chondroitin and Osteoarthritis--Knee

Though glucosamine and chondroitin have become common practices for treating knee osteoarthritis, the clinical value of these two drugs in combination are still questionable. To evaluate the efficacy and safety of the combination of glucosamine (GS) and chondroitin (CS) in knee osteoarthritis (KOA) treatment.. We searched electronic databases, including PubMed, Embase, Web of Science, SCOPUS, The Cochrane Central Register of Controlled Trials (CENTRAL), OVID, Chinese Clinical Trial Registry (ChiCTR), CBM, CNKI, WanFang and VIP from their inception to August 20, 2020, for literature concerning the combination of glucosamine and chondroitin in knee osteoarthritis treatment. The Cochrane Collaboration's tool for assessing risk of bias and Jadad scale were used to evaluate the risk of bias and quality of literature. The meta-analysis was performed using Review Manager 5.3 software.. Eight randomized controlled trials (RCTs) were included, including 7 studies in English and 1 study in Chinese. While the number of included papers was quite limited, the number of participants was decent, and quality appraisal result is acceptable. The total number of patients was 3793, with 1067 patients receiving a combination of glucosamine and chondroitin and 2726 patients receiving other treatments. The meta-analysis results revealed the following: (1) Regarding the total Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, compared with the placebo group, the combination group showed a statistically significant advantage [MD = - 12.04 (- 22.33 ~ - 1.75); P = 0.02], while the other groups showed no significance. (2) Regarding the VAS score, none of the comparisons showed significance. (3) In the secondary outcomes, except the comparison of JSN between the combination and placebo groups (MD = - 0.09 (- 0.18 ~ - 0.00); P = 0.04) and the comparison of the WOMAC stiffness score between the combination and CS groups [MD = - 4.70 (- 8.57 ~ - 0.83); P = 0.02], none of the comparisons showed a significant difference. (4)Safety analysis results show that none of the comparisons have significant differences.. Our study confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent. It is worthwhile to popularize and apply the combination in KOA treatment considering the point of effect, tolerability and economic costs. Additionally, regarding the limited number of studies and uneven trial quality, more high-quality trials are required to investigate the accurate clinical advantages of the combination.. CRD42020202093.

Topics: Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee; Treatment Outcome

This analysis was aimed at providing evidence-based medicine basis for systematic evaluation of chondroitin combined with glucosamine in the treatment of knee osteoarthritis.. The randomized controlled trials (RCTs) of chondroitin combined with glucosamine in the treatment of knee osteoarthritis (KOA) were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) online database. The retrieval time ranges from the database creation to the present. Two investigators gathered the information individually. The risk of bias was assessed using the criteria of the Cochrane back review group. RevMan5.4 statistical software analyzed the selected data.. A total of 6 RCT articles were obtained. Overall, 764 samples were evaluated by meta-analysis. The clinical efficacy of chondroitin combined with glucosamine was significantly better than that of routine treatment by meta-analysis. The confidence interval of 95% was (4.86, 17.08) (. Chondroitin combined with glucosamine is more effective than chondroitin or glucosamine alone in the treatment of KOA and deserves clinical promotion. However, this conclusion still needs to be supported by multicenter, high-quality, double-blind, large-sample randomized controlled clinical trials due to the limitations of the six trials included.

Topics: China; Chondroitin; Glucosamine; Humans; Multicenter Studies as Topic; Osteoarthritis, Knee; Randomized Controlled Trials as Topic; Treatment Outcome

Osteoarthritis (OA) is common and burdensome for patients and health care systems. Our study purpose was to evaluate the long-term efficacy and safety of DMOADs in adults with knee and hip osteoarthritis.. We searched Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Web of Knowledge without language, publication, or date restrictions from inception through November 2018 for randomized controlled trials assessing 12 classes of DMOADs with at least 12 months of follow-up. Therapeutic effects were evaluated with pairwise and network meta-analysis. Outcomes included pain, function, minimum joint space width or cartilage volume, radiographic progression, and total joint replacement. Analyses were also performed for drug safety.. Twenty-eight randomized controlled trials with 11,890 patients were included. Glucosamine and chondroitin minimally improved both structure (minimum joint width or cartilage volume: network results: glucosamine: SMD 0.16; 95% CI [0.04, 0.28], chondroitin: SMD 0.21 [0.10, 0.32]) and symptoms (glucosamine: pain: - 0.15 [- 0.25, - 0.05]; function: - 0.17 [- 0.28, - 0.07], chondroitin: pain: - 0.06 [- 0.15, 0.03], and function: - 0.15 [- 0.26, - 0.03]). Strontium demonstrated improvement in structure (minimum joint width or cartilage volume: 0.20 [0.02, 0.38]), and vitamin D on symptoms (pain: - 0.15 [- 0.27, -0.03]; function: - 0.18 [- 0.31, - 0.06]). Although doxycycline also demonstrated a favorable efficacy ranking, its safety profile was poor (withdrawal: network relative risk 1.69 [1.03, 2.75]). The therapeutic effects of other medications were not ranked as highly.. Glucosamine and chondroitin yielded statistically significant but clinically questionable long-term benefit on structure and symptoms, though both had favorable safety profiles. Strontium improved structure, and vitamin D improved symptoms. Although doxycycline had a favorable efficacy ranking, its safety profile was poor. None of the 12 classes of drugs appears to have long-term clinically significant benefit.

