Background At present hyaluronic acid (HA) is rather widely used in treatment of patients with osteoarthritis (OA). HA normalises the properties of the synovial fluid; has a protective effects; promotes the cartilage nutrition and so improves the signs of OA and function of the joints. To the contrary the effects of sodium succinate (the salt of the succinic acid) are not investigated but can be promising in OA treatment due to its known anti hypoxic and energetic properties.
Objectives To investigate the clinical efficacy of combination of hyaluronate and sodium succinate in OA treatment in early stages.
Methods The study included 126 patients with knee OA (stages I-II, Kelgren and Lawrence), mean age (54.3±2.7) years, among them – 75 women(60%) and 51 men(40%). All enrolled patients had OA exacerbation (without clinically evident synivitis) and received standard OA treatment (NSAIDs, exercises, orthopaedic devices) for 15 days; Gr.1 patients (58) also got 5 intra-articular injections of 1.1% hyaluronic acid, stabilised with sodium succinate (2 ml, once a week); patients of Gr.2 (68) in addition to standard treatment received 5 intra-articular injections of 1,1% solution of non-stabilised HA (2 ml, once a week). Clinical observation and evaluation of the results were performed at the beginning of the treatment, at 6th, 12th and 24th week after the study beginning
Results During the treatment period, patients in both groups showed the positive changes in clinical signs and symptoms of OA. The VAS score in both groups indicated a significant pain reduction, but the stability and duration of the clinical effect in the groups was different. In patients of Gr.1, the pain syndrome continued to decrease after 12 weeks till 24th week, whereas in Gr.2 after the treatment course there was no significant changes in further pain regression after 6th week point. The general WOMAC index was decreased from (78.3±4.1) in Gr. 1 and (75.4±3.8) in Gr. 2 at the beginning of the study to (27.9±2.6) and (29.8±1.9) accordingly at week 12, p<0,05. The changes in Lisholm score were also significantly better in Gr.1 than in Gr. 2 (before treatment (21.7±4.6) and (22.6±5.3), at week 6 – (86.4±5.7) and (71.3±4.8), at week 12 – (87.6±6.2) and (63.8±5.3), respectively, p<0,05.
Conclusions Combination of the hyaluronic acide and sodium succinate in early stages of knee OA (as intra-articular injections) allows to increase the treatment efficacy. Add of sodium succinate to hyaluronic acide achieve better pain control and longer remission.
Disclosure of Interest None declared
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