The present and progress of common drug therapy in treating osteoarthritis

doi:10.3877/cma.j.issn.2096-0263.2018.04.011

Abstract

Abstract:

Osteoarthritis (OA) is an very common disease among elderly people but still no effective therapy to cure. Drug therapy-as the first line treatment in OA has been proved valuable in releasing the clinical symptom and slow down the progress of the disease. Along with constantly use of drug therapy, the comprehension of the effect and side effect of drugsaregrowing. This article reviews the present and outlook of drug therapy, hopefully it can provide theoretical basis for clinical treatment of OA.

Key words: Osteoarthritis, Drug therapy, Intra-articular therapy

Zhengquan Dong, Chongwei Chen, Xiaochun Wei, Lei Wei. The present and progress of common drug therapy in treating osteoarthritis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(04): 252-256.

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References 41

1	Allen KD, Golightly YM. State of the evidence [J]. Curr Opin Rheumatol, 2015, 27(3): 276-283.
2	Poulet B, Staines KA. New developments in osteoarthritis and cartilage biology [J]. Curr Opin Pharmacol, 2016, 28: 8-13.
3	Ueberall MA, Mueller-Schwefe GH, Wigand R, et al. Efficacy, tolerability, and safety of an oral enzyme combination vs diclofenac in osteoarthritis of the knee: results of an individual patient-level pooled reanalysis of data from six randomized controlled trials [J]. J Pain Res, 2016, 9: 941-961.
4	Ackerman IN, Bohensky MA, de Steiger R, et al. Substantial rise in the lifetime risk of primary total knee replacement surgery for osteoarthritis from 2003 to 2013: an international, population-level analysis [J]. Osteoarthritis Cartilage, 2017, 25(4): 455-461.
5	Bohensky MA, Ackerman I, Desteiger R, et al. Lifetime risk of total knee replacement and temporal trends in incidence by health care setting, socioeconomic status, and geographic location [J]. Arthritis Care Res (Hoboken), 2014, 66(3): 424-431.
6	Hochberg MC, Altman RD, April KT, et al. American college of rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee [J]. Arthritis Care Res (Hoboken), 2012, 64(4): 465-474.
7	Pelletier JP, Martel-Pelletier J, Rannou F, et al. Efficacy and safety of oral NSAIDs and analgesics in the management of osteoarthritis: Evidence from real-life setting trials and surveys [J]. Semin Arthritis Rheum, 2016, 45(4 Suppl): S22-S27.
8	Harirforoosh S, Asghar W, Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications [J]. J Pharm Pharm Sci, 2013, 16(5): 821-847.
9	Ganeshanand, Jeet K, Baldi A. Approaches to overcome nsaid induced ulceration in arthritic pain management: perspectives and prospects [J]. J Drug Deliv, 2015, 5(2): 9-16.
10	Belshaw Z, Asher L, Dean RS. The attitudes of owners and veterinary professionals in the United Kingdom to the risk of adverse events associated with using non-steroidal anti-inflammatory drugs (NSAIDs) to treat dogs with osteoarthritis [J]. Prev Vet Med, 2016, 131: 121-126.
11	Hsu CC, Wang H, Hsu YH, et al. Use of nonsteroidal Anti-Inflammatory drugs and risk of chronic kidney disease in subjects with hypertension: nationwide longitudinal cohort study [J]. Hypertension, 2015, 66(3): 524-533.
12	Galluccio F, Barskova T, Cerinic MM. Short-term effect of the combination of hyaluronic acid, chondroitin sulfate, and keratin matrix on early symptomatic knee osteoarthritis [J]. Eur J Rheumatol, 2015, 2(3): 106-108.
13	Pelletier JP, Raynauld JP, Beaulieu AD, et al. Chondroitin sulfate efficacy versus celecoxib on knee osteoarthritis structural changes using magnetic resonance imaging: a 2-year multicentre exploratory study [J]. Arthritis Res Ther, 2016, 18(1): 256.
14	Bruyere O, Altman RD, Reginster JY. Efficacy and safety of glucosamine sulfate in the management of osteoarthritis: Evidence from real-life setting trials and surveys [J]. Semin Arthritis Rheum, 2016, 45(4, S): S12-S17.
15	Yu SP, Hunter DJ. Intra-articular therapies for osteoarthritis [J]. Expert Opin Pharmacother, 2016, 17(15): 2057-2071.
16	O'hanlon CE, Newberry SJ, Booth M, et al. Hyaluronic acid injection therapy for osteoarthritis of the knee: concordant efficacy and conflicting serious adverse events in two systematic reviews [J]. Syst Rev, 2016, 5(1): 186.
17	Chen L, Qi H, Jiang D, et al. The new use of an ancient remedy: a double-blinded randomized study on the treatment of rheumatoid arthritis [J]. Am J Chin Med, 2013, 41(2): 263-280.
