Algorithms for managing patients over 60 years old with chronic joint and back pain
https://doi.org/10.37586/2686-8636-4-2021-444-450
Abstract
Chronic pain syndrome is one of the most common geriatric syndromes. Chronic pain negatively affects the mobility and autonomy of the older person, reducing the quality of life and longevity. An active screening for chronic pain in the geriatric population improves the geriatric status. Treatment strategies for chronic pain in older patients include non-pharmacological measures as well as drug administration. However, advanced age is associated with high comorbidity, polypharmacy, and in some cases does not allow the active use of systemic non-steroidal anti-inflammatory drugs (NSAIDs). In this connection, the use of parenteral symptomatic slow-acting drugs, the representative of which is chondroitin sulfate (CS), becomes an alternative. The efficacy and safety of CS has been proven by the mean of clinical studies meta-analysis data of osteoarthritis treatment effectiveness with parenteral chondroitin sulfate, including patients with back pain.
About the Authors
A. V. Naumov
Pirogov Russian National Research Medical University, Russian Gerontology Research and Clinical Centre
Russian Federation
Naumov Anton V., MD, PhD, professor, Head of Bone and Muscular Diseases Laboratory
Russian Federation
Naumov Anton V., MD, PhD, professor, Head of Bone and Muscular Diseases Laboratory
Moscow
N. O. Khovasova
Pirogov Russian National Research Medical University, Russian Gerontology Research and Clinical Centre
Russian Federation
Russian Federation
Khovasova Natalia O., MD, PhD, associate professor, Age-related Diseases Department
Moscow
V. I. Moroz
Pirogov Russian National Research Medical University, Russian Gerontology Research and Clinical Centre
Russian Federation
Moroz Victoria I., Age-related Diseases Department
Russian Federation
Moroz Victoria I., Age-related Diseases Department
Moscow
References
1. Ткачева О.Н., Воробьева Н.М., Котовская Ю.В., Остроумова О.Д., Черняева М.С., Силютина М.В., Чернов А.В., Тестова С.Г., Овчарова Л.Н., Селезнева Е.В. Распространённость гериатрических синдромов у лиц в возрасте старше 65 лет: первые результаты российского эпидемиологического исследования ЭВКАЛИПТ // РКЖ. 2020. № 10.
2. Hana S., Aicha B.T., Selim D., Ines M., Rawdha T. Clinical and Radiographic Features of Knee Osteoarthritis of Elderly Patients. Curr Rheumatol Rev. 2018; 14(2): 181–187. DOI: 10.2174/157339 7113666170425150133. PMID: 28443512.
3. Castell M.V., van der Pas S., Otero A., et al. Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA).//BMC Musculoskelet Disord. 2015; 16: 359. Published 2015 Nov 17. DOI: 10.1186/s12891-015-0807-8.
4. Coyle P.C., Sions J.M., Velasco T., Hicks G.E. Older Adults with Chronic Low Back Pain: A Clinical Population Vulnerable to Frailty?.//J Frailty Aging. 2015; 4(4): 188–190. DOI: 10.14283/ jfa.2015.75.
5. Sharma P.K., Reddy B.M., Ganguly E. Frailty Syndrome among oldest old Individuals, aged ≥80 years: Prevalence & Correlates.//J Frailty Sarcopenia Falls. 2020; 5(4): 92–101. Published 2020 Dec 1. DOI: 10.22540/JFSF-05-092.
6. Thinuan P., Siviroj P., Lerttrakarnnon P., Lorga T. Prevalence and Potential Predictors of Frailty among Community-Dwelling Older Persons in Northern Thailand: A Cross-Sectional Study.// Int J Environ Res Public Health. 2020 Jun 8; 17(11): 4077. DOI: 10.3390/ijerph17114077. PMID: 32521642; PMCID: PMC7312471.
7. Leyland K.M., Gates L.S., Sanchez-Santos M.T. et al. Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participantlevel data. Aging Clin Exp Res (2021). https://doi.org/10.1007/s40520–020–01762–2
8. F. Cacciatore, D. Della-Morte, C. Basile, F. Mazzella, C. Mastrobuoni, E. Salsano, G. Gargiulo, G. Galizia, F. Rengo, D. Bonaduce, P. Abete. Long-term mortality in frail elderly subjects with osteoarthritis//Rheumatology, Volume 53, Issue 2, February 2014, Pages 293–299, https://doi.org/10.1093/rheumatology/ket348
9. Yamada K., Kubota Y., Tabuchi T., et al. A prospective study of knee pain, low back pain, and risk of dementia: the JAGES project.//Sci Rep. 2019; 9(1): 10690. Published 2019 Jul 23. DOI: 10.1038/s41598-019-47005-x.
