Aktuelle Rheumatologie 2012; 37(06): 366-370
DOI: 10.1055/s-0032-1323825
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Medikamentöse Therapie der Arthrose

Pharmacological Treatment of Osteoarthrosis
F. Luttosch
1   Department für Innere Medizin, Dermatologie und Neurologie, Universitätsklinikum Leipzig, Leipzig
,
C. Baerwald
2   Medizinische Klinik II, Sektion Rheumatologie, Universitätsklinikum Leipzig, Leipzig
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2012 (online)

Zusammenfassung

Arthrose stellt mit Millionen Betroffenen die häufigste Gelenkerkrankung weltweit dar. Die Er­krankung verursacht Schmerzen, Bewegungseinschränkungen und Gelenkdeformierungen bis zur Invalidität mit einschneidenden Folgen für das berufliche und private Leben. Da es keine kau­sale Therapie gibt, zielen die aktuellen medikamentösen Maßnahmen auf die Verhinderung von Schmerzen und die Verbesserung der Beweglichkeit. Die Standardtherapie umfasst NSAR, Paracetamol, Opioide und Glukokortikoide, wobei beim Einsatz dieser Medikamente verschiedene Nebenwirkungen (gastrointestinal, kardiovaskulär) zu berücksichtigen sind. Alternative Therapieansätze sind Hyaluronsäure, Glucosamin und Chondroitin. Einige Studien zeigten positive Effekte dieser Substanzen auf Schmerzen und andere Outcomeparameter, aber die Datenlage ist noch uneinheitlich. Aufgrund des besseren Verständnisses pathophysiologischer Zusammenhänge sind aber neue therapeutische Ansätze in der Entwicklung.

Abstract

Osteoarthritis (OA) is the most frequent joint disease. It affects millions of patients worldwide. OA leads to pain, decreased mobility, joint deformity and disability. Thus, OA has a high impact on the patient’s quality of life. Since there is no causal treatment, pharmacological treatment focusses on the prevention of pain and improvement of function. Standard analgesic/anti-in­flammatory treatment includes NSAIDs, paraceta­mol, opiods and glucocorticoids, but these drugs exert different side effects (i. e., gastrointestinal, cardiovascular). Alternative treatment options include hyaluronic acid, glucosamine and chondroitin. Some studies have revealed positive effects on pain and other outcome parameters but data are still heterogenous. Due to increased understanding of pathogenic mechanisms underlying OA, new therapeutic approaches are under investigation.

 
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