The use of injectable collagen in osteoarthritis in multimorbid patients

Abstract

It has been established that osteoarthritis (OA) refers to diseases with high comorbidity. According to available data, OA is most often combined with arterial hypertension (AH) and other cardiovascular diseases (CVD). The combination of OA and CVD causes certain difficulties when choosing drug therapy. Traditionally, with pain syndrome, the choice falls on NSAIDs, since this allows in most cases to get a quick response to treatment. However, the use of NSAIDs may be accompanied by an increase in average blood pressure by 5 mm Hg or more in patients with arterial hypertension (AH) and significantly reduces the antihypertensive effectiveness of beta-blockers and ACE inhibitors. Symptomatic effect of the use of symptom-modifying drugs of delayed action (SYSADOA - Symptomatic slow acting drugs for osteoarthritis) develops approximately 8-12 weeks after the start of administration. Limitations in the use of NSAIDs in patients with OA and CVD due to increased cardiovascular risk and a long waiting period for the onset of the effect when using drugs of the SYSADOA group dictate the need to search for new approaches in the treatment of OA, on the one hand, with rapid effectiveness, and on the other - meeting all the requirements of cardiovascular safety. It is known that local injection therapy with the use of different groups of drugs has high efficiency in OA: glucocorticosteroids (GCS), hyaluronic acid, chondroitin, etc. Currently, microinduction collagen preparations with a high safety profile have joined them. Special attention in OA deserves the drug Plexatron, which has in its composition a type 1 tropocollagen with a molecular weight of 300 kD and calcium phosphate 1 mcg, and is intended for intra-articular and periarticular administration. Injectable collagen preparations are capable of inducing the regeneration of damaged collagen fibers by stimulating the migration of fibroblasts to the sites of damage, the release of growth factors and the activation of a key enzyme for the induction of endogenous collagen synthesis - lysine hydroxylase