Technology of magnetophoresis of topical nonsteroidal anti-inflammatory drugs in osteoarthritis (clinical and experimental study)

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Abstract

BACKGROUND: The high degree of evidence for the use of pharmacotherapy currently does not cause doctors to doubt, however, the use of non-pharmacological approaches in general and physical factors in particular is the subject of many years of discussion for them. One of the main places in the pharmacotherapy of osteoarthritis is occupied by nonsteroidal anti-inflammatory drugs, while our interest is associated with a group of so-called topical drugs.

AIM: In order to methodically substantiate the application of the magnetophoresis technology of the topical form of nimesulide in an experimental study, the influence of the magnetic field on the spectroscopic and thixotropic characteristics of the drug was determined, and the clinical efficacy of the combined use of magnetotherapy and the transdermal form of nimesulide in comparison with the application of the drug and magnetic therapy with a pulsed low-frequency magnetic field was determined.

MATERIAL AND METHODS: A randomized study involving 60 patients with osteoarthritis of the knee joints was performed. The experimental part of the study on the effect of the magnetic field on the structure and properties of the gel form of the preparation containing 1% nimesulide (chemical formula: 4'-nitro-2'-phenoxy-methane sulfonanilide) was carried out in laboratory conditions. The clinical part of the study included the use of local therapy (application of nimesulide gel in an amount of 2–4 g) to the skin in the knee joint area, followed by the placement of inductors of the ALMAG+ magnetic therapy apparatus on the medial and lateral surfaces of the knee joint. The impact was carried out according to the recommended "3+1" program.

RESULTS: An analysis of the effectiveness of therapy conducted in a group of 60 patients with osteoarthritis of the knee joints showed high efficiency, expediency and safety of the use of the technology under study in the treatment of patients with joint diseases.

CONCLUSION: Due to the synergistic effect on the pathogenesis of articular syndrome, the gel form of nimesulide and the magnetic field have a unidirectional effect: anti-inflammatory, decongestant, analgesic, microcirculatory. In addition, the magnetic field enhances the absorption and flow of the drug into the tissues, being a physical enhancer (amplifier), which significantly affects the result of treatment.

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About the authors

Irina P. Osnovina

Ivanovo State Medical Academy

Author for correspondence.
Email: iosnovina@mail.ru
ORCID iD: 0000-0002-4828-5645
SPIN-code: 4938-7822

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Ivanovo

Elena L. Vladimirtseva

Ivanovo State University of Chemistry and Technology

Email: elvladimirtseva@mail.ru
ORCID iD: 0000-0003-2389-0192
SPIN-code: 3152-9744

MD, Dr. Sci. (Tech), Professor

Russian Federation, Ivanovo

References

  1. Alekseeva LI. Updating of clinical recommendations for the treatment of patients with osteoarthritis in 2019. Russkii meditsinskii zhurnal. 2019;27(4):2–6. (In Russ).
  2. Karateev AE, Lila AM, Churyukanov MV, et al. Evaluation of the effectiveness of the algorithm for prescribing nonsteroidal anti-inflammatory drugs (NSAIDs) based on the analysis of risk factors for drug complications in real clinical practice. Results of the All-Russian project "PRINCIPLE" (Application of Recommendations on the Use of NSAIDs: Purposeful Change of Practice). Nauchno-prakticheskaya revmatologiya. 2017;55(5):485–492. (In Russ). doi: 10.14412/1995-4484-2017-485-492
  3. Alekseeva LA. The place of local therapy in the treatment of osteoarthritis. Meditsinskii sovet. 2011;(7-8):45–48. (In Russ).
  4. Karateev AE, Lila AM. Osteoarthritis: a modern clinical concept and some promising therapeutic approaches. Nauchno-prakticheskaya revmatologiya. 2018;56(1):70–81. (In Russ). doi: 10.14412/1995-4484-2018-70-81
  5. Ponomarenko GN, Ulashchik VS. Low-frequency magnetotherapy. Saint Petersburg: Chelovek; 2017. 171 р. (In Russ).
  6. Bagnato GL, Miceli G, Marino N, et al. Pulsed electromagnetic field on knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial. Rheumatology (Oxford). 2016;55(4):755–762 doi: 10.1093/rheumatology/kev426
  7. Magnetotherapy in medical rehabilitation and preventive programs: clinical recommendations. Moscow; 2015. 47 р. (In Russ).
  8. Wuschech H, Von Hehn U, Mikus E, Funk RH. Effects of PEMF on patients with osteoarthritis: Results of prospective double blind, placebo-controlled study. Bioelectromagnetics. 2015;36(8):576–585. doi: 10/1002/bem.21942

Supplementary files

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2. Fig. 1. Infrared spectrogram under magnetic influence on a sample of the gel form of nimesulide: a — is the initial gel sample; b — is the gel sample after exposure to a magnetic field.

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3. Fig. 2. The imposition of magnetic inductors on the knee joint area using the magnetophoresis technique of the gel form of nimesulide and the ALMAG+ apparatus.

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