efficacy and safety of these first line pharmacotherapies, many smokers continue to relapse and alternative pharmacotherapies and cessation options are required. Thus, the aim of this review is to summarize the existing and developing pharmacotherapeutic and other options for smoking cessation, to identify gaps in current clinical practice, and to provide recommendations for future evaluations and research.

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