chondroitin-sulfates and Arthralgia

There are some controversies about treatment modalities in osteoarthritis (OA), including chondroitin sulfate (CS). The objective of this study was to determine whether CS is effective at alleviating pain and improving function in patients with knee OA and to identify the factors that explain inconsistencies in clinical trial results.. We conducted a systematic review of randomized, placebo-controlled trials, searching the databases Medline, Cochrane central register for controlled trials and Scopus. Random effects meta-analysis was then performed, using tau. The inclusion criteria yielded 18 trials. Overall, CS significantly but inconsistently reduced pain (SMD: - 0.63; 95% CI: - 0.91, - 0.35; I. This new meta-analysis suggests that CS provides a moderate benefit for pain and has a large effect on function in knee OA, however with large inconsistency. The risks of bias, brand and study size were the factors explaining heterogeneity among the clinical trial results.

Topics: Arthralgia; Chondroitin Sulfates; Clinical Trials as Topic; Dietary Supplements; Humans; Osteoarthritis, Knee; Pain Measurement; Randomized Controlled Trials as Topic

Topics: Acetylgalactosamine; Arthralgia; Chondroitin Sulfates; Humans; Osteoarthritis; Polysaccharides; Uronic Acids

Glucosamine and chondroitin sulfate, alone or in combination, are used worldwide by individuals suffering from osteoarthritis pain. They are by prescription in some countries but are available as over-the-counter dietary supplements in other countries, such as the United States. The inconclusive results of the National Institutes of Health-sponsored Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) did little to clarify the efficacy of these agents. However, some newer studies have provided a better perspective on the potential benefits that they can offer. Because the 2 in combination showed a significant level of efficacy in the moderate-to-severe knee osteoarthritis subgroup of the GAIT, this review examines the randomized, controlled trials published from that time to the present. The findings of these studies are mixed, owing in some cases to the high rate of placebo response added to by the ethical incorporation of rescue analgesics into protocols designed to evaluate the slow-acting, subtle effects of glucosamine and chondroitin sulfate in combination. The strong influence of the placebo effect and confounding of results by rescue analgesics point to the importance of objective measurement tools such as osteoarthritis biomarker panels in long-term glucosamine/chondroitin sulfate clinical trials with less reliance on the subjective measurement tools commonly used in osteoarthritis trials of pharmaceuticals. [Orthopedics. 2018; 41(4):200-207.].

Topics: Analgesics; Arthralgia; Chondroitin Sulfates; Dietary Supplements; Glucosamine; Humans; Osteoarthritis, Knee; Randomized Controlled Trials as Topic

Glucosamine and chondroitin sulfate, components of normal cartilage that are marketed as dietary supplements in the United States, have been evaluated for their potential role in the treatment of osteoarthritis. Due to claims of efficacy, increased prevalence of osteoarthritis, and a lack of other effective therapies, there has been substantial interest in using these dietary supplements as therapeutic agents for osteoarthritis. Though pharmacokinetic and bioavailability data are limited, use of these supplements has been evaluated for management of osteoarthritis symptoms and modification of disease progression. Relevant clinical trial efficacy and safety data are reviewed and summarized.

Topics: Analgesics; Animals; Arthralgia; Biological Availability; Cartilage, Articular; Chondroitin Sulfates; Clinical Trials as Topic; Dietary Supplements; Glucosamine; Humans; Mice; Models, Animal; Osteoarthritis; Rabbits; Treatment Outcome

Topics: Arthralgia; Chondroitin Sulfates; Humans; Osteoarthritis, Hip; Osteoarthritis, Knee; Randomized Controlled Trials as Topic

Topics: Administration, Oral; Arthralgia; Chondroitin Sulfates; Humans; Osteoarthritis, Knee; Pain Measurement; Randomized Controlled Trials as Topic; Research Design

Therapy of osteoarthritis requires a combination of pharmacological and non-pharmacological modalities. Management should be individualized according to the constitutional features of the patient, comorbidities, disease status, treatment availability and costs. Paracetamol is the analgesic of choice. Beside NSAIDs and intra-articular steroids, SYSADOA have symptomatic effects and may modify structure. Patient education, exercises, orthopaedic devices and physical therapy are indicated as supportive therapy. Alternative therapy modalities should be discussed with the patient using the available evidence and the cost/benefit ratio.