18	Wei L, Zhang H, Li X, et al. Efficacy and safety evaluation of intra-venous infusion of cervus and cucumis polypeptides for treatment of avascular necrosis of the femoral head: a randomized clinical trial [J]. J Tradit Chin Med, 2016, 36(1): 39-44.
19	Wang AY, Tian Y, Yuan M, et al. Effect of cervus and cucumis peptides on osteoblast activity and fracture healing in osteoporotic bone[J]. Evid Based Complement Alternat Med, 2014: 958908.
20	Smith SR, Deshpande BR, Collins JE, et al. Comparative pain reduction of oral non-steroidal anti-inflammatory drugs and opioids for knee osteoarthritis: systematic analytic review [J]. Osteoarthritis Cartilage, 2016, 24(6): 962-972.
21	Conaghan PG, Serpell M, Mcskimming P, et al. Satisfaction, adherence and Health-Related quality of Life with transdermal buprenorphine compared with oral opioid medications in the usual care of osteoarthritis pain [J]. Patient, 2016, 9(4): 359-371.
22	Dieu-Donné O, Théodore O, Joëlle ZT, et al. An open randomized trial comparing the effects of oral NSAIDs versus steroid Intra-Articular infiltration in congestive osteoarthritis of the knee [J]. Open Rheumatol J, 2016, 10: 8-12.
23	Zhang W, Jones A, Paracetamol DD. Reduce the pain of osteoarthritis?a meta-analysis of randomised controlled trials [J]. Ann Rheum Dis, 2004, 63(8): 901-907.
24	Machado GC, Maher CG, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials [J]. BMJ, 2015, 350: h1225.
25	Moore N, Salvo F, Duong M, et al. Does paracetamol still have a future in osteoarthritis? [J]. Lancet, 2016, 387(133): 2065-2066.
26	Maheu E, Cadet C, Marty M, et al. Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: the ERADIAS study [J]. Ann Rheum Dis, 2014, 73(2): 376-384.
27	Winther K. Shells from rose-hip (rosa canina) do not reduce symptom scores or improve anti-inflammatory property in patients with osteoarthritis - a double-blind, placebo-controlled, rabdomized study [J]. Osteoarthritis Cartilage, 2014, 22(S): S321.
28	Pavelka K, Bruyère O, Cooper C, et al. Diacerein: benefits, risks and place in the management of osteoarthritis. an Opinion-Based report from the ESCEO [J]. Drugs Aging, 2016, 33(2): 75-85.
29	Permuy M, Guede D, López-Peña M, et al. Effects of diacerein on cartilage and subchondral bone in early stages of osteoarthritis in a rabbit model [J]. BMC Vet Res, 2015, 11(1): 143.
30	Laslett LL, Jones G. Capsaicin for osteoarthritis pain [J]. Prog Drug Res, 2014, 68: 277-291.
31	Persson MS, Fu Y, Bhattacharya A, et al. Relative efficacy of topical non-steroidal anti-inflammatory drugs and topical capsaicin in osteoarthritis: protocol for an individual patient data meta-analysis [J]. Syst Rev, 2016, 5(1): 165.
32	Rannou F, Pelletier JP, Martel-Pelletier J. Efficacy and safety of topical NSAIDs in the management of osteoarthritis: Evidence from real-life setting trials and surveys [J]. Semin Arthritis Rheum, 2016, 45(4 Suppl): S18-S21.
33	Sajjadi P, Khodayar MJ, Sharif MB, et al. Percutaneous absorption of salicylic Acid after administration of trolamine salicylate cream in rats with transcutol((R))and eucalyptus oil pre-treated skin [J]. Adv Pharm Bull, 2013, 3(2): 295-301.
34	Nakhostin-Roohi B, Khoshkhahesh F, Bohlooli S. Effect of virgin olive oil versus piroxicam phonophoresis on exercise-induced anterior knee pain [J]. Avicenna J phytomed, 2016, 6(5): 535-541.
35	Henriksen M, Christensen R, Klokker L, et al. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee: a randomized clinical trial [J]. JAMA Intern Med, 2015, 175(6): 923-930.
36	Ayhan E, Kesmezacar H, Akgun I. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis [J]. World J Orthop, 2014, 5(3): 351-361.
37	Zhang Z, Wei X, Gao J, et al. Intra-Articular injection of Cross-Linked hyaluronic Acid-Dexamethasone hydrogel attenuates osteoarthritis: an experimental study in a rat model of osteoarthritis [J]. Int J Mol Sci, 2016, 17(4): 411.
38	Wang S, Wei X, Zhou J, et al. Identification of alpha 2-Macroglobulin as a Master Inhibitor of Cartilage-Degrading Factors That Attenuates the Progression of Posttraumatic Osteoarthritis [J]. Arthritis Rheumatol, 2014, 66(7): 1843-1853.
39	Chen FP, Chang CM, Hwang SJ, et al. Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of National health insurance dataset [J]. BMC Complement Altern Med, 2014, 14: 91.
40	Yan H, Su YX, Chen LD, et al. Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial [J]. Trials, 2013, 14: 367.
41	Zhang W, Ouyang H, Dass CR, et al. Current research on pharmacologic and regenerative therapies for osteoarthritis [J]. Bone Research, 2016, 4: 15040.