Topics: Chondroitin; Humans; Network Meta-Analysis; Osteoarthritis, Hip; Osteoarthritis, Knee; Pharmaceutical Preparations; Randomized Controlled Trials as Topic

To assess the symptomatic effectiveness and safety of oral symptomatic slow-acting drugs (SYSADOAs) on the treatment of knee and/or hip osteoarthritis, such as chondroitin, glucosamine, and combination treatment with chondroitin plus glucosamine.. We searched electronic database including PubMed, Embase, Cochrane Library, and the reference lists of relevant articles published from inception to May 22, 2018. An updated meta-analysis was performed to assess the effectiveness of these slow-acting drugs for osteoarthritis.. Twenty-six articles describing 30 trials met our inclusion criteria and were included in the meta-analysis. The estimates between chondroitin and placebo showed that chondroitin could alleviate pain symptoms and improve function. Compared with placebo, glucosamine proved significant effect only on stiffness improvement. However, the combination therapy did not have enough evidence to be superior to placebo. Additionally, there was no significant difference in the incidence of AEs and discontinuations of AEs when compared with placebo.. Given the effectiveness of these symptomatic slow-acting drugs, oral chondroitin is more effective than placebo on relieving pain and improving physical function. Glucosamine showed effect on stiffness outcome. Regarding on the limited number of combination therapy, further studies need to investigate the accurate effectiveness. This information accompanied with the tolerability and economic costs of included treatments would be conducive to making decisions for clinicians.

Topics: Chondroitin; Drug Therapy, Combination; Glucosamine; Humans; Osteoarthritis, Hip; Osteoarthritis, Knee; Randomized Controlled Trials as Topic; Treatment Outcome

Topics: Cell- and Tissue-Based Therapy; Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee; Physical Therapy Modalities; Self Care; Treatment Outcome; Weight Loss

Structure-modifying medications or nutraceuticals may be an effective treatment for osteoarthritis. This study identified 12 treatments that may possess chondroprotective properties: oral glucosamine; chondroitin; nonsteroidal anti-inflammatory drugs (NSAIDs); polyunsaturated fatty acids; S-adenosylmethionine; avocado and soybean unsaponifiable fractions; methylsulfonylmethane; vitamins C, D, and E; intra-articular injections of hyaluronic acid; and platelet-rich plasma (PRP).. To perform a systematic review of randomized controlled trials for the effectiveness of each agent in preserving articular cartilage of the knee and delaying the progression of osteoarthritis.. Systematic review; Level of evidence, 2.. A literature search was performed using PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Searches were performed using "treatment," "osteoarthritis," and "knee" as keywords. Selection criteria included randomized controlled trials of ≥12 months, with a placebo control, measuring radiographic changes in joint space width, cartilage volume, or radiographic progression of osteoarthritis. The primary outcome was changes in joint integrity measures.. A total of 3514 studies were identified from the initial search, 13 of which met inclusion criteria. Treatment with chondroitin sulfate showed a significant reduction in cartilage loss in 3 of 4 studies identified compared with placebo. Two of 3 trials identified for glucosamine also reported significant structural effects relative to placebo. Intra-articular hyaluronic acid was effective in lowering the rate of cartilage loss in only 1 of 3 studies identified versus placebo. Of the 6 studies identified for NSAIDs, vitamin E, and vitamin D, none showed any structural effect compared with placebo. No studies were found that met the inclusion criteria for polyunsaturated fatty acids, S-adenosylmethionine, avocado and soybean unsaponifiable fractions, methylsulfonylmethane, vitamin C, or PRP.. For patients with or at risk for osteoarthritis, the use of glucosamine and chondroitin sulfate may serve as a nonoperative means to protect joint cartilage and delay osteoarthritis progression. Hyaluronic acid injections showed variable efficacy, while NSAIDs and vitamins E and D showed no effect on osteoarthritis progression. The other agents evaluated had no evidence in the literature to support or refute their use for chondroprotection.

Topics: Administration, Oral; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Cartilage, Articular; Chondroitin; Dietary Supplements; Disease Progression; Glucosamine; Humans; Hyaluronic Acid; Injections, Intra-Articular; Osteoarthritis, Knee; Randomized Controlled Trials as Topic; Viscosupplements; Vitamins

This study aimed to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA). PubMed, Embase and Cochrane Library were searched through from inception to February 2015. A total of 54 studies covering 16427 patients were included. Glucosamine plus chondroitin, glucosamine alone, and celecoxib were all more effective than placebo in pain relief and function improvement. Specifically, celecoxib is most likely to be the best treatment option, followed by the combination group. All treatment options showed clinically significant improvement from baseline pain, but only glucosamine plus chondroitin showed clinically significant improvement from baseline function. In terms of the structure-modifying effect, both glucosamine alone and chondroitin alone achieved a statistically significant reduction in joint space narrowing. Although no significant difference was observed among the five options with respect to the three major adverse effects (withdrawal due to adverse events, serious adverse events and the number of patients with adverse events), the additional classical meta-analysis showed that celecoxib exhibited a higher rate of gastrointestinal adverse effect comparing with the placebo group. The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA.