Topics: Acetaminophen; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Chondroitin Sulfates; Exercise Therapy; Humans; Osteoarthritis; Palliative Care; Practice Guidelines as Topic; Practice Patterns, Physicians'; Severity of Illness Index; Steroids; Treatment Outcome

To compare the efficacy and safety of a new fixed dose combination of glucosamine sulfate and chondroitin sulfate capsules (GS/CS) versus the fixed dose combination of glucosamine hydrochloride and chondroitin sulfate (Cosamin DS®) in capsules in patients with osteoarthritis (OA) of the knee.. Multicenter, randomized, double-blind study. Participants with knee OA Kellgren-Lawrence grades 1 to 3 and VAS of symptoms ≥4 cm were randomized to receive GS/CS or Cosamin DS® over 12 weeks. The primary efficacy endpoint was the evaluation of the analgesic efficacy by the investigator. Secondary efficacy endpoints included: joint pain and swelling, investigator efficacy of the medication, and the use of rescue medication. Adverse events and drug tolerability were analyzed.. One hundred patients were randomized, and 50 patients were allocated to each group. The analgesic efficacy evaluated by the investigator in the GS/CS group was 88.9, 95%CI: 75.2, 95.8% and in the Cosamin DS® group was 85.4%; 95%CI: 70.1, 93.4%. The mean reduction in the pain intensity was significant in both groups (p < 0.001), with no difference between them. The primary efficacy analysis demonstrated the non-inferiority of the GS/CS group compared with the Cosamin DS® group; the lower limit of the 90% confidence interval (CI) between the two groups (- 8.39%) was higher than the established margin of non-inferiority of - 10.00%. Improvement in other efficacy outcomes was observed, again without differences between groups. Adverse events were similar between groups and both presented good tolerability.. The new fixed-dose formulation of GS/CS is effective in treating knee OA, presenting a good safety and tolerability profile.. ( https://clinicaltrials.gov/ct2/show/NCT00955552?term=NCT00955552&rank=1 ; ClinicalTrials.gov ; register number NCT00955552; First randomized patient: 08/17/2010).

Topics: Adult; Arthralgia; Brazil; Capsules; Chondroitin Sulfates; Double-Blind Method; Drug Combinations; Equivalence Trials as Topic; Female; Glucosamine; Humans; Male; Middle Aged; Osteoarthritis, Knee; Treatment Outcome

To assess the efficacy and safety of combination therapy with chondroitin sulfate (CS) and glucosamine sulfate (GS) compared to placebo in patients with symptomatic knee osteoarthritis (OA).. A multicenter, randomized, double-blind, placebo-controlled study was performed in 164 patients with Kellgren/Lawrence grade 2 or grade 3 radiographic knee OA and moderate-to-severe knee pain (mean ± SD global pain score 62.1 ± 11.3 mm on a 100-mm visual analog scale [VAS]). Patients were randomized to receive either combined treatment with CS (1,200 mg) plus GS (1,500 mg) or placebo in a single oral daily dose for 6 months. The mean change from baseline in the VAS global pain score was set as the primary end point. Secondary outcomes included the mean change in the investigator's global assessment of disease activity, total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain and function subscale scores on the WOMAC, responder rates based on the Outcome Measures in Rheumatology (OMERACT)-Osteoarthritis Research Society International (OARSI) 2004 response criteria, and rescue medication use. Adverse events were also recorded. A Data and Safety Monitoring Board was instituted to ensure patient safety and data accuracy.. Intriguingly, in the modified intent‐to‐treat (mITT) population, CS/GS combination therapy was inferior to placebo in the reduction of joint pain (mean ± SEM change in VAS global pain score over 6 months −11.8 ± 2.4 mm [19% reduction] in patients receiving CS plus GS versus −20.5 ± 2.4 mm [33% reduction] in patients receiving placebo; peak between‐group difference in global pain score at 6 months 8.7 mm [14.2%], P < 0.03), but no between‐group differences were seen in the per‐protocol completers. Both placebo treatment and CS/GS combination treatment improved to a similar extent the total WOMAC score as well as the pain and function WOMAC subscale scores, both in the mITT population and in the per-protocol completers. Neither the OMERACT-OARSI responder rate nor the frequency of rescue medication use differed between the treatment groups. Severe adverse events were uncommon and equally distributed.. The results of this trial demonstrate a lack of superiority of CS/GS combination therapy over placebo in terms of reducing joint pain and functional impairment in patients with symptomatic knee OA over 6 months. Further research might fully elucidate the suitability of CS/GS combination therapy in patients with OA.

