The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Ushkalova E.A.

Peoples’ Friendship University of Russia (RUDN University)

Zyryanov S.K.

Peoples’ Friendship University of Russia (RUDN University)

Zatolochina K.E.

Peoples’ Friendship University of Russia (RUDN University)

Symptomatic slow-acting drugs in the treatment of osteoarthritis: focus on glucosamine preparations

Authors:

Ushkalova E.A., Zyryanov S.K., Zatolochina K.E.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2020;(10): 104‑111

Read: 5432 times


To cite this article:

Ushkalova EA, Zyryanov SK, Zatolochina KE. Symptomatic slow-acting drugs in the treatment of osteoarthritis: focus on glucosamine preparations. Pirogov Russian Journal of Surgery. 2020;(10):104‑111. (In Russ.)
https://doi.org/10.17116/hirurgia2020101104

Recommended articles:
Chondroprotective therapy and adju­vant support for patients with chro­nic lower back pain. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(12):120-125
Comparative evaluation of oral chondroprotectors effe­ctiveness in patients with low back pain. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(7):98-103
Musculoskeletal diso­rders in patients with Parkinson’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(11-2):6-10

References:

  1. Neogi T, Zhang Y. Epidemiology of osteoarthritis. Rheum Dis Clin North Am. 2013;39(1):1-19.  https://doi.org/10.1016/j.rdc.2012.10.004
  2. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.  https://doi.org/10.1016/S0140-6736(15)60692-4
  3. Conaghan PG, Kloppenburg M, Schett G, Bijlsma JW. EULAR osteoarthritis ad hoc committee. Osteoarthritis research priorities: a report from a EULAR ad hoc expert committee. Ann Rheum Dis. 2014;73(8):1442-1445. https://doi.org/10.1136/annrheumdis-2013-204660
  4. Bhatia D, Bejarano T, Novo M. Current interventions in the management of knee osteoarthritis. J Pharm Bioallied Sci. 2013;5:30-38.  https://doi.org/10.4103/0975-7406.106561
  5. Balabanova RM, Erdes ShF. Rasprostranennost’ revmaticheskih zabolevanij v Rossii v 2012—2013 gg. Nauchno-prakticheskaya revmatologiya. 2015;53(2):120-124. (In Russ.). https://doi.org/10.14412/1995-4484-2015-120-124
  6. Folomeeva OM, Galushko EA, Erdes ShF. Rasprostranennost’ revmaticheskih zabolevanij v populyaciyah vzroslogo naseleniya Rossii i SSHA. Nauchno-prakticheskaya revmatologiya. 2008;46(4):4-13. (In Russ.). https://doi.org/10.14412/1995-4484-2008-529
  7. Hawker GA. Osteoarthritis is a serious disease. Clin Exp Rheumatol. 2019;37(suppl 120(5)):3-6. 
  8. Kabalyk MA. Rasprostranennost’ osteoartrita v Rossii: regional’nye aspekty dinamiki statisticheskih pokazatelej za 2011—2016 gg. Nauchno-prakticheskaya revmatologiya. 2018;56(4):416-422. (In Russ.). https://doi.org/10.14412/1995-4484-2018-416-422
  9. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333.  https://doi.org/10.1016/j.ejpain.2005.06.009
  10. Nüesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Jüni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ. 2011;342:1165. https://doi.org/10.1136/bmj.d1165
  11. Xie F, Kovic B, Jin X, He X, Wang M, Silvestre C. Economic and Humanistic Burden of Osteoarthritis: A Systematic Review of Large Sample Studies. Pharmacoeconomics. 2016;34(11):1087-1100. https://doi.org/10.1007/s40273-016-0424-x
  12. Bernad Pineda M. Current status of symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) in Spain. Situación actual de los SYSADOA en España. Reumatol Clin. 2016;12(4):181-183.  https://doi.org/10.1016/j.reuma.2016.03.012