Topics: Arthralgia; Celecoxib; Chondroitin; Drug Therapy, Combination; Glucosamine; Humans; Odds Ratio; Osteoarthritis, Knee; Pain Management; Treatment Outcome

Osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases. Collagen derivatives are candidates for disease-modifying OA drugs. This group of derivatives can be divided into undenatured collagen (UC), gelatine and collagen hydrolysate (CH). Collagen derivatives are marketed as having direct chondroprotective action and reducing complaints of OA. This review summarizes the evidence for the effectiveness of symptomatic and chondroprotective treatment with collagen derivatives in patients with OA.. Eligible randomised controlled trials (RCTs) and quasi-RCTs were identified by searching PubMed, Embase and the Cochrane Central Register of Controlled Trials until November 2011. Methodological quality was assessed using methods of the Cochrane Back Review Group.. Eight studies were identified: six on CH, two on gelatine, and one on UC. The pooled mean difference based on three studies for pain reduction measured with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index comparing CH with placebo was -0.49 (95% CI -1.10-0.12). However, some studies report significant between-group differences in pain when measured with a visual analogical scale (VAS) or other instruments, or when CH is compared with glucosamine sulphate. For disability no significant between-group mean differences were found when comparing CH with placebo. Gelatine compared with placebo and with alternative therapies was superior for the outcome pain. UC compared with glucosamine+chondroitin showed no significant between-group differences for pain and disability. The most reported adverse events of collagen derivatives were mild to moderate gastro-intestinal complaints. The overall quality of evidence was moderate to very low.. There is insufficient evidence to recommend the generalized use of CHs in daily practice for the treatment of patients with OA. More independent high-quality studies are needed to confirm the therapeutic effects of collagen derivatives on OA complaints.

Topics: Chondroitin; Collagen; Female; Gelatin; Glucosamine; Humans; Male; Middle Aged; Osteoarthritis, Hip; Osteoarthritis, Knee; Pain; Pain Measurement; Protein Hydrolysates; Randomized Controlled Trials as Topic; Treatment Outcome

Glucosamine and chondroitin are members of a group of dietary supplements often termed "complementary agents," "disease-modifying agents," or "disease-modifying osteoarthritis drugs" (DMOADs). They are among the best-selling dietary supplements in the United States. DMOADs are thought to act by affecting cytokine-mediated pathways regulating inflammation, cartilage degradation, and immune responses. Given the results of recent studies, investigators have begun to question whether the popular combination of glucosamine and chondroitin alleviates disease progression or pain in people with mild to moderate knee osteoarthritis. Reasons proposed for the lack of benefit include incorrect dosing, suboptimal compound manufacture, and a lack of complete understanding of when and how to apply the compounds. In addition, adjuvant medications also could augment the therapeutic potential of these agents. Although these agents are considered safe, some uncommon and minor adverse effects have been reported, including epigastric pain or tenderness (3.5%), heartburn (2.7%), diarrhea (2.5%), and nausea (1%). In conclusion, although some questions have arisen about whether DMOADs are as effective as has been claimed, a trial should be considered in in selected patients with sustained refractory cases of osteoarthritis.

Topics: Cartilage, Articular; Chondroitin; Complementary Therapies; Dietary Supplements; Disease Progression; Glucosamine; Humans; Osteoarthritis; Osteoarthritis, Knee; Treatment Outcome

To determine the effect of glucosamine, chondroitin, or the two in combination on joint pain and on radiological progression of disease in osteoarthritis of the hip or knee. Design Network meta-analysis. Direct comparisons within trials were combined with indirect evidence from other trials by using a Bayesian model that allowed the synthesis of multiple time points.. Pain intensity. Secondary outcome was change in minimal width of joint space. The minimal clinically important difference between preparations and placebo was prespecified at -0.9 cm on a 10 cm visual analogue scale.. Electronic databases and conference proceedings from inception to June 2009, expert contact, relevant websites. Eligibility criteria for selecting studies Large scale randomised controlled trials in more than 200 patients with osteoarthritis of the knee or hip that compared glucosamine, chondroitin, or their combination with placebo or head to head. Results 10 trials in 3803 patients were included. On a 10 cm visual analogue scale the overall difference in pain intensity compared with placebo was -0.4 cm (95% credible interval -0.7 to -0.1 cm) for glucosamine, -0.3 cm (-0.7 to 0.0 cm) for chondroitin, and -0.5 cm (-0.9 to 0.0 cm) for the combination. For none of the estimates did the 95% credible intervals cross the boundary of the minimal clinically important difference. Industry independent trials showed smaller effects than commercially funded trials (P=0.02 for interaction). The differences in changes in minimal width of joint space were all minute, with 95% credible intervals overlapping zero. Conclusions Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.

Topics: Anti-Inflammatory Agents; Chondroitin; Glucosamine; Humans; Osteoarthritis, Hip; Osteoarthritis, Knee; Randomized Controlled Trials as Topic; Treatment Outcome

Osteoarthritis (OA) is the leading cause of knee morbidity. Age and overweight are the main risk factors for development of knee OA. The majority of patients respond to conservative treatment. For those who don't, surgical treatment is the only alternative. Arthroscopic surgery for the osteoarthritic knee is a well known procedure. Recently, numerous publications addressed the advantages of arthroscopic treatment for this indication. Some of the publications concluded that arthroscopic treatment for knee OA equals placebo. Others found temporary relief of symptoms. Among special subgroup of patients, in which acute pain exacerbation, mechanical block or early OA, utilizing arthroscopic techniques revealed satisfactory results. In this review, we discuss the indications and contraindications for arthroscopic treatment of the osteoarthritic knee according to the latest literature.

Topics: Adrenal Cortex Hormones; Arthroscopy; Cartilage, Articular; Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee; Randomized Controlled Trials as Topic

The focus of pharmacologic treatment of osteoarthritis (OA) includes targets from the cell and cytokine level to the larger joint components such as cartilage, bone, innervations, and vascular supply. The most important goals of therapy in patients who have OA are pain management, improvement in function and disability, and ultimately disease modification. This article discusses the current pharmacologic regimens available to address these goals. Specific attention is paid to current trends and controversies related to pharmacologic management, including the use of oral, topical, and injectable agents.

