Effect of systemic enzyme therapy on clinical manifestations of inflammation in gonarthrosis

Despite a significant number of studies on various schemes of OA therapy, there are only some studies with the use of systemic enzyme therapy (ETS) in combination with NSAIDs and / or SYSADOA. The aim was to study the effect of different groups of drugs (NSAIDs, ETS, SYSADOA) on the clinical course of gonarthrosis, as well as to develop an algorithm for the choice of treatment tactics depending on the clinical and sonographic manifestations of this disease. Methods. The data of 46 patients with stage I and stage II OA of Kellgren-Lawrence were analyzed. Patients of the first group received combined oral therapy with chondroitin sulfate (HS) 500 mg 2 times a day and glucosamine sulfate (GS) 750 mg 2 times a day in combination with selective NSAIDs. The second group of patients received combined therapy of HS 500 mg 2 times a day with the GS 750 mg 2 times daily together with Phlogenzym (PL), 2 tablets 3 times a day. All patients included in the study were examined initially, after 8 and 12 weeks. Procedures included clinical (VAS, WOMAC) and instrumental methods with the use of ultrasound of joints to evaluate the pathology of soft tissues and detect synovitis.. Results. Comparing groups 1 (HS, GS and NSAIDs) and 2 (HS and GS together with PL) on the effect on the structural state of cartilage and the dynamics of the main ultrasonic manifestations of OA knee joint, it should be noted that the effectiveness of drugs HS and GS in combination with enzyme therapy was higher, because in this group of treatment of synovitis decreased, whereas in the group of HS and GS, together with NSAIDs, these parameters either increased or remained unchanged. Conclusions. The use of polyenzyme drugs significantly increases the effectiveness of complex therapy in patients with osteoarthritis of the knee joints. In patients with gonarthrosis treated with a combination of chondroitin sulfate, glucosamine sulfate and phlogenzym was observed a significant reduction in the severity of synovitis, as well as more frequent lower daily dose of the selective NSAID or their full cancellation, compared with a control group of patients treated with symptomatic drugs retardation in combination with NSAIDs. (For citation: Mazurov VI, Dorovskikh AG, Trofimov EA. Effect of systemic enzyme therapy on clinical manifestations of inflammation in gonarthrosis. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):107-112).