To improve the efficacy of osteoarthrosis (AO) treatment by chondroprotectors by defining individual indications for their use, based on the initial level of antibodies to cartilaginous glycosaminoglycans (GAG) in the blood serum.
Anti-GAG were detected by indirect solid-phase enzyme immunoassay. The antigen was a sulfated GAG preparation GAG-polysulfate (arteparon) manufactured by Luitpold-Werk (Germany). Sera of 110 OA patients were tested. Fifty of them were treated by rumalon, 20 with arteparon, and protocols of 40 patients included no chondroprotectors.
The highest levels of anti-GAG were found in OA patients with multiple involvement of the joints, rapidly progressing disease, and secondary synovitis. The titer of antibodies increases with disease duration and in patients with the roentgenological stage of OA, reaching the maximum by 10-15 years of disease or by stage III. Efficacy of chondroprotectors was lower at lower levels of antibodies to cartilaginous GAG.
Chondroprotector therapy of patients with initially high levels of antibodies to GAG is unadvisable, for it can lead to exacerbations, specifically, to secondary synovitis.