Technology of magnetophoresis of topical nonsteroidal anti-inflammatory drugs in osteoarthritis (clinical and experimental study)

BACKGROUND: The high degree of evidence for the use of pharmacotherapy currently does not cause doctors to doubt, however, the use of non-pharmacological approaches in general and physical factors in particular is the subject of many years of discussion for them. One of the main places in the pharmacotherapy of osteoarthritis is occupied by nonsteroidal anti-inflammatory drugs, while our interest is associated with a group of so-called topical drugs. AIM: In order to methodically substantiate the application of the magnetophoresis technology of the topical form of nimesulide in an experimental study, the influence of the magnetic field on the spectroscopic and thixotropic characteristics of the drug was determined, and the clinical efficacy of the combined use of magnetotherapy and the transdermal form of nimesulide in comparison with the application of the drug and magnetic therapy with a pulsed low-frequency magnetic field was determined. MATERIAL AND METHODS: A randomized study involving 60 patients with osteoarthritis of the knee joints was performed. The experimental part of the study on the effect of the magnetic field on the structure and properties of the gel form of the preparation containing 1% nimesulide (chemical formula: 4'-nitro-2'-phenoxy-methane sulfonanilide) was carried out in laboratory conditions. The clinical part of the study included the use of local therapy (application of nimesulide gel in an amount of 24 g) to the skin in the knee joint area, followed by the placement of inductors of the ALMAG+ magnetic therapy apparatus on the medial and lateral surfaces of the knee joint. The impact was carried out according to the recommended "3+1" program. RESULTS: An analysis of the effectiveness of therapy conducted in a group of 60 patients with osteoarthritis of the knee joints showed high efficiency, expediency and safety of the use of the technology under study in the treatment of patients with joint diseases. CONCLUSION: Due to the synergistic effect on the pathogenesis of articular syndrome, the gel form of nimesulide and the magnetic field have a unidirectional effect: anti-inflammatory, decongestant, analgesic, microcirculatory. In addition, the magnetic field enhances the absorption and flow of the drug into the tissues, being a physical enhancer (amplifier), which significantly affects the result of treatment.