Topics: Aged; Arthralgia; Chondroitin Sulfates; Double-Blind Method; Drug Therapy, Combination; Female; Glucosamine; Humans; Male; Osteoarthritis, Knee; Time Factors

There was no evidence of satisfying the standard to decide the efficacies of glucosamine and chondroitin in middle-aged and older Japanese adults with knee pain and/or stiffness.. To investigate the effects of 24 week oral N-acetyl glucosamine and chondroitin sulfate supplementation on knee pain, self-reported knee function, physical activity, and physical performance.. We randomly assigned 11 men and 39 women (aged 52-87 years) to receive 100 mg of N-acetyl glucosamine and 180 mg of chondroitin sulfate daily (Glu/Cho group) or a placebo (control, C group) for 24 weeks. The primary outcomes were a 100 mm visual analog pain scale (VAS) and the Japanese Knee Osteoarthritis Measure (JKOM) score. The secondary outcomes were physical activity and physical performance.. We observed a significant group × time interaction on the JKOM score. According to the post hoc test, it significantly decreased (i.e., improved knee function) from the 4- to 12-week follow-up in the Glu/Cho group and the Glu/Cho group score was significantly lower than the C group at the 12-week follow-up. We found a significant interaction on household physical activity. There was no significant interaction on VAS or physical performance tests.. The results of the present study were consistent with previous studies mainly conducted in European and American countries.. These results suggest that consumption of N-acetyl glucosamine and chondroitin sulfate for 12 weeks or longer has a positive effect on self-reported knee function and household physical activity in middle-aged and older Japanese adults with knee pain and/or stiffness.

Topics: Acetylglucosamine; Aged; Aged, 80 and over; Arthralgia; Chondroitin Sulfates; Dietary Supplements; Double-Blind Method; Drug Monitoring; Female; Humans; Japan; Knee Joint; Male; Middle Aged; Motor Activity; Osteoarthritis, Knee; Pain Measurement; Psychomotor Performance; Range of Motion, Articular; Self Report; Treatment Outcome

Intra-articular injection of hyaluronic acid is a well-established therapy for the treatment of knee osteoarthritis. The aim of the study was to assess the effectiveness and safety of the use of Arthrum HCS(®) (40 mg hyaluronic acid and 40 mg chondroitin sulfate in 2 mL).. This was an open, multicenter, prospective study. Men or women over 40 years of age with documented knee osteoarthritis and WOMAC subscore A (severity of pain) ≥25 were enrolled. They received three weekly intra-articular injections of sodium hyaluronate 2 % and chondroitin sulfate 2 % in combination. WOMAC subscore A was assessed at 1, 3 and 6 months after the last injection.. One hundred and twelve patients were included (women, 66 %). The mean (SD) WOMAC subscore A decreased from 52.1 (15.2) at inclusion to 20.5 (19.7) at month 6 (P < 0.0001). The mean subscore was already significantly decreased 1 month after the last injection at 25.7 (P < 0.0001). Pain relief and consumption of analgesic drugs, both assessed with visual analogic scale (VAS), consistently decreased. The investigators were satisfied/very satisfied as regards the therapeutic effectiveness of sodium hyaluronate-chondroitin sulfate in reducing pain (77 %), improving mobility (78 %) and reducing the consumption of analgesics (74 %). Only one adverse effect was reported by one patient (knee tumefaction).. These results suggest that intra-articular injections of Arthrum HCS(®) (sodium hyaluronate plus chondroitin sulfate) in patients with knee osteoarthritis are efficient and safe. These results should be confirmed in a randomized controlled study.. IV.