药物		代表药物及英文名	药物疗效	不良反应	评价
口服类药物		?	?	?	?
NSAIDs		?	?	?	?
?	Cox无选择性药物	普奈生Naproxen	?	胃肠道损害	骨关节炎治疗常规一线药物，药效显著稳定。Cox-2选择性抑制药的应用可有效缓解不良反应的发生
?	Cox-1低选择性抑制药	布洛芬Ibuprofen	解热、镇痛、抗炎	心血管损害
?	Cox-1高选择性抑制药	阿司匹林Aspirin	?	肾损害
?	Cox-2选择性抑制药	塞来昔布Celebrex	?	?
SYSADOA		?	?	?	?
?	硫酸软骨素	Chindroition sulfate	止痛、保护、强化软骨结构	未见明显不良反应	作为症状缓解类药物的补充，其疗效有明显的稳定延续性
?	氨基葡糖	Glucoasmine	?	?	?
?	透明质酸盐	Hyaluronic acid	?	?	?
?	鹿瓜多肽	cervusandcucumispolypeptides	?	?	?
阿片类镇痛剂		?	?	?	?
?	强效类	氢吗啡酮hydromorphone	?	?	阿片类镇痛剂在重症骨关节炎患者疼痛控制方面有重要作用。
?	?	氧可酮osycodone	镇痛	药物滥用
?	非强效类	曲马多tramadol	?	?
其他		?	?	?	?
?	鳄梨大豆未皂化物	avocado-soybean unsaponifiable	改善软骨结构、抗炎	未见明显不良反应	可改善病情但疗效尚未肯定。
?	野玫瑰果粉	rose-hip	症状减轻、降低C反应蛋白	未见明显不良反应	疗效尚未肯定
?	双醋瑞因	Diacerein	抗炎、抗凋亡、促代谢	恶心、便秘、抵抗力下降	疗效明显、副作用轻微。
外敷类药物		?	?	?	?
?	辣椒碱	Topical capsaicin	镇痛	?	疗效肯定，不良反应轻微
?	外敷类NSAIDs	Topical NSAIDs	抗炎、镇痛	局部不良反应	相对于口服药物，减少了非甾体抗炎药的严重副作用。
?	初榨橄榄油	Virgin olive oil	症状缓解、抗衰老	未见明显不良反应	疗效尚未肯定
局部作用类		?	?	?	?
?	封闭疗法	Block therapy	抗炎、镇痛、解痉	糖皮质激素副作用	疗效依患者、手法而异。副作用明显。
?	关节腔内注射药物	皮质甾体类激素cortcosteroid	改善与保护软骨结构，抗炎镇痛	?	作为骨关节炎终末期改善症状的有效手段，但价格昂贵且为有创手段，副作用严重。
?	?	透明质酸hyaluronic acid	抗炎镇痛和改善关节活动度	感染
?	?	富血小板血浆platelet rich lasma	?	?
?	中医药	杜仲	?	?	亚洲人群中较为常见，其副作用未明。
?	?	骨碎补	?	未明
?	?	断续	?	?