  13. Nasonov EL, Yahno NN, Karateev AE, Alekseeva LI, Barinov AN, Barulin AE, Davydov OS, Danilov AB, Zhuravleva MV, Zavodovskij BV, Kopenkin SS, Kukushkin ML, Parfenov VA, Strahov MA, Tyurin VP, Chichasova NV, Chorbinskaya SA. Obshchie principy lecheniya skeletno-myshechnoj boli: mezhdisciplinarnyj konsensus. Nauchno-prakticheskaya revmatologiya. 2016;54(3):247-265. (In Russ.). https://doi.org/10.14412/1995-4484-2016-247-265
  14. Aweid O, Haider Z, Saed A, Kalairajah Y. Treatment modalities for hip and knee osteoarthritis: A systematic review of safety. J Orthop Surg (Hong Kong). 2018;26(3):2309499018808669. https://doi.org/10.1177/2309499018808669
  15. Charlesworth J, Fitzpatrick J, Perera NKP, Orchard J. Osteoarthritis- a systematic review of long-term safety implications for osteoarthritis of the knee. BMC Musculoskelet Disord. 2019;20(1):151.  https://doi.org/10.1186/s12891-019-2525-0
  16. Rahme E, Barkun A, Nedjar H, Gaugris S, Watson D. Hospitalizations for upper and lower GI events associated with traditional NSAIDs and acetaminophen among the elderly in Quebec, Canada. Am J Gastroenterol. 2008;103(4):872-882.  https://doi.org/10.1111/j.1572-0241.2008.01811.x
  17. Machado GC, Maher CG, Ferreira PH, Pinheiro MB, Lin C-WC, Day RO, McLachlan AJ, Ferreira ML. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ. 2015;350:1225. https://doi.org/10.1136/b
  18. Mazer M, Perrone J. Acetaminophen-induced nephrotoxicity: pathophysiology, clinical manifestations, and management. J Med Toxicol. 2008;4(1):2-6.  https://doi.org/10.1007/bf03160941
  19. Park WY. Controversies in acetaminophen nephrotoxicity. Kidney Res Clin Pract. 2020;39(1):4-6.  https://doi.org/10.23876/j.krcp.20.027
  20. Conaghan PG, Arden N, Avouac B, Migliore A, Rizzoli R. Safety of Paracetamol in Osteoarthritis: What Does the Literature Say? Drugs Aging. 2019;36(suppl 1):7-14.  https://doi.org/10.1007/s40266-019-00658-9
  21. McCrae JC, Morrison EE, MacIntyre IM, Dear JW, Webb DJ. Long-term adverse effects of paracetamol — a review. Br J Clin Pharmacol. 2018;84(10):2218-2230. https://doi.org/10.1111/bcp.13656
  22. Zhu X, Wu D, Sang L, Wang Y, Shen Y, Zhuang X, Chu M, Jiang L. Comparative effectiveness of glucosamine, chondroitin, acetaminophen or celecoxib for the treatment of knee and/or hip osteoarthritis: a network meta-analysis. Clin Exp Rheumatol. 2018;36(4):595-602. 
  23. Ennis ZN, Dideriksen D, Vaegter HB, Handberg G, Pottegård A. Acetaminophen for Chronic Pain: A Systematic Review on Efficacy. Basic Clin Pharmacol Toxicol. 2016;118(3):184-189.  https://doi.org/10.1111/bcpt.12527
  24. Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JWJ, Dieppe P, Gunther K, Hauselmann H, Herrero-Beaumont G, Kaklamanis P, Lohmander S, Leeb B, Lequesne M, Mazieres B, Martin- Mola E, Pavelka K, Pendleton A, Punzi L, Serni U, Swoboda B, Verbruggen G, Zimmerman-Gorska I, Dougados M, Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003;62(12):1145-1155. https://doi.org/10.1136/ard.2003.011742
  25. Bruyère O, Cooper C, Pelletier JP, Maheu E, Rannou F, Branco J, Brandi ML, Kanis JA, Altman RD, Hochberg MC, Martel-Pelletier J, Reginster J-Y. A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life setting. Semin Arthritis Rheum. 2016;45(suppl 4):3-11.  https://doi.org/10.1016/j.semarthrit.2015.11.010
  26. Gumustas SA, Oznam K, Mutlu CA, Kaya YE, Yilmaz I, Isyar M, Guzelant AY, Guler O, Akkaya S, Mahirogullari M. Are We Using Slow-Acting Symptomatic Chondroprotective Drugs Conscious Enough? Open Orthop J. 2017;11:533-540.  https://doi.org/10.2174/1874325001711010533
