Classification of drugs for osteoarthritis
1.Non-specific drugs
Antipyretic and analgesic drugs: aspirin, acetaminophen, etc.
Non-steroidal anti-inflammatory drugs: ibuprofen, diclofenac, anti-inflammatory pain, etc.
Steroidal (hormonal) anti-inflammatory drugs
2.Specific drugs (symptom relief drugs, disease improvement drugs)
Glucosamine
Hyaluronic acid (mucus supplementation therapy)
What are NSAIDs?
It is the abbreviation of Non-steroid Anti-inflammation Drugs
Chinese: abbreviation for “Non-steroidal Anti-inflammatory Drugs
Definition of NSAIDs.
They are drugs other than adrenocorticosteroids that are used to treat inflammatory conditions. NSAIDs are currently used routinely in the treatment of osteoarthritis. NSAIDs inhibit the synthesis of prostaglandins by inhibiting the action of cyclooxygenase, thereby achieving anti-inflammatory pain relief. For osteoarthritis, a degenerative disease of the articular cartilage, treatment with NSAIDs lacks specificity. Long-term use of certain NSAIDs can even aggravate the pathological progression of osteoarthritis (e.g., anti-inflammatory pain).
The role of NSAIDs (anti-inflammatory and analgesic drugs): anti-inflammatory and analgesic.
Side effects of NSAIDs.
4 times higher peptic ulcers.
Increased mortality due to ulcers.
Interaction with multiple drugs.
Water and sodium retention.
Renal insufficiency.
High risk factors for caution with NSAIDs: history of peptic ulcer and bleeding; concomitant application of anticoagulants; advanced age; other systemic diseases; concomitant application of corticosteroids, etc.
Steroidal (hormonal) anti-inflammatory drugs
Intra-articular closure: anti-inflammatory and anti-swelling C For patients with concurrent synovitis, this method can be used, but long-term application has the potential to aggravate the condition.
Specific drug therapy – glucosamine
Glucosamine is a physiological substance necessary for the biological metabolism of chondrocytes. Chondrocytes use glucosamine to synthesize large molecules of mucopolysaccharides, and these proteoglycans form an important part of the cartilage matrix and, together with type II collagen fibers, maintain the morphology and function of cartilage.
Glucosamine Efficacy
Domestic and international clinical studies have shown that glucosamine is equal to or better than traditional drugs used to treat osteoarthritis, such as NSAIDs, in improving symptoms in patients with osteoarthritis in the short term, and is more than 10 times safer than the latter.
Unlike NSAIDs, the therapeutic effect of glucosamine does not disappear rapidly after discontinuation, but is maintained for a considerable period of time.
The results of domestic studies suggest that after 5 weeks of treatment with glucosamine, the therapeutic effect lasts for 4-6 months in 2/3 of patients. The latest foreign studies suggest that after 3 years of continuous administration of glucosamine, the joint space in the affected joints remained unchanged compared to the control group, which showed a significant narrowing of the joint space by 1 mm per year.
Specific Drug Therapy – Hyaluronic Acid Intra-articular Injection Therapy Viscoelastic Supplementation
In the 1970s, Balazs et al. were the first to propose the use of exogenous HA supplementation to restore the lubricating function of synovial fluid, promote cartilage repair, and improve joint function.
Hyaluronic acid can best meet the four principles of osteoarthrosis treatment: protect cartilage; lubricate joints; inhibit inflammation; relieve pain; and simultaneously promote endogenous HA secretion
Physiological functions of sodium vitreous acid in joints: lubricating joints, cushioning stress and reducing friction; acting as a filler and diffusion barrier; scavenger function.