OBAT DAN SUPLEMEN UNTUK OSTEOARTHRITIS - Rina Herowati (PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia), 2014)
ABSTRAK Osteoarthritis (OA) merupakan salah satu penyebab ketidakmampuan beraktivitas pada geriatri. Tujuan terapi OA adalah untuk mengontrol gejala, meminimalkan ketidakmampuan, dan meningkatkan kualitas hidup. Tata laksana OA meliputi terapi non farmakologi, terapi farmakologi, dan pembedahan. Terapi farmakologi lebih lanjut dibagi lagi menjadi terapi simptomatik dan terapi pemodifikasi penyakit. Asetaminofen merupakan terapi lini pertama, digunakan dengan mempertimbangkan resiko toksisitas saluran cerna dan kardiovaskuler, terutama pada geriatri. Injeksi glukokortikoid maupun asam hialurodonat intra-articular memberikan efek jangka pendek yang menguntungkan. Saat ini riset masih terus dilakukan terhadap obat pemodifikasi penyakit, seperti tetrasiklin, asam glikosaminoglikan polisulfat, pentosan polisulfat, diacerein, glukosamin dan lain-lain. Saat ini masih terus dilakukan riset target obat baru antagonis reseptor IL-1R (IL-1Ra), inhibitor mitogen-activated protein (MAP) kinases, maupun inhibitor NF-kappaB. Selain itu terapi gen, tranplantasi chondrocyte dan stem cell juga sedang dikembangkan. Berbagai suplemen sudah banyak digunakan untuk terapi OA, seperti glukosamin, chondroitin sulfate, ekstrak jahe, alpukat, dan kedelai, herba cakar kucing, dan tulang rawan hiu. Glukosamin dan chondroitin sulfate, merupakan nutraseutikal yang memberikan efek paling bermakna dalam terapi OA. Kata kunci: osteoarthritis, terapi farmakologi, suplemen. ABSTRACT Osteoarthritis (OA) is one cause of disability activities in geriatrics. The goals of OA therapy are to control symptoms, minimize disability and improve the quality of life. Management of OA include non-pharmacological therapy, pharmacological therapy, and surgery. Pharmacological therapy is further classified into symptomatic therapy and disease modifying therapy. Acetaminophen, the first-line symptomatic therapy, is used by consider the risk of gastrointestinal and cardiovascular toxicity, especially in geriatric. Intra-articular injection of glucocorticoid or hyalurodonic acids provided short-term benefit effects. Currently research is still conducted on disease modifier drugs, such as tetracycline, glycosaminoglycans polysulfuric acid, pentosan polysulphate, diacerein, glucosamine and others. Researchs of new drug targets such as Interleucine-1R receptor antagonist (IL-1Ra), inhibitors of mitogen-activated protein (MAP) kinases, NF-kappaB inhibitor, are also continuously conducted. In addition, gene therapy, stem cell and chondrocytes transplantation also being developed. Various supplements have been widely used for the treatment of OA, such as glucosamine, chondroitin sulfate, ginger extract, avocado and soy, herbs cat's claw, as well as shark cartilage. Glucosamine and chondroitin sulfate are nutraceuticals that provided the most significant effect in the treatment of OA. Key words: osteoarthritis, pharmacological therapy, supplements drug.