Topics: Aged; Aged, 80 and over; Arthralgia; Chondroitin Sulfates; Dose-Response Relationship, Drug; Drug Combinations; Female; Humans; Hyaluronic Acid; Injections, Intra-Articular; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Prospective Studies; Treatment Outcome

The article presents the results of prospective longitudinal study. The aim of the study was to investigate influence of complex therapy with chondroitin sulfate on pain and functional disorders in elderly patients with knee osteoarthritis. The study shows sufficient decreasing of pain, stiffness and functional disorders with complex therapy with chondroitin sulfate in comparison with nonsteroidal anti-inflammatory drugs (NSAID) by the second month of therapy with stable effect the next 2 months. All patients decrease their NSAID intake by the end of the study. Satisfaction of complex therapy was high according to patient's and physician's opinion.

Topics: Age of Onset; Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Chondroitin Sulfates; Combined Modality Therapy; Drug Monitoring; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Osteoarthritis; Pain Measurement; Patient Education as Topic; Range of Motion, Articular; Risk Factors; Self Care; Severity of Illness Index; Treatment Outcome

Oral glucosamine and chondroitin sulfate, alone and in combination, have been used worldwide for the treatment of osteoarthritis (OA), but their efficacy is controversial. This clinical study was aimed at investigating the potential of a dietary supplement containing glucosamine and chondroitin sulfate in combination with derivatives of quercetin, a naturally occurring flavonoid, (GCQ supplement) for knee OA care.. A randomized, double-blind, placebo-controlled study was conducted in 40 Japanese subjects with symptomatic knee OA. Subjects were randomly assigned to GCQ supplement (1200 mg glucosamine hydrochloride, 60 mg chondroitin sulfate and 45 mg quercetin glycosides per day) or placebo and the treatment and follow-up were continued for 16 weeks. The results of symptomatic efficacy assessment based on Japanese Orthopaedic Association criteria showed that scores for two of the four symptom/function subscales, as well as the aggregate scores, were significantly improved at week 16 or earlier in the GCQ group compared to the placebo group. Moreover, analyses of cartilage metabolism biomarkers showed a trend of improvement in type II collagen synthesis/degradation balance in the GCQ group during follow-up.. GCQ supplement was thought to be more effective than placebo in decreasing the intensity of knee OA-associated clinical symptoms.

Topics: Adult; Aged; Aged, 80 and over; Antirheumatic Agents; Arthralgia; Biomarkers; Chondroitin Sulfates; Collagen Type II; Dietary Supplements; Double-Blind Method; Female; Glucosamine; Glycosides; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis, Knee; Peptide Fragments; Quercetin; Severity of Illness Index

To determine whether chondroitin sulfate (CS) is effective in inhibiting cartilage loss in knee osteoarthritis (OA).. In this randomized, double-blind, placebo-controlled trial, 300 patients with knee OA were recruited from an outpatient clinic, from private practices, and through advertisements. Study patients were randomly assigned to receive either 800 mg CS or placebo once daily for 2 years. The primary outcome was joint space loss over 2 years as assessed by a posteroanterior radiograph of the knee in flexion; secondary outcomes included pain and function.. Of 341 patients screened, 300 entered the study and were included in the intent-to-treat analysis. The 150 patients receiving placebo had progressive joint space narrowing, with a mean +/- SD joint space loss of 0.14 +/- 0.61 mm after 2 years (P = 0.001 compared with baseline). In contrast, there was no change in mean joint space width for the 150 patients receiving CS (0.00 +/- 0.53 mm; P not significant compared with baseline). Similar results were found for minimum joint space narrowing. The differences in loss of joint space between the two groups were significant for mean joint space width (0.14 +/- 0.57 mm; P = 0.04) and for minimum joint space width (0.12 +/- 0.52 mm; P = 0.05). CS was well tolerated, with no significant differences in rates of adverse events between the two groups.. While there was no significant symptomatic effect in this study, long-term treatment with CS may retard radiographic progression in patients with OA of the knee. However, the clinical relevance of the observed structural results has to be further evaluated, and further studies are needed to confirm the structural effects of CS.

