ON ROLE OF CHONDROPROTECTIVE AGENTS IN OSTEOARTHRITIS: ON THE WAY TO THE EVIDENCE-BASED MEDICINE
Chondroitin sulfate, glucosamine and hyaluronic acid (HA) applied for the treatment of arthrosis (osteoarthritis) are designated as chondroprotective agents. There is evidence in favor of their effectiveness. However, some recent reviews questioned it, while it was noticed that later publications tended to be less positive than older industry-sponsored trials. For intraarticular injections predominantly HA is used. Clinical efficacy of intraarcticular injections and significance of the difference from placebo has been questioned as well. Moreover, no plausible explanation has been found for the discrepancy between the short intraarticular half-life of injected HA and reported long duaration of the positive effect (6-9 months) after a course of intraarticular injections. Chondroprotective agents are administered to osteoarthritis patients, including pensioners and citizens with low incomes, who purchase them for a prolonged use. It must be largely equivalent to recommend them, instead of peroral drugs or dietary supplements, a diet modification with consumption of more food containing natural glycosaminoglycans. More comprehensive analysis of literature is required in the process of registration of drugs and dietary supplements.