Abstract
Introduction. Primary open-angle glaucoma is considered a multifactorial disease, in the pathogenesis of which low-grade inflammation, cytokine imbalance, extracellular matrix remodeling, and neuroinflammation play a significant role. In comorbid patients with osteoarthritis, these mechanisms may be enhanced by systemic age-associated inflammation.
Objective. To analyze the clinical significance of the pleiotropic effect of diacerein in patients with primary open-angle glaucoma and osteoarthritis from the standpoint of common molecular inflammatory mechanisms of comorbidity and a personalized therapeutic approach.
Material and methods. The study included 42 patients with advanced primary open-angle glaucoma affecting one or both eyes and concomitant osteoarthritis. Group 1 comprised 22 patients treated with diacerein according to the standard regimen in two courses during a 12-month follow-up; Group 2 included 20 patients who did not receive diacerein. The assessment included pain severity according to VAS and WOMAC, the need for nonsteroidal anti-inflammatory drugs, visual acuity, intraocular pressure, ocular hydrodynamic parameters, perimetric indices, and morphometric parameters of the optic nerve disc and retina according to optical coherence tomography data.
Results. In comorbid patients receiving diacerein, a persistent tendency towards stabilization of intraocular pressure, perimetric and morphometric parameters was observed against the backdrop of favorable dynamics of pain syndrome and functional insufficiency in osteoarthritis, as well as a lower need for nonsteroidal anti-inflammatory drugs. In the control group, there was a tendency toward worsening ophthalmic parameters, and some patients required intensification of hypotensive therapy.
Conclusion. The obtained data confirm the significance of low-grade inflammation in the progression of primary open-angle glaucoma in comorbid patients. Diacerein, which possesses anti-inflammatory and structure-modifying effects, can be considered as a component of a personalized approach to managing patients with the combination of glaucoma and osteoarthritis due to its impact on common molecular pathways.
Keywords
Authors and affiliations
https://elibrary.ru/qhgpxg
A.N. Zhuravleva(1), A.V. Naumov(2)
1-Federal State Budgetary Institution “Helmholtz National Medical Research Center for Eye Diseases”, Sadovaya-Chernogryazskaya St., 14/19, Moscow, 105062, Russian Federation; 2-Russian Gerontology Research and Clinical Centre, Federal State Autonomous Educational Institution
of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian Federation,
Leonova St., 16 1st, Moscow, 129226, Russian Federation
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