A combination of chondroitin and glucosamine is widely used in clinical practice as both a symptomatic and structure-modifying agent for the treatment of osteoarthritis (OA). The emergence of new drugs based on this combination substantially expands treatment options for OA therapy.Objective: to evaluate the efficacy and safety of Artroflex® that is a combination of chondroitin sulfate 400 mg and glucosamine sulfate 500 mg (CS + GS) to support joint health in patients with knee and/or hip OA.Patients and methods. When implementing an open observational research program, the results of using the CS + GS complex were assessed in 644 OA patients (74.7% women) (mean age, 58.0±14.6 years) who experienced moderate/severe pain and required to continuously take non-steroidal anti-inflammatory drugs (NSAIDs). The CS + GS complex was prescribed in a dose of 2 capsules per day for 3 months. The investigators estimated changes in pain on movement by a 0 to 10 verbal pain scale, general health (GH) by a 0–10 visual analogue scale), the Lequesne index, the need for NSAIDs, and patient satisfaction with treatment and its tolerance.Results and discussion. After 3-month therapy, there were decreases in pain intensity by 49.2±16.8%, GH scores by 45.6±18.1%, the Lequesne index from 9.0 [6.0; 13.0] to 5.0 [3.0; 9.0]; less than half (45.2%) of the patients still needed for NSAIDs. 82.2% of patients were satisfied or completely satisfied with treatment results; 89.6% reported good treatment tolerance.Adverse events (apparently associated with NSAID use) were recorded in 2.2% of cases. There were no serious complications that required CS + GS treatment discontinuation or hospitalization.Conclusion. The findings have indicated that Artroflex® used to support joint health is an effective agent that controls OA symptoms and has a good safety level.
Adult-onset Still’s disease (AOSD) is a rare multisystem disease of unknown etiology. According to the literature, AOSD incidence in the world is 0.1–0.4 per 100 thousand population and it has two age-related peaks: the first peak — young age (15–25 years), the second — in persons aged 35–46 years. The causes and pathogenetic mechanism of AOSD are not established. The infectious pathology nature has not received proper scientific confirmation. According to modern concepts, this disease belongs to the group of auto-inflammatory, occurring without autoimmune disorders. It was found that patients with AOSD have a T-cell regulation disorder, increased production of the proinflammatory cytokine, the long-term persistence of which leads to the occurrence of fever and aseptic inflammation in various organs and tissues. The main criteria for this nosology are young age, persistent fever, arthritis, maculopapular rash, elevated ferritin level, neutrophilic leukocytosis, seronegative rheumatoid arthritis. Concomitant diseases include polyserositis, lymphadenopathy, hepatosplenomegaly, and nasopharyngeal infection. The article presents a clinical case of AOSD verified in a young woman at the Infectious Diseases Clinical Hospital. The difficulties of diagnostics are described, taking into account the variety of symptoms and the absence of pathognomonic disease signs. KEYWORDS: Adult-onset Still’s disease, fever, auto-inflammatory disease, arthritis, maculopapular rash, ferritin. FOR CITATION: Kharlamova T.V., Smirnova T.Yu., Golub V.P. et al. Adult-onset Still’s disease in the clinical practice of infectious disease physician. Russian Medical Inquiry. 2020;4(11):705–709. DOI: 10.32364/2587-6821-2020-4-11-705-709.
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