10. Leveille S.G., Bean J., Bandeen-Roche K., Jones R., Hochberg M., &Guralnik J.M. (2002). Musculoskeletal Pain and Risk for Falls in Older Disabled Women Living in the Community.// Journal of the American Geriatrics Society, 50(4), 671–678. DOI: 10.1046/j.1532–5415.2002.50161.x.
11. Papalia R., Zampogna B., Torre G., Lanotte A., Vasta S., Albo E., Tecame A., Denaro V. Sarcopenia and its relationship with osteoarthritis: risk factor or direct consequence?//Musculoskelet Surg. 2014 Jun; 98(1): 9–14. DOI: 10.1007/s12306-014-0311-6. Epub 2014 Jan 31. PMID: 24482109.
12. Thapa S., Shmerling R.H., Bean J.F., Cai Y., Leveille S.G. Chronic multisite pain: evaluation of a new geriatric syndrome. Aging Clin Exp Res. 2019 Aug; 31(8): 1129–1137. DOI: 10.1007/ s40520-018-1061-3. Epub 2018 Oct 25. PMID: 30361952; PMCID: PMC6483883.
13. Ткачева О.Н., Наумов А.В., Котовская Ю.В., Рунихина Н.К., Мильто А.С., Алексанян Л.А., Ховасова Н.О., Мороз В.И., Маневич Т.М., Розанов А.В., Остапенко В.С., Мешков А.Д. Хроническая боль у пациентов пожилого и старческого возраста. Клинические рекомендации. Российский журнал гериатрической медицины. 2021; 3(7): 275–320. https://doi.org/10.37586/2686-8636-3-2021-275-312
14. Ткачева О.Н., Котовская Ю.В., Мильто А.С., Рунихина Н.К., Фролова Е.В., Наумов А.В., Дудинская Е.Н., Мачехина Л.В., Воробьева Н.М., Розанов А.В., Остапенко В.С., Мхитарян Э.А., Шарашкина Н.В., Ховасова Н.О., Тюхменев Е.А., Бабенко И.В., Лесняк О.М., Белова К.Ю., Евстигнеева Л.П., Ершова О.Б. Падения у пациентов пожилого и старческого возраста. Клинические рекомендации. Российский журнал гериатрической медицины. 2021; 2(6): 153–185. https://doi.org/10.37586/2686-8636-2-2021-148-174
15. Лила А.М., Ткачева О.Н., Наумов А.В. и др. Место и роль парентеральной формы хондроитина сульфата в терапии остеоартрита: мультидисциплинарный Консенсус. РМЖ. 2021; 6: 68–74.
16. Honvo G., Bruyère O., Geerinck A., Veronese N., Reginster J.-Y. Efficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials.//AdvTher. 2019; 36(5): 1085. DOI: 10.1007/s12325-019-00921-w.
17. Beaudart C., Lengelé L., Leclercq V., Geerinck A., SanchezRodriguez D., Bruyère O, Reginster J. Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon.//Drugs. 2020; 19. DOI: 10.1007/s40265-020-01423-8. Epub ahead of print. PMID: 33074440.
18. Торшин И.Ю., Лила А.М., Наумов А.В., Кочиш А.Ю., Сарвилина И.В., Зоткин Е.Г., Галустян А.Н., Хаджидис А.К., Громова О.А. Метаанализ клинических исследований эффективности лечения остеоартрита препаратом Хондрогард. ФАРМАЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология. 2020; 13(4): 388–399. DOI: 10.17749/2070-4909/farmakoekonomika.2020.066.
19. Золотовская И.А., Давыдкин И.Л., Повереннова И.Е. Терапия неспецифической боли в нижней части спины у пациентов с высоким кардиоваскулярным риском. Журнал неврологии и психиатрии им. С.С. Корсакова. 2019; 119(8): 18–23. https://doi.org/10.17116/jnevro201911908118
Review
For citations:
Naumov A.V., Khovasova N.O., Moroz V.I. Algorithms for managing patients over 60 years old with chronic joint and back pain. Russian Journal of Geriatric Medicine. 2021;(4):444-450. (In Russ.) https://doi.org/10.37586/2686-8636-4-2021-444-450
Views:
356
Email this article 