[Combination therapy for exacerbations of pain in osteoarthritis with non-fixed combinations].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI:10.26442/00403660.2025.05.203272

A V Naumov, A V Unkovskiy, N O Khovasova, D K Fokeev, A V Kolesnikova

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Abstract

Aim: To evaluate the efficacy of a combination therapy containing chondroitin sulfate (CS), glucosamine (GL), methylsulfonylmethane (MSM), hyaluronic acid (HA), and native/hydrolyzed collagen compared to collagen-free therapy in the initial management of knee osteoarthritis (OA) exacerbations.

Materials and methods: A single-center, prospective, comparative phase IV study included 60 patients with knee OA (Kellgren-Lawrence stages 2-3). Participants were randomized into two groups: Group A (n=30) received CS/GL/MSM/HA, while Group B (n=30) received the same regimen supplemented with collagen. Pain dynamics (VAS, WOMAC), NSAID requirements, and functional outcomes (Timed Up-and-Go test, walking speed, muscle strength) were assessed at weeks 1, 2, 4, and 8.

Results: Group B demonstrated significant superiority: a 76% reduction in WOMAC pain scores (vs. 47% in Group A; p=0.04) and a 74% reduction in VAS scores (vs. 56%; p<0.05). NSAID use at week 8 was 2.6±0.5 days in Group B (vs. 4.3±1.8 in Group A; p=0.04). Functional improvements (12% increase in walking speed, 42% reduction in Timed Up-and-Go test duration) were also more pronounced in Group B (p<0.05).

Conclusion: The combination of CS/GL/MSM/HA with collagen significantly outperforms collagen-free therapy in reducing pain, improving joint function, and decreasing symptomatic treatment needs in patients with knee OA exacerbations. These findings support the inclusion of collagen in OA combination therapy.

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[骨关节炎疼痛加重的非固定联合治疗]。

目的：评价含硫酸软骨素（CS）、氨基葡萄糖（GL）、甲基磺酰甲烷（MSM）、透明质酸（HA）和天然/水解胶原的联合治疗与无胶原治疗在膝关节骨性关节炎（OA）加重期初始治疗中的疗效。材料和方法：一项单中心、前瞻性、比较IV期研究包括60例膝关节OA患者（Kellgren-Lawrence期2-3）。参与者被随机分为两组：A组（n=30）接受CS/GL/MSM/HA治疗，而B组（n=30）接受相同的方案，并补充胶原蛋白。疼痛动态（VAS、WOMAC）、非甾体抗炎药需求和功能结果（定时上-走测试、步行速度、肌肉力量）在第1、2、4和8周进行评估。结果：B组表现出显著的优势：WOMAC疼痛评分降低76% (a组为47%；p=0.04)， VAS评分降低74% (vs. 56%；页= 0.04)。功能改善（步行速度增加12%，Timed Up-and-Go测试持续时间减少42%）在B组中也更为明显(结论：CS/GL/MSM/HA联合胶原蛋白治疗在减轻膝关节OA加重患者疼痛、改善关节功能和减少症状治疗需求方面明显优于无胶原蛋白治疗。这些发现支持将胶原蛋白纳入OA联合治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.