药物		代表药物及英文名	药物疗效	不良反应	评价
口服类药物		?	?	?	?
NSAIDs		?	?	?	?
?	Cox无选择性药物	普奈生Naproxen	?	胃肠道损害	骨关节炎治疗常规一线药物，药效显著稳定。Cox-2选择性抑制药的应用可有效缓解不良反应的发生
?	Cox-1低选择性抑制药	布洛芬Ibuprofen	解热、镇痛、抗炎	心血管损害
?	Cox-1高选择性抑制药	阿司匹林Aspirin	?	肾损害
?	Cox-2选择性抑制药	塞来昔布Celebrex	?	?
SYSADOA		?	?	?	?
?	硫酸软骨素	Chindroition sulfate	止痛、保护、强化软骨结构	未见明显不良反应	作为症状缓解类药物的补充，其疗效有明显的稳定延续性
?	氨基葡糖	Glucoasmine	?	?	?
?	透明质酸盐	Hyaluronic acid	?	?	?
?	鹿瓜多肽	cervusandcucumispolypeptides	?	?	?
阿片类镇痛剂		?	?	?	?
?	强效类	氢吗啡酮hydromorphone	?	?	阿片类镇痛剂在重症骨关节炎患者疼痛控制方面有重要作用。
?	?	氧可酮osycodone	镇痛	药物滥用
?	非强效类	曲马多tramadol	?	?
其他		?	?	?	?
?	鳄梨大豆未皂化物	avocado-soybean unsaponifiable	改善软骨结构、抗炎	未见明显不良反应	可改善病情但疗效尚未肯定。
?	野玫瑰果粉	rose-hip	症状减轻、降低C反应蛋白	未见明显不良反应	疗效尚未肯定
?	双醋瑞因	Diacerein	抗炎、抗凋亡、促代谢	恶心、便秘、抵抗力下降	疗效明显、副作用轻微。
外敷类药物		?	?	?	?
?	辣椒碱	Topical capsaicin	镇痛	?	疗效肯定，不良反应轻微
?	外敷类NSAIDs	Topical NSAIDs	抗炎、镇痛	局部不良反应	相对于口服药物，减少了非甾体抗炎药的严重副作用。
?	初榨橄榄油	Virgin olive oil	症状缓解、抗衰老	未见明显不良反应	疗效尚未肯定
局部作用类		?	?	?	?
?	封闭疗法	Block therapy	抗炎、镇痛、解痉	糖皮质激素副作用	疗效依患者、手法而异。副作用明显。
?	关节腔内注射药物	皮质甾体类激素cortcosteroid	改善与保护软骨结构，抗炎镇痛	?	作为骨关节炎终末期改善症状的有效手段，但价格昂贵且为有创手段，副作用严重。
?	?	透明质酸hyaluronic acid	抗炎镇痛和改善关节活动度	感染
?	?	富血小板血浆platelet rich lasma	?	?
?	中医药	杜仲	?	?	亚洲人群中较为常见，其副作用未明。
?	?	骨碎补	?	未明
?	?	断续	?	?