  27. Honvo G, Reginster JY, Rabenda V, Geerinck A, Mkinsi O, Charles A, Rizzoli R, Cooper C, Avouac B, Bruyère O. Safety of Symptomatic Slow-Acting Drugs for Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis. Drugs Aging. 2019;36(suppl 1):65-99.  https://doi.org/10.1007/s40266-019-00662-z
  28. Xing D, Wang B, Liu Q, Ke Y, Xu Y, Li Z, Lin J. Intra-articular Hyaluronic Acid in Treating Knee Osteoarthritis: a PRISMA-Compliant Systematic Review of Overlapping Meta-analysis. Sci Rep. 2016;6:32790. https://doi.org/10.1038/srep32790
  29. He WW, Kuang MJ, Zhao J, Sun L, Lu B, Wang Y, Ma J-X, Ma X-L. Efficacy and safety of intraarticular hyaluronic acid and corticosteroid for knee osteoarthritis: A meta-analysis. Int J Surg. 2017;39:95-103.  https://doi.org/10.1016/j.ijsu.2017.01.087
  30. Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev. 2014;5:CD002947. https://doi.org/10.1002/14651858.cd002947.pub2
  31. Eriksen P, Bartels EM, Altman RD, Bliddal H, Juhl C, Christensen R. Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken). 2014;66:1844-1855. https://doi.org/10.1002/acr.22376
  32. Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ. Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Br J Sports Med. 2018;52(3):167-175.  https://doi.org/10.1136/bjsports-2016-097333
  33. Russell AS, Aghazadeh-Habashi A, Jamali F. Active ingredient consistency of commercially available glucosamine sulfate products. J Rheumatol. 2002;29(11):2407-2409.
  34. Volpi N. Quality of different chondroitin sulfate preparations in relation to their therapeutic activity. J Pharm Pharmacol. 2009;61(10):1271-1280. https://doi.org/10.1211/jpp/61.10.0002
  35. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P, American College of Rheumatology. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474.  https://doi.org/10.1002/acr.21596
  36. McAlindon TE, Bannuru RR, Sullivan MC, Ardenz NK, Berenbaumxk F, Bierma-Zeinstra SM, Hawker GA, Henrotinyyzz Y, Hunterxx DJ, Kawaguchikk H, Kwoh K, Lohmander S, Rannouyyy F, Rooszzz EM, Underwood M. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014;22(3):363-388.  https://doi.org/10.1016/j.joca.2014.01.003
  37. National Clinical Guideline Centre (UK). Osteoarthritis: Care and Management in Adults. London: National Institute for Health and Care Excellence (UK); 2014.
  38. Henrotin Y, Marty M, Mobasheri A. What is the current status of chondroitin sulfate and glucosamine for the treatment of knee osteoarthritis? Maturitas. 2014;78(3):184-187.  https://doi.org/10.1016/j.maturitas.2014.04.015
  39. Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther K-P, Hauselmann HJ, Herrero-Beaumont G, Jordan K, Kaklamanis P, Leeb B, Lequesne M, Lohmander S, Mazieres B, Martin-Mola E, Pavelka K, Pendleton A, Punzi L, Swoboda B, Varatojo R, Verbruggen G, Zimmermann-Gorska I, Dougados M, EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005;64(5):669-681.  https://doi.org/10.1136/ard.2004.028886
  40. Rovati LC, Girolami F, Persiani S. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties. Ther Adv Musculoskelet Dis. 2012;4(3):167-180.  https://doi.org/10.1177/1759720X12437753
  41. Bruyère O, Cooper C, Al-Daghri NM, Dennison EM, Rizzoli R, Reginster JY. Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res. 2018;30(2):111-117.  https://doi.org/10.1007/s40520-017-0861-1
  42. Uitterlinden EJ, Jahr H, Koevoet JL, Jenniskens YM, Bierma-Zeinstra SMA, Degroot J, Verhaar JAN, Weinans H, van Osch GJVM. Glucosamine decreases expression of anabolic and catabolic genes in human osteoarthritic cartilage explants. Osteoarthritis Cartilage. 2006;14(3):250-257.  https://doi.org/10.1016/j.joca.2005.10.001