Topics: Administration, Oral; Adrenal Cortex Hormones; Aged; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Chondroitin; Dose-Response Relationship, Drug; Female; Glucosamine; Humans; Injections, Intra-Articular; Male; Middle Aged; Osteoarthritis, Hip; Osteoarthritis, Knee; Pain Measurement; Prognosis; Range of Motion, Articular; Severity of Illness Index; Treatment Outcome

Systematic review of outcomes of three treatments for osteoarthritis (OA) of the knee: intra-articular viscosupplementation; oral glucosamine, chondroitin or the combination; and arthroscopic lavage or debridement.. We abstracted data from: 42 randomized, controlled trials (RCTs) of viscosupplementation, all but one synthesized among six meta-analyses; 21 RCTs of glucosamine/chondroitin, 16 synthesized among 6 meta-analyses; and 23 articles on arthroscopy. The search included foreign-language studies and relevant conference proceedings.. The review methods were defined prospectively in a written protocol. We sought systematic reviews, meta-analyses, and RCTs published in full or in abstract. Where randomized trials were few, we sought other study designs. We independently assessed the quality of all primary studies.. Viscosupplementation trials generally report positive effects on pain and function scores compared to placebo, but the evidence on clinical benefit is uncertain, due to variable trial quality, potential publication bias, and unclear clinical significance of the changes reported. The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), a large (n=1,583), high-quality, National Institutes of Health-funded, multicenter RCT showed no significant difference compared to placebo. Glucosamine sulfate has been reported to be more effective than glucosamine hydrochloride, which was used in GAIT, but the evidence is not sufficient to draw conclusions. Clinical studies of glucosamine effect on glucose metabolism are short term, or if longer (e.g., 3 years), excluded patients with metabolic disorders. The best available evidence for arthroscopy, a single sham-controlled RCT (n=180), showed that arthroscopic lavage with or without debridement was equivalent to placebo. The main limitations of this trial are the use of a single surgeon and enrollment of patients at a single Veterans Affairs Medical Center. No studies reported separately on patients with secondary OA of the knee. The only comparative study was an underpowered, poor-quality trial comparing viscosupplementation to arthroscopy with debridement.. Osteoarthritis of the knee is a common condition. The three interventions reviewed in this report are widely used in the treatment of OA of the knee, yet the best available evidence does not clearly demonstrate clinical benefit. Uncertainty regarding clinical benefit can be resolved only by rigorous, multicenter RCTs. In addition, given the public health impact of OA of the knee, research on new approaches to prevention and treatment should be given high priority.

Topics: Aged; Arthroscopy; Chondroitin; Debridement; Drug Therapy, Combination; Female; Glucosamine; Humans; Hyaluronic Acid; Injections, Intra-Articular; Knee; Male; Middle Aged; Osteoarthritis, Knee; Pain; Synovial Fluid; Therapeutic Irrigation; Treatment Outcome

Treatment of the knee with unicompartmental osteoarthritis remains a challenging clinical problem. Despite pharmacologic advances and surgical innovations, the ideal strategy for the patient who has single-compartment degenerative disease can be complicated. The understanding and management of this problem are further confounded by the fact that so much of the data are unreliable. Given these constraints, this article outlines the current alternatives available in nonoperatively managing the symptomatic unicompartmental arthritic knee.

Topics: Adjuvants, Immunologic; Administration, Topical; Analgesics, Non-Narcotic; Anti-Inflammatory Agents; Arthroscopy; Chondroitin; Cortisone; Dietary Supplements; Glucosamine; Humans; Hyaluronic Acid; Injections, Intra-Articular; Life Style; Orthotic Devices; Osteoarthritis, Knee

Topics: Acupuncture Therapy; Adrenal Cortex Hormones; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Knee; Chondroitin; Exercise Therapy; Glucosamine; Humans; Hyaluronic Acid; Injections, Intra-Articular; Osteoarthritis, Knee; Osteotomy; Physical Therapy Modalities

To assess the structural and symptomatic efficacy of oral glucosamine sulfate and chondroitin sulfate in knee osteoarthritis through independent meta-analyses of their effects on joint space narrowing, Lequesne Index, Western Ontario MacMaster University Osteoarthritis Index (WOMAC), visual analog scale for pain, mobility, safety, and response to treatment.. An exhaustive systematic research of randomized, placebo-controlled clinical trials published or performed between January 1980 and March 2002 that assessed the efficacy of oral glucosamine or chondroitin on gonarthrosis was performed using MEDLINE, PREMEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Current Contents, BIOSIS Previews, HealthSTAR, EBM Reviews, manual review of the literature and congressional abstracts, and direct contact with the authors and manufacturers of glucosamine and chondroitin. Inclusion, quality scoring, and data abstraction were performed systematically by 2 independent reviewers who were blinded to sources and authors. Conservative approaches were used for clear assessment of potential efficacy.. Our results demonstrated a highly significant efficacy of glucosamine on all outcomes, including joint space narrowing and WOMAC. Chondroitin was found to be effective on Lequesne Index, visual analog scale pain, mobility, and responding status. Safety was excellent for both compounds.. Our study demonstrates the structural efficacy of glucosamine and indistinguishable symptomatic efficacies for both compounds. Regarding the relatively sparse data on glucosamine and joint space narrowing and the absence of data on structural effects of chondroitin, further studies are needed to investigate the relationship among time, dose, patient baseline characteristics, and structural efficacy for an accurate, disease-modifying characterization of these 2 compounds.