[1]	The Joint Surgery Branch of the Chinese Orthopedic Association, Guangdong’s Medical Association of Osteoporosis And Bone Mineral Research, Foshan Shunde 3rd Peoele’s Hospital. Clinical intervention guideline for using of anti-osteoporosis drugs in postoperative fragile hip fractures in China (2023 Edition) [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 751-764.
[2]	Wen Yan, Xingwen Xie, Yubiao Gu, Ningbo Lei, Cheng Ma, Wenxia Yu, Yaxiong Gao, Lei Zhang. Research progress of microRNA and deep vein thrombosis after total knee arthroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 842-846.
[3]	Xuguo Fan, Yonggang Zhao, Yanwei Yang. Current research perspectives on role of fibula in knee osteoarthritis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 855-859.
[4]	Shanwu Li, Yongjie Ye, Bing Wang, Ziyi Wang, Yi Yin, Guanjun Sun, Dagang Zhang. Early efficacy comparison of open wedge high tibial osteotomy and unicompartmental knee arthroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 882-888.
[5]	Zhongbin Zhang, Kunpeng Fu, Kai Zhu, Yu Zhang, Hua Li. High tibial osteotomy and platelet rich plasma in treatment of knee osteoarthritis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(05): 633-641.
[6]	Hongxing Chen, Lijun Zhang, Yong Zhang, Hu Li, Chi Zhou, Yinuo Fan. Meta-analysis of effect of external application of traditional Chinese medicine after arthroscopic debridement in knee osteoarthritis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(05): 663-672.
[7]	Yan Wang, Jianxiong Ma, Shuang Lang, Benchao Dong, Aixian Tian, Yan Li, Lei Sun, Hongzhen Jin, Bin Lu, Ying Wang, Haohao Bai, Xinlong Ma. Research progress in application of exosomes in diagnosis and treatment of osteoporosis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(05): 673-678.
[8]	Zhidong Zhao, Zhongli Li. Research progress of early diagnosis and treatment in osteoarthritis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(05): 689-693.
[9]	Lun Liu, Yunlu Wang, Xiyong Li, Pengfei Han, Peng Zhang, Xiaodong Li. Research progress on robotic-assisted unicompartmental knee arthroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(05): 715-721.
[10]	Zeying Jiang, Anting Wang, Jiaoli Wang, Ci Chen, Qiuling Zhou, Yanjuan Huang, Fang Zhou, Yan Xue, Jianfeng Zhou, Wenyong Tan, Meifang Du. Effect of multiple plant oils combination in preventing the chemoradiotherapy induced toxicities [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(06): 523-527.
[11]	Changying Ye, Jing Xie, Guicong Ding. Research advances in interim treatment of deciduous tooth caries [J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(05): 365-370.
[12]	Xu Wang, Shaomin Shi, Yan Mao, Shang Ji, Yaling Liu. Metabolism of liver enzymes in osteoarthritis: a literature review [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(06): 379-384.
[13]	Xiaoqiang Zhou, Chao Sun, Xiao Yu, Yujie Jin, Zhiqiang Li, Xiangxin Zhang, Guangxiang Chen. Clinical Analysis of the Early Effect of Synchronous Total and Unicompartmental Knee Arthroplasty in the Same Patient [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(05): 275-281.
[14]	Cong Ma, Xuejing Li, Xiaozuo Zheng, Xiaoyang Zhang, Kunfeng Duan, Guoqiang Liu, Suhui Qie. A comparative study of intraarticular injection of platelet-rich plasma and sodium hyaluronate in the treatment of Stage I-Ⅲ knee osteoarthritis [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(05): 282-288.
[15]	Ziyan Zhang, Hong Zeng, Yuanjing Xu, Luqi Guo, Jinwu Wang, Shaobai Wang, Fuchao Ren, Weiqiang Miao, Kerong Dai, Ru Wang. A review of biomechanical markers of knee predicting the progression of knee osteoarthritis [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(05): 315-320.

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