  43. Hoffer LJ, Kaplan LN, Hamadeh MJ, Grigoriu AC, Baron M. Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism. 2001;50(7):767-770.  https://doi.org/10.1053/meta.2001.24201
  44. Cordoba F, Nimni ME. Chondroitin sulfate and other sulfate containing chondroprotective agents may exhibit their effects by overcoming a deficiency of sulfur amino acids. Osteoarthritis Cartilage. 2003;11: 228-230.  https://doi.org/10.1016/s1063-4584(02)00351-5
  45. Zhang K, Liu Y, Zhao X, Tang Q, Dernedde J, Zhang J, Fan H. Anti-inflammatory properties of GLPss58, a sulfated polysaccharide from Ganoderma lucidum. Int J Biol Macromol. 2018;107(Pt A):486-493.  https://doi.org/10.1016/j.ijbiomac.2017.09.015
  46. Persiani S, Roda E, Rovati LC, Locatelli M, Giacovelli G, Roda A. Glucosamine oral bioavailability and plasma pharmacokinetics after increasing doses of crystalline glucosamine sulfate in man. Osteoarthritis Cartilage. 2005;13:1041-1049. https://doi.org/10.1016/j.joca.2005.07.009
  47. Roda A, Sabatini L, Barbieri A, Guardigli M, Locatelli M, Violante FS, Rovati LC, Persiani S. Development and validation of a sensitive HPLC-ESI-MS/MS method for the direct determination of glucosamine in human plasma. J Chromatogr B Analyt Technol Biomed Life Sci. 2006;844(1):119-126.  https://doi.org/10.1016/j.jchromb.2006.07.013
  48. Chiusaroli R, Piepoli T, Zanelli T, Ballanti P, Lanza M, Rovati L, Caselli G. Experimental pharmacology of glucosamine sulfate. Int J Rheumatol. 2011;939265. https://doi.org/10.1155/2011/939265
  49. Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, Gossett C. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001;357(9252):251-256.  https://doi.org/10.1016/S0140-6736(00)03610-2
  50. Setnikar I, Rovati LC. Absorption, distribution, metabolism and excretion of glucosamine sulfate. A review. Arzneimittelforschung. 2001;51:699-725.  https://doi.org/10.1055/s-0031-1300105
  51. Jackson CG, Plaas AH, Sandy JD, Hua C, Kim-Rolands S, Barnhill JG, Harris CL, Clegg DO. The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulfate taken separately or in combination. Osteoarthritis Cartilage. 2010;18:297-302.  https://doi.org/10.1016/j.joca.2009.10.013
  52. Altman RD. Glucosamine therapy for knee osteoarthritis: pharmacokinetic considerations. Expert Rev Clin Pharmacol. 2009;2(4):359-371.  https://doi.org/10.1586/ecp.09.17
  53. Meulyzer M, Vachon P, Beaudry F, Vinardell T, Richardy H, Beauchamp G, Laverty S. Comparison of pharmacokinetics of glucosamine and synovial fluid levels following administration of glucosamine sulphate or glucosamine hydrochloride. Osteoarthritis Cartilage. 2008;16(9):973-979.  https://doi.org/10.1016/j.joca.2008.01.006
  54. Saengnipanthkul S, Waikakul S, Rojanasthien S, Totemchokchyakarn K, Srinkapaibulaya A, Chin TC, Hong NM, Bruyère O, Cooper C, Reginster J-Y, Lwin M. Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations will optimize osteoarthritis treatment. Int J Rheum Dis. 2019;22(3):376-385.  https://doi.org/10.1111/1756-185X.13068
  55. Bottegoni C, Muzzarelli RA, Giovannini F, Busilacchi A, Gigante A.Oral chondroprotection with nutraceuticals made of chondroitin sulphate plus glucosamine sulphate in osteoarthritis. Carbohydr Polym. 2014;109:126-138.  https://doi.org/10.1016/j.carbpol.2014.03.033
  56. Vangsness CT Jr, Spiker W, Erickson J. A review of evidence-based medicine for glucosamine and chondroitin sulfate use in knee osteoarthritis. Arthroscopy. 2009;25(1):86-94.  https://doi.org/10.1016/j.arthro.2008.07.020
  57. Bruyère O, Altman RD, Reginster JY. Efficacy and safety of glucosamine sulfate in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016;45(4 suppl):12-17.  https://doi.org/10.1016/j.semarthrit.2015.11.011