Topics: Administration, Oral; Chondroitin; Data Interpretation, Statistical; Dietary Supplements; Glucosamine; Humans; Osteoarthritis, Knee; Pain Measurement; Randomized Controlled Trials as Topic

Hyaluronan (HA), glucosamine, and chondroitin sulfate are widely consumed as dietary supplements for the treatment of knee osteoarthritis (OA). This study aimed to explore the efficacy and safety of a dietary liquid supplement mixture containing HA, glucosamine, and chondroitin in patients with knee OA who had moderate knee pain (visual analogue scale of 4-6 points).. This was a short-term, randomized, double-blind, placebo-controlled study. Subjects were allocated to administer either a bottle of 20 mL supplement mixture (50 mg HA plus 750 mg glucosamine plus 250 mg chondroitin, namely A + HA) or placebo once daily for 8 weeks. Outcome measures included the Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, 36-item Short Form Survey (SF-36), Chinese version of Pittsburgh Sleep Quality Index, and incidence of adverse event were evaluated at the end of week 8. Efficacy analyses were conducted in the modified intent-to-treat population.. Of the 80 subjects in the modified intent-to-treat population, 39 received A + HA while 41 received placebo. After 8 weeks of treatment, the A + HA group failed to demonstrate a significant symptomatic efficacy and quality of life improvement in terms of Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, SF-36, and Chinese version of Pittsburgh Sleep Quality Index as compared to the placebo group. However, the mean changes in most of the SF-36 scale scores were numerically higher in the A + HA group than in the placebo group. No treatment-related adverse event was reported in both groups.. This present study found that the combination of liquid low molecular weight HA, glucosamine, and chondroitin oral supplement did not effectively improve knee OA pain and symptoms after short-term use in knee OA patients with moderate knee pain. However, these results should be interpreted with caution due to the intrinsic limitation of the study design.

Topics: Administration, Oral; Aged; Chondroitin; Dietary Supplements; Double-Blind Method; Drug Combinations; Female; Glucosamine; Humans; Hyaluronic Acid; Male; Middle Aged; Osteoarthritis, Knee; Pain Management

The popularity of dietary supplements for knee osteoarthritis (OA) management is on the rise; however, their effects are still debated.. This study aimed to investigate the effect of an oral low molecular weight liquid hyaluronic acid supplement in the treatment of knee OA patients with mild knee pain (visual analogue scale [VAS] ≤ 3) in Taiwan population. This was a randomized, double-blind, placebo-controlled study. Forty-seven subjects were enrolled and randomly allocated to either the A+HA or the placebo groups. The subjects were required to drink a bottle contained 20 mL of A+HA or placebo daily throughout an 8-week study period. The efficacy was assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-item Short Form Survey (SF-36).. At Week 8, significant reductions from baseline in the WOMAC pain (-2.6 ± 1.68, P < .0001), stiffness (-1.2 ± 1.50, P = .007), physical function (-5.8 ± 4.39, P < .0001), and total (-9.4 ± 5.82, P < .0001) scores were observed in the A+HA group but not in the placebo group. Significant differences in the mean change of WOMAC scores from baseline at Week 8 between groups were detected (P < .01). At Week 8, the A+HA group also showed significant improvements in SF-36 physical functioning (2.7 ± 3.10, P = .001) and bodily pain (0.7 ± 1.50, P < .05) domains. Although the A+HA group had a higher increase in the SF-36 total score than the placebo group but the difference was not statistically significant (2.1 ± 12.75 vs 0.3 ± 19.66, P = .12).. Oral administration of low molecular weight liquid HA appeared to be effective for knee OA patients with mild knee pain (VAS ≤ 3) in the relief of knee OA symptoms, particularly in pain and physical function.Clinical Trial Registration: NCT04352322.

Topics: Administration, Oral; Arthralgia; Chondroitin; Complex Mixtures; Dietary Supplements; Double-Blind Method; Drug Monitoring; Female; Glucosamine; Humans; Hyaluronic Acid; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Treatment Outcome; Viscosupplements

Osteoarthritis (OA) is an age-related disease caused by the wear and tear of the joints. Presently, there is no known cure for OA, but its management involves the use of high doses of pain killers and antiinflammatory agents with different side and dependency effects. Alternative management strategies involve the use of high doses of glucosamine-chondroitin (GC). This study was carried out to evaluate the efficacy of Q-Actin™, an aqueous extract of. Overall, 122 patients (56 males and 66 females) aged between 40 and 75 years and diagnosed with moderate knee OA were included in this randomized double-blind, parallel-group clinical trial that took place in three different centers. The 180 day intervention involved two groups of 61 participants in each: the GC group, which received orally the generally prescribed dose of 1,350 mg of GC twice daily and the CSE group, which received orally10 mg twice daily of CSE. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog scale, and Lequesne's Functional Index were used to evaluate pain, stiffness, and physical function of knee OA in participants at baseline (Day 0) and on Days 30, 60, 90, 120, 150, and 180.. In the CSE group, the WOMAC score was decreased by 22.44% and 70.29% on Days 30 and 180, respectively, compared to a 14.80% and 32.81% decrease in the GC group. Similar trends were observed for all the other pain scores. No adverse effect was reported during the trial period.. The use of 10 mg CSE, twice daily, was effective in reducing pain related to moderate knee OA and can be potentially used in the management of knee pain, stiffness, and physical functions related to OA.

