Medikamentöse Strategien zur Strukturverbesserung des Gelenkknorpels („disease modifying osteoarthritis drugs”)

K. Huch; J. Stöve; W. Puhl

doi:10.1055/s-2004-813573

Aktuelle Rheumatologie, Table of Contents

Aktuelle Rheumatologie 2005; 30(2): 85-97
DOI: 10.1055/s-2004-813573

Originalarbeit

Medikamentöse Strategien zur Strukturverbesserung des Gelenkknorpels („disease modifying osteoarthritis drugs”)

Pharmacological Strategies to Improve the Structure of Articular CartilageK. Huch¹ , J. Stöve² , W. Puhl¹

¹Orthopädische Klinik der Universität Ulm mit Querschnittgelähmtenzentrum (RKU, Ärztlicher Direktor: Prof. Dr. med. W. Puhl), Ulm
²Orthopädische Universitätsklinik, Fakultät für klinische Medizin Mannheim der Universität Heidelberg (Ärztlicher Direktor: Prof. Dr. med. H.-P. Scharf), Mannheim

Abstract

Zusammenfassung

Studienziel: Kritische Analyse verschiedener Therapeutika, denen chondroprotektive Eigenschaften zugesprochen werden. Diese werden neuerdings als „disease modifying osteoarthritis drugs” (DMOADs) bezeichnet. Methode: Die Literatur wurde insbesondere anhand einer „Medline”-gestützten Recherche durchsucht, um relevante Arbeiten der letzten 25 Jahre zu dem Thema Chondroprotektion und „DMOADs” zu identifizieren. Ergebnisse: Als objektiver Erfolgsparameter wird der Langzeitverlauf der radiologisch bestimmten Gelenkspaltbreite (Radiochondrometrie) favorisiert. Insgesamt ist die Datenlage zu den verschiedenen Medikamenten und Medizinprodukten begrenzt. Die verfügbaren Studien sind zum Teil widersprüchlich und zum Teil von nur beschränkter Aussagekraft. Schlussfolgerung: Die Kosten für einige Medikamente bzw. Medizinprodukte oder Nahrungsbestandteile sind nicht unerheblich, so dass weitere Studien mit optimalem Design (Berücksichtigung der Kriterien der evidenzbasierten Medizin) wünschenswert wären. Das Ergebnis derartiger Untersuchungen ließe die Eingruppierung der angewendeten Substanzen in chondroprotektive oder strukturmodifizierende zu. Die Studien der letzten Jahre sind teilweise viel versprechend.

Abstract

Aim: Critical analysis of different therapeutical agents with suggested chondroprotective properties called “disease modifying osteoarthritis drugs” (DMOADs). Method: Relevant papers dealing with “chondroprotection” and “DMOADs” within the last 25 years were mainly identified via MEDLINE®. Results: The radiological measurement of the joint gap (radiochondrometry) is considered the gold standard for the evaluation of chondroprotective drugs. Altogether, the data gathered for such agents are incomplete, with the available studies partly controversial and partly limited. Conclusion: The costs for some drugs are high. Therefore, further studies of optimal design according to the criteria of “evidence based medicine” are imperative. The results of such trials could offer a better discrimination of agents with disease modifying potential. Some recent studies appear promising.

Schlüsselwörter

Chondroprotektion - Arthrose - Kosten - DMOADs

Key words

Chondroprotection - osteoarthritis - socioeconomic impact - DMOADs

Full Text

References

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PD Dr. med. K. Huch

Orthopädische Klinik der Universität Ulm mit Querschnittgelähmtenzentrum (RKU)

Oberer Eselsberg 45

89081 Ulm

Phone: 07 31/1 77-51 07

Fax: 07 31/1 77-11 03

Email: klaus.huch@rku.de