  58. Aghazadeh-Habashi A, Jamali F. The glucosamine controversy; a pharmacokinetic issue. J Pharm Pharm Sci. 2011;14(2):264-273.  https://doi.org/10.18433/j3xg6f
  59. Clegg DO, Reda DJ, Harris CL, Klein MA, O’Dell JR, Hooper MM, Bradley JD, Bingham CO 3rd, Weisman MH, Jackson CG, Lane NE, Cush JJ, Moreland LW, Schumacher Jr HR, Oddis CV, Wolfe F, Molitor JA, Yocum DE, Schnitzer TJ, Furst DE, Sawitzke AD, Shi H, Brandt KD, Moskowitz RW, Williams HJ. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354(8):795-808.  https://doi.org/10.1056/NEJMoa052771
  60. Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco J. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007;56(2):555-567.  https://doi.org/10.1002/art.22371
  61. Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002;162(18):2113-2123. https://doi.org/10.1001/archinte.162.18.2113
  62. Towheed TE, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MC. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2001;1:CD002946. https://doi.org/10.1002/14651858.CD002946
  63. Bruyère O, Cooper C, Pelletier JP, Branco J, Brandi ML, Guillemin F, Hochberg MC, Kanis JA, Kvien TK, Martel-Pelletier J, Rizzoli R, Silverman S, Reginster J-Y. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum. 2014;44(3):253-263.  https://doi.org/10.1016/j.semarthrit.2014.05.014
  64. Bruyere O, Pavelka K, Rovati LC, Gatterová J, Giacovelli G, Olejarová M, Deroisy R, Reginster JY. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthritis Cartilage. 2008;16(2):254-260.  https://doi.org/10.1016/j.joca.2007.06.011
  65. Rovati LC, Girolami F, D’Amato M, Giacovelli G. Effects of glucosamine sulfate on the use of rescue non-steroidal anti-inflammatory drugs in knee osteoarthritis: Results from the Pharmaco-Epidemiology of GonArthroSis (PEGASus) study. Semin Arthritis Rheum. 2016;45(4 suppl):34-41.  https://doi.org/10.1016/j.semarthrit.2015.10.009
  66. Bruyère O, Reginster JY, Honvo G, Detilleux J. Cost-effectiveness evaluation of glucosamine for osteoarthritis based on simulation of individual patient data obtained from aggregated data in published studies. Aging Clin Exp Res. 2019;31(6):881-887.  https://doi.org/10.1007/s40520-019-01138-1
  67. Bruyère O, Honvo G, Veronese N, Arden NK, Branco J, Curtis EM, Al-Daghri NM, Herrero-Beaumont G, Martel-Pelletier J, Pelletier J-P, Rannou F, Rizzoli R, Roth R, Uebelhart D, Cooper C, Reginster J-Y. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019;49(3):337-350.  https://doi.org/10.1016/j.semarthrit.2019.04.008
  68. Denisov LN, Cvetkova ES, Golubev GSh, Bugrova OV, Dydykina IS, Dubikov AI, Men’shikova LV, Peshekhonova LK, Rebrov AP, Torgashin AN, Trofimov EA, Yakupova SP, Zonova EV, Bryujer O, Kuper C, Redzhinster Zh, Knyazeva LA. Algoritm lecheniya osteoartrita kolennogo sustava Evropejskogo obshchestva po klinicheskim i ekonomicheskim aspektam osteoporoza i osteoartrita (ESCEO) primenim v rossijskoj klinicheskoj praktike: sovmestnoe zaklyuchenie vedushchih rossijskih specialistov i ekspertov ESCEO po osteoartritu. Nauchno-prakticheskaya revmatologiya. 2016;54(6):641-653. (In Russ.). https://doi.org/10.14412/1995-4484-2016-641-653
  69. Wangroongsub Y, Tanavalee A, Wilairatana V, Ngarmukos S. Comparable clinical outcomes between glucosamine sulfate-potassium chloride and glucosamine sulfate sodium chloride in patients with mild and moderate knee osteoarthritis: a randomized, double-blind study. J Med Assoc Thai. 2010;93(7):805-811. 

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.