This prospective observational study evaluated the efficacy and safety of different treatment modalities in 240 osteoarthritis (OA) patients (mean age 58.7±9.2 years; 68.3% female) at a diagnostic center in the Republic of Dagestan from 2022 to 2024. Patients were stratified into four treatment groups: NSAIDs (n=72), chondroprotectors (n=60), hyaluronic acid (HA) injections (n=54), and combination therapy (n=54). Primary outcomes included changes in pain intensity (VAS) and functional status (WOMAC) at 12 months. Combination therapy demonstrated superior clinical outcomes, with 41.7% of patients achieving ≥50% pain reduction compared to 22.2% in the NSAID group (p=0.008). Mean WOMAC improvement was significantly greater with combination therapy (-35.2±10.1%) versus monotherapies (p<0.001). Multivariate analysis identified KL Grade I-II (OR 2.65, p<0.001), normal CRP (OR 2.01, p=0.006), and BMI<30 kg/m² (OR 1.87, p=0.012) as independent predictors of treatment success. Safety profiles were favorable across groups, with the highest discontinuation rate observed in NSAID-treated patients (12.5%). These findings support the use of multimodal therapy in OA management, particularly for patients with early-stage disease and low systemic inflammation. The study provides novel real-world evidence from the North Caucasus region, highlighting the importance of personalized treatment strategies in diverse populations.