Topics: Adult; Aged; Chondroitin; Cucumis sativus; Double-Blind Method; Drug Combinations; Female; Glucosamine; Humans; Knee Joint; Male; Middle Aged; Musculoskeletal Pain; Osteoarthritis, Knee; Pain Measurement; Phytotherapy; Plant Extracts; Treatment Outcome; Visual Analog Scale

The authors studied efficiency of chondroxide and phinalgel phonophoresis in osteoarthritis patients with roentgenologic stages I and II, aged 40 to 66. Recommendations are to use these treatment modalities in accordance with severity of joints inflammation.

Topics: Adult; Aged; Chondroitin; Humans; Middle Aged; Occupational Diseases; Osteoarthritis; Osteoarthritis, Knee; Phonophoresis; Ultrasonic Therapy; Workload

This preliminary study sought to determine whether using 1500/1200mg of glucosamine hydrochloride and chondroitin sulfate (GH/CS) is effective, both separately and combined with exercise, compared to a placebo plus exercise program in improving physical function, pain, strength, balance, and mobility in older adults with knee osteoarthritis (OA).. This double-blind, placebo-controlled, randomized clinical trial lasted 12 months. Participants included 89 older adults (age>/=50 years) with knee OA randomized to either GH/CS or placebo group. Phase I was a 6-month trial comparing the effects of assignment to either GH/CS or placebo. Phase II added 6 months of exercise for both groups. The primary outcome measure was Western Ontario and McMaster University Osteoarthritis Index (WOMAC) function, and secondary outcome measures included WOMAC pain, 6-min walk, balance, and knee strength.. Of the 89 randomized participants, 72 (81%) completed the study. The median pill compliance was 94% and 95% in Phase I, and, in Phase II, 97% and 91% for the GH/CS and placebo groups, respectively. Median exercise compliance during Phase II was 77% for the GH/CS group and 78% for the placebo group. WOMAC function and pain did not differ significantly between the groups at 6- or 12-month follow-up. There were also no significant differences between the groups in 6-min walk or knee strength; however, balance was better in the placebo group with approximately a 10% difference compared to the GH/CS group.. The GH/CS group was not superior to the placebo group in function, pain, or mobility after both phases of the intervention (pill only and pill plus exercise).

Topics: Activities of Daily Living; Aged; Aged, 80 and over; Analgesics, Non-Narcotic; Analysis of Variance; Chondroitin; Double-Blind Method; Exercise Therapy; Female; Glucosamine; Humans; Male; Middle Aged; Osteoarthritis, Knee; Pain; Patient Compliance; Severity of Illness Index

Topics: Administration, Oral; Chondroitin; Delayed-Action Preparations; Glucosamine; Humans; Injections, Intra-Articular; Knee Joint; Osteoarthritis, Knee; Treatment Outcome

Topics: Chondroitin; Dietary Supplements; Glucosamine; Humans; Osteoarthritis, Knee

Osteoarthritis of the knee is a common disease that causes significant disability. Most patients can be managed conservatively in the outpatient setting. A small minority require surgery. The cornerstones of treatment are weight loss, exercise and analgesia. Walking aids, medial patellar taping, acupuncture and transcutaneous electrical nerve stimulation are useful management adjuncts. Current evidence does not support routine prescription of glucosamine and chondroitin supplements. Early consultation with an orthopaedic surgeon should be made when conservative measures fail.

Topics: Acetaminophen; Acupuncture Therapy; Analgesia; Chondroitin; Chondroitin Sulfates; Dietary Supplements; Exercise; Female; Gait; Glucosamine; Humans; Injections, Intra-Articular; Knee Joint; Osteoarthritis, Knee; Outpatients; Transcutaneous Electric Nerve Stimulation; Weight Loss

Topics: Arthralgia; Celecoxib; Chondroitin; Cyclooxygenase 2 Inhibitors; Drug Combinations; Education, Medical, Continuing; Glucosamine; Humans; Osteoarthritis, Knee

The purpose of this study was to estimate the effectiveness of the combination of glucosamine and chondroitin in relieving knee symptoms and slowing disease progression among patients with knee osteoarthritis (OA).. The 4-year followup data from the Osteoarthritis Initiative data set were analyzed. We used a "new-user" design, for which only participants who were not using glucosamine/chondroitin at baseline were included in the analyses (n = 1,625). Cumulative exposure was calculated as the number of visits when participants reported use of glucosamine/chondroitin. Knee symptoms were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and structural progression was determined by measuring the joint space width (JSW). To control for the time-varying confounders that might be influenced by previous treatments, we used marginal structural models to estimate the effects on OA of using glucosamine/chondroitin for 3 years, 2 years, and 1 year.. During the study period, 18% of the participants initiated treatment with glucosamine/chondroitin. After adjustment for potential confounders with marginal structural models, we found no clinically significant differences between users at all assessments and never-users of glucosamine/chondroitin in WOMAC pain (β = 0.68 [95% confidence interval (95% CI) -0.16 to 1.53]), WOMAC stiffness (β = 0.41 [95% CI 0 to 0.82]), and WOMAC function (β = 1.28 [95% CI -1.23 to 3.79]) or JSW (β = 0.11 [95% CI -0.21 to 0.44]).. Use of glucosamine/chondroitin did not appear to relieve symptoms or modify disease progression among patients with radiographically confirmed OA. Our findings are consistent with the results of meta-analyses of clinical trials and extend those results to a more general population with knee OA.

Topics: Aged; Chondroitin; Dietary Supplements; Disease Progression; Drug Combinations; Female; Follow-Up Studies; Glucosamine; Humans; Knee; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Treatment Outcome

Topics: Anti-Inflammatory Agents, Non-Steroidal; Chondroitin; Dietary Supplements; Female; Glucosamine; Humans; Knee Joint; Male; Osteoarthritis, Knee

Topics: Celecoxib; Chondroitin; Drug Therapy, Combination; Glucosamine; Humans; Multicenter Studies as Topic; Osteoarthritis, Knee; Pyrazoles; Randomized Controlled Trials as Topic; Sulfonamides; Treatment Outcome

Topics: Celecoxib; Chondroitin; Drug Therapy, Combination; Glucosamine; Humans; Multicenter Studies as Topic; Osteoarthritis, Knee; Placebo Effect; Pyrazoles; Randomized Controlled Trials as Topic; Sulfonamides

Topics: Chondroitin; Dietary Supplements; Female; Glucosamine; Humans; Male; Osteoarthritis, Knee

Topics: Chondroitin; Dietary Supplements; Female; Glucosamine; Humans; Male; Osteoarthritis, Knee

Topics: Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee; Pyrazoles; Sulfonamides

Topics: Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee; Pyrazoles; Sulfonamides

Topics: Chondroitin; Dietary Supplements; Glucosamine; Humans; Osteoarthritis, Knee; Pain Management; Pain Measurement

Osteoarthritis (OA) is a joint disease of high prevalence and affects > 90 % of the population, depending on several risk factors. Symptomatic OA is less frequent, but requires an individually tailored therapeutic regimen consisting of non-pharmacological and pharmacological treatment modalities. Pharmacologic therapy, however, is mainly limited to analgetic and anti-inflammatory agents; structure modifying remedies do not exist. The therapeutic approach to hand-, knee- and hip-OA is basically similar and differs only at some minor points. Generally, topical agents or paracetamol are recommended as first-line agents. If unsuccessful oral non-steroidal anti-inflammatory drugs (NSAIDs) or COX-2-selctive inhibitors should be introduced. Tramadol is an option in the case patients will not respond satisfactorily to NSAIDs. Glucosamine and chondroitine sulphate are no longer recommended in knee and hip OA, but chondroitine might be efficient in treating hand OA. Oral NSAIDs should be prescribed with caution due to potential side effects. Opioids are not recommended as their benefits are outweighed by an increased risk for serious adverse events.

Topics: Acetaminophen; Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Analgesics; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Capsaicin; Chondroitin; Combined Modality Therapy; Cyclooxygenase 2 Inhibitors; Glucosamine; Hand Joints; Humans; Osteoarthritis; Osteoarthritis, Hip; Osteoarthritis, Knee; Tramadol

Osteoarthritis (OA), a chronic and often painful disease for which there is no cure, accounts for more mobility issues in older adults than any other disease. Cross-sectional studies have found that arthritis is the most common reason for older adults to use complementary and alternative medicine (CAM). Although previous research has profiled the sociodemographic and clinical characteristics of CAM users, few studies have provided information on variation in CAM use over time and most only considered use of any CAM, which was often a mixture of heterogeneous therapies.. This study sought to describe the longitudinal patterns of CAM use among older adults with knee OA and to identify correlates and predictors of different commonly used CAM therapies.. The Osteoarthritis Initiative included 1121 adults aged ≥65 years with radiographic tibiofemoral OA in one or both knees at baseline. Annual surveys captured current use of conventional therapies and 25 CAM modalities (grouped into 6 categories) for joint pain or arthritis at baseline and during the 4-year follow-up. We assessed longitudinal use of CAM modalities by summing the number of visits with participants reporting use of each modality. Correlates of CAM use under consideration included sociodemographic indicators, body mass index, overall measures of mental and physical well-being, and clinical indices of knee OA. Generalized estimation equations provided adjusted odds ratio estimates and 95% CIs.. Nearly one-third of older adults reported using ≥1 CAM modality for treating OA at all assessments. With the exception of glucosamine and chondroitin (18%), few were persistent users of other CAM modalities. One in 5 of those using nonsteroidal anti-inflammatory drugs or glucosamine and/or chondroitin were using them concurrently. Adjusted models revealed the following: (1) adults aged ≥75 years were less likely to use dietary supplements than those between ages 65 and 75 years; (2) persons with more severe knee pain or stiffness reported more CAM use; (3) better knee-related physical function was correlated with more use of chiropractic care or massage; and (4) older adults with more comorbidities were less likely to report use of dietary supplements.. Patterns of CAM use are, to some extent, inconsistent with current guidelines for OA treatment. Evaluating the potential risks and benefits in older adults from commonly used CAM modalities, with or without combination use of conventional analgesics, is warranted.

Topics: Aged; Aged, 80 and over; Chondroitin; Chronic Pain; Combined Modality Therapy; Complementary Therapies; Female; Glucosamine; Humans; Knee Joint; Longitudinal Studies; Male; Manipulation, Chiropractic; Manipulation, Orthopedic; Osteoarthritis, Knee; Pain Management; Radiography; Socioeconomic Factors

Topics: Acupuncture Therapy; Chondroitin; Complementary Therapies; Dietary Supplements; Glucosamine; Humans; Osteoarthritis, Knee; Pain Management; Platelet-Rich Plasma; Viscosupplementation

Insufficient data are available on the efficacy of combined conservative interventions recommended by treatment guidelines for knee/hip osteoarthritis (OA). The aims of this observational cohort study were (i) to estimate the results of an evidence-based 12-week tailored multimodal conservative treatment protocol for patients with knee/hip OA and (ii) to identify predictors for response.. After obtaining data on previous OA-related interventions, multimodal treatment was offered to patients with knee and/or hip OA at a specialized outpatient clinic. Treatment with analgesics was tailored using a numeric rating scale (NRS) for pain, aiming for NRS ≤ 4. The following outcome measures were assessed: (i) the proportion of patients fulfilling OMERACT-OARSI (Outcome Measures in Rheumatoid Arthritis Clinical Trials/Osteoarthritis Research Society International) responder criteria and (ii) the proportion of patients with NRS pain ≤ 4 after 12 weeks.. A total of 183 out of 299 patients was included. OMERACT-OARSI responder criteria were fulfilled at 12 weeks in 47% of patients; 39% reached NRS pain ≤ 4. The only independent predictor for response was the number of previously used non-steroidal anti-inflammatory drugs (NSAIDs). The majority of patients had not been exposed adequately to conservative treatment modalities for knee and/or hip OA in the past (81%).. Evidence-based multimodal conservative treatment using a standardized protocol for knee and/or hip OA is feasible and successful in 47% of patients. In general, response could not be predicted. Basic first-line recommended conservative treatment options have not been used adequately prior to referral to secondary care in the vast majority of patients.

Topics: Analgesics; Chondroitin; Cohort Studies; Dietary Supplements; Evidence-Based Medicine; Female; Glucosamine; Humans; Male; Middle Aged; Osteoarthritis, Hip; Osteoarthritis, Knee; Pain; Pain Measurement; Physical Therapy Modalities; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome

To learn more about the health services and products that patients use after receiving a diagnosis of knee osteoarthritis (OA), as well as the trajectory of their health-related quality of life (HRQOL).. Using a simple screening survey, community pharmacists identified 194 participants with previously undiagnosed knee OA. Of these participants, 190 were confirmed to have OA on further investigation. At baseline and 1, 3, and 6 months after diagnosis, a survey was administered to assess health services, product use, and HRQOL, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Medical Outcomes Study Short Form 36 (SF-36) health survey, the Paper Adaptive Test (PAT-5D-QOL), and the Health Utilities Index Mark 3.. With a mean age of 63 years, participants were mostly women, white, and overweight. By 6 months, more than 90% of the participants had visited their family physician to discuss their OA, and more than 50% of participants took either prescription or nonprescription analgesics. In addition, three-quarters of the participants started exercising, one-third initiated activity aids, and one-third had started natural medicine products. At 6 months compared with baseline, significant improvements were seen in the SF-36 physical component summary (P = 0.001) and bodily pain domain scores (P = 0.02), the PAT-5D-QOL overall, pain, and usual daily activities scores (P < 0.001 for all), and the WOMAC total, pain, and function scores (P < 0.001 for all).. Within 6 months of receiving a diagnosis of knee OA, participants made several lifestyle interventions, often without the advice of a health professional, and saw improvements in their pain and function.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; British Columbia; Chondroitin; Dietary Supplements; Exercise Therapy; Female; Follow-Up Studies; Glucosamine; Health Surveys; Humans; Male; Middle Aged; Orthotic Devices; Osteoarthritis, Knee; Pharmacies; Quality of Life; Risk Reduction Behavior; Self Care; Severity of Illness Index

Topics: Anti-Inflammatory Agents; Chondroitin; Glucosamine; Humans; Osteoarthritis, Hip; Osteoarthritis, Knee; Treatment Outcome

Topics: Anti-Inflammatory Agents; Cartilage, Articular; Chondroitin; Glucosamine; Humans; Osteoarthritis, Hip; Osteoarthritis, Knee; Randomized Controlled Trials as Topic; Treatment Outcome

Topics: Chondroitin; Dietary Supplements; Drug Administration Schedule; Drug Interactions; Drug Therapy, Combination; Glucosamine; Humans; Osteoarthritis, Knee; Platelet Aggregation Inhibitors

Topics: Cartilage, Articular; Chondroitin; Dietary Supplements; Glucosamine; Humans; Osteoarthritis, Knee; Treatment Outcome

Topics: Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Knee; Arthroscopy; Chondroitin; Drug Therapy, Combination; Evidence-Based Medicine; Glucosamine; Humans; Hyaluronic Acid; Injections, Intra-Articular; Male; Middle Aged; Osteoarthritis, Knee; Physical Therapy Modalities; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Treatment Outcome; Viscosupplements

Topics: Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee

Topics: Anti-Inflammatory Agents, Non-Steroidal; Celecoxib; Chondroitin; Dietary Supplements; Glucosamine; Humans; Osteoarthritis; Osteoarthritis, Hip; Osteoarthritis, Knee; Placebo Effect; Pyrazoles; Sulfonamides

Topics: Adult; Arthralgia; Chondroitin; Dietary Supplements; Female; Glucosamine; Humans; Male; Osteoarthritis, Knee; Treatment Failure

Topics: Chondroitin; Dietary Supplements; Female; Glucosamine; Humans; Osteoarthritis, Knee; Treatment Outcome

Topics: Anti-Inflammatory Agents, Non-Steroidal; Chondroitin; Glucosamine; Humans; Osteoarthritis, Knee; Pain

Topics: Chondroitin; Dietary Supplements; Disclosure; Glucosamine; Humans; Osteoarthritis, Knee; Pain Measurement; Research Support as Topic

Topics: Chondroitin; Double-Blind Method; Glucosamine; Humans; Meta-Analysis as Topic; Osteoarthritis, Knee; Pain Measurement; Randomized Controlled Trials as Topic