Effectiveness of pathogenetic correction of sarcopenia in patients with osteoarthritis
Notice bibliographique
Résumé
Background: there is an unmet need to optimize pharmacological and adjunctive treatment tactics for the management of sarcopenia in elderly patients with osteoarthritis (OA) undergoing total joint replacement (TJR). Aim: to evaluate the efficacy and safety of a stepwise sarcopenia treatment regimen comprising parenteral chondroitin sulfate (CS) and subsequent pharmaconutraceutical support in elderly patients with stage III knee osteoarthritis according to the Kellgren–Lawrence classification and grade 2 joint functional insufficiency (FI) undergoing TJR. Materials and Methods: an open-label, prospective, randomized, controlled study was conducted in accordance with predefined inclusion and exclusion criteria. The total follow-up period was 126 days, with assessments at Visit 0, Visit 1, and Visit 2. TJR was performed using the C. Ranawat technique. The study enrolled 62 patients with knee OA and sarcopenia, allocated to the main group (MG, n=32) and control group (CG, n=30). All patients received systemic and topical nonsteroidal anti-inflammatory drugs (NSAIDs). In addition, patients in the MG received intramuscular CS (Chondroguard) administered every other day for 50 days prior to TJR, followed by pharmaconutraceutical (composition per daily dose: glucosamine sulfate [GS] 1500 mg, CS 1200 mg, undenatured type II collagen 40 mg; Chondroguard TRIO) for 2 months after hospital discharge. Pain intensity was assessed using the visual analogue scale (VAS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne index for joint function. The severity of sarcopenia was evaluated using the SARC-F questionnaire, handgrip dynamometry, the 5-chair stand test, and the skeletal muscle index (DXA). Histological examination of quadriceps femoris muscle biopsies was performed. Serum levels of albumin, leptin, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-α ( TNF-α), IL-1β, N-terminal propeptide of type IIA procollagen (PIIANP), brain-derived neurotrophic factor (BDNF), myostatin, follistatin, insulin-like growth factor 1 (IGF-1), dehydroepiandrosterone sulfate (DHEAS), cortisol, 25-hydroxyvitamin D3 [25(OH)D3], vitamin C, total carotenoids, and α-tocopherol were measured, and the sarcopenia index was calculated. Results: at Visits 1 and 2, patients in the MG demonstrated a significant reduction in pain intensity according to VAS, WOMAC, and KOOS scores, as well as an improvement in joint function according to the Lequesne index, compared both with baseline (Visit 0) and with the CG. A decrease in sarcopenia severity was observed in the MG, as evidenced by improved SARC-F scores, shorter times in the 5-chair stand test, and an increase in skeletal muscle index (DXA), relative to Visit 0 and to the CG. There was an improvement in the serum vitamin profile, a reduction in markers of systemic inflammation, and increases in serum albumin, BDNF, IGF-1, and DHEAS, along with an increase in the sarcopenia index. Concurrently, reductions in serum PIIANP, myostatin, follistatin, and cortisol were recorded in the MG compared with baseline and with the CG at Visit 1. At Visit 2, significant between-group differences in handgrip dynamometry were observed in favor of the MG. Histological assessment of quadriceps muscle biopsies in the MG revealed signs of adaptive myofibrillar hypertrophy, an increased number of myocyte nuclei, and initial manifestations of connective tissue proliferation. The requirement for celecoxib decreased progressively in the MG, with complete discontinuation in 18.7% and 81.3% of patients by day 60 of the study, respectively; topical meloxicam was discontinued in 31.2% and 68.8% of MG patients by day 60. Conclusion: in elderly patients with knee OA and pain undergoing TJR, a stepwise therapeutic approach combining parenteral CS with subsequent pharmaconutraceutical support appears to be a promising strategy for the management of sarcopenia. Keywords: sarcopenia, elderly patients, osteoarthritis, efficacy, safety, chondroitin sulfate, glucosamine sulfate, undenatured type II collagen, Chondroguard, Chondroguard TRIO. For citation: Minasov T.B., Sarvilina I.V., Gromova O.A., Nazarenko A.G., Zagorodniy N.V., Yakupova E.R. Effectiveness of pathogenetic correction of sarcopenia in patients with osteoarthritis. RMJ. 2025;10:9–20. DOI: 10.32364/2225-2282-2025-10-2
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».