Expert Opinion on the Extensive Use of Prescription Crystalline Glucosamine Sulfate in the Multimodal Treatment of Osteoarthritis in Ukraine, Kazakhstan, Uzbekistan, and Armenia

Andriy M Gnylorybov; Semen K Ter-Vartanian; Irina Y Golovach; Oleg E Vyrva; Oleksandr A Burianov; Gulnara S Yesirkepova; Murodjon E Irismetov; Mashkhura Z Rizamuhamedova; Valentina S Vardanyan; Knarik V Ginosyan

doi:10.1177/1179544120946743

Expert Opinion on the Extensive Use of Prescription Crystalline Glucosamine Sulfate in the Multimodal Treatment of Osteoarthritis in Ukraine, Kazakhstan, Uzbekistan, and Armenia

Clin Med Insights Arthritis Musculoskelet Disord. 2020 Aug 4:13:1179544120946743. doi: 10.1177/1179544120946743. eCollection 2020.

Affiliations

¹ Department of Clinical Trials, Clinic of Modern Rheumatology, Kyiv, Ukraine.
² Clinic of Modern Rheumatology, Kyiv, Ukraine.
³ Rheumatology Center, Clinical Hospital, Kyiv, Ukraine.
⁴ Bone Tumor Department, Sytenko Institute of Spine and Joint Pathology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine.
⁵ Traumatology and Orthopedic Department, Bogomolets National Medical University, Kyiv, Ukraine.
⁶ City Rheumatology Center, Almaty, Kazakhstan.
⁷ Department of Sports Traumatology, UzNIITO, Tashkent, Uzbekistan.
⁸ Department of Faculty and Hospital Therapy, Republican Rheumatology Center, Tashkent, Uzbekistan.
⁹ Department of Internal diseases (Rheumatology), Yerevan State Medical University, Yerevan, Armenia.
¹⁰ Department of Rheumatology, Yerevan State Medical University, Yerevan, Armenia.

Abstract

Objective: The present work was led by a multidisciplinary panel of experts and proposes an extensive review on the use of prescription crystalline glucosamine sulfate (pCGS) in the multimodal treatment of osteoarthritis (OA) applicable in Ukraine and other Commonwealth of Independent States (CIS) countries.

Methods: A panel of rheumatologists, orthopedic surgeons, and field experts from Ukraine and CIS regions discussed the management of OA. Literature was systematically searched using Medline, EMBASE, CIHNAL, and Cochrane Library databases. The 2-day meeting critically reviewed the available literature, treatment algorithms, pharmacoeconomic aspects, and real-world instances to form a multimodal approach based both on real-life clinical practice and systematic literature research for the management of OA in Ukraine and CIS countries.

Expert opinion: pCGS plays a pivotal role in the stepwise approach to OA treatment. If it is necessary (step 1), the combined use of pCGS with paracetamol and topical nonsteroidal anti-inflammatory drugs (NSAIDs) has been recommended. If symptoms persist, oral NSAIDs and intra-articular (IA) hyaluronic acid or corticosteroids are added to the therapy (step 2) of pCGS in the patients. In case of insufficient relief and severe OA (step 3), pCGS along with oral NSAIDs, IA corticosteroids, and duloxetine have been recommended. Patient stratification with regular monitoring and careful alterations in treatment were advocated.

Conclusions: This expert opinion article recommends a modified approach to the existing guidelines incorporating pCGS in treatment modality of OA in Ukraine and CIS countries. Extensive use of pCGS targets early symptomatic relief in OA while limiting the adverse effects due to long-term use of analgesics and NSAIDs.

Keywords: Commonwealth of Independent States (CIS) countries; Osteoarthritis; SYSADOAs; Ukraine; crystalline glucosamine sulfate; expert opinion.