Inflammatory phenotype of osteoarthritis: diacerein in the focus of evidence-based therapy
Summary. Osteoarthritis (OA), one of the most common pathologies of the musculoskeletal system, affects millions of people worldwide. After the start of a full-scale war, the problem of OA has become particularly relevant for the Ukrainian population. According to domestic statistical data, over the past 10 years there has been a rapid and significant increase in the prevalence of OA: in the cohort of elderly people, the incidence of OA increased by 83.4% compared to 2013 (p<0.05), with the most significant increase in this indicator being recorded in front-line regions and regions where temporarily displaced persons moved [1]. The war also brought changes to the structure of the disease, causing a significant increase in the share of secondary OA. Unlike the pre-war period, when primary OA occurred gradually in the elderly, manifesting as morning stiffness and pain, now it is mainly secondary OA that invades the lives of Ukrainians of working age, usually suddenly — after knee joint injury, ligamentous damage or surgical interventions, which are accompanied by a pronounced inflammatory component. Chronic pain, mobility restrictions have become frequent companions of internally displaced persons, elderly people and people who have experienced physical and emotional stress. This trend is of serious concern, especially if we take into account the peculiarities of the course of the inflammatory phenotype of OA in young and middle-aged people — a tendency to progression and early disability [2]. Given the significant negative impact of primary and secondary OA on the socio-economic aspects of society, leading experts emphasize the importance of early prescription of the most effective medications [1–3].
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