Topics: Aged; Arthralgia; Cartilage, Articular; Chondroitin Sulfates; Disease Progression; Double-Blind Method; Female; Humans; Male; Middle Aged; Osteoarthritis, Knee; Radiography; Recovery of Function

This multicenter randomized, double-blind, controlled study was performed to compare the efficacy and tolerability of chondroitin sulfate (CS, Condrosulf, IBSA, Lugano, CH) 1200 mg/day oral gel vs CS 3 x 400 mg/day capsules vs placebo, in patients with mono or bilateral knee osteoarthritis (Kellgren and Lawrence radiographic score grade I to III). A total of 127 patients, 40 of whom were treated with CS 1200 mg/day, 43 with CS 3 x 400 mg/day and 44 with placebo, were included in the statistical analysis of this 3-month treatment study. In the CS groups, Lequesne's Index and spontaneous joint pain (VAS) showed a significant reduction of clinical symptoms (P < 0.01 for both parameters), while only a slight reduction was observed in the placebo group (P = ns for Lequesne's Index and P < 0.05 for VAS). The physician's and patient's overall efficacy assessments were significantly in favour of the CS groups (P < 0.01). The treatment carried out with the three formulations was very well tolerated. In conclusion, these results indicate that CS favours the improvement of the subjective symptoms, improving the joint mobility. An additional consideration is that the efficacy of 1200 mg CS as a single daily dose does not differ from that of 3 x 400 mg daily doses of CS for all the clinical parameters taken into consideration.

Topics: Administration, Oral; Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Chondroitin Sulfates; Dosage Forms; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Osteoarthritis; Pain Measurement; Treatment Outcome

Patients with osteoarthritis (OA) of the knee were treated with chondroitin sulfate (CS, Condrosulf, IBSA, Lugano, CH) in a randomized, double-blind, placebo-controlled study, performed in two centres. The efficacy and tolerability of oral CS capsules 2 x 400 mg/day vs placebo was assessed in a 6-month study period. Patients with idiopathic or clinically symptomatic knee OA, with Kellgren and Lawrence radiological scores I-III, were included in this trial. Clinical controls were performed at months 0, 1, 3 and 6. Eighty patients completed the 6-month treatment period. Lequesne's Index and spontaneous joint pain (VAS) decreased constantly in the CS group; on the contrary, slight variations of the scores were reported in the placebo group. The walking time, defined as the minimum time to perform a 20-meter walk, showed a statistically significant constant reduction only in the CS group. ANOVA with repeated measures showed a statistically significant difference in favor of the CS group for these three parameters. During the study, patients belonging to the placebo group reported a higher paracetamol consumption, but this consumption was not statistically different between the two treatment groups. Efficacy judgements were significant in favor of the CS group. Both treatments were very well tolerated. All these results strongly suggest that chondroitin sulfate acts as a symptomatic slow-acting drug in knee OA.

Topics: Activities of Daily Living; Administration, Oral; Adult; Aged; Aged, 80 and over; Analysis of Variance; Arthralgia; Chondroitin Sulfates; Delayed-Action Preparations; Double-Blind Method; Female; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis; Pain Measurement; Time Factors; Treatment Outcome

The aim of this study was to assess the clinical, radiological and biological efficacy and tolerability of the SYSADOA, chondroitin 4- and 6-sulfate (CS, Condrosulf, IBSA, Lugano, Switzerland), in patients suffering from knee osteoarthritis. This was a 1-year, randomized, double-blind, controlled pilot study which included 42 patients of both sexes, aged 35-78 years with symptomatic knee OA. Patients were treated orally with 800 mg chondroitin sulfate (CS) per day or with a placebo (PBO) administered in identical sachets. The main outcome criteria were the degree of spontaneous joint pain and the overall mobility capacity. Secondary outcome criteria included the actual joint space measurement and the levels of biochemical markers of bone and joint metabolism. This limited study confirmed that chondroitin sulfate was well-tolerated and both significantly reduced pain and increased overall mobility capacity. Treatment with CS was also associated in a limited group of patients with a stabilization of the medial femoro-tibial joint width, measured with a digitized automatic image analyzer, whereas joint space narrowing did occur in placebo-treated patients. In addition, the metabolism of bone and joint assessed by various biochemical markers also stabilized in the CS patients whereas it was still abnormal in the PBO patients. These results confirm that oral chondroitin 4- and 6-sulfate is an effective and safe symptomatic slow-acting drug for the treatment of knee OA. In addition, CS might be able to stabilize the joint space width and to modulate bone and joint metabolism. This is the first preliminary demonstration that a SYSADOA might influence the natural course of OA in humans.

Topics: Administration, Oral; Adult; Aged; Arthralgia; Chondroitin Sulfates; Double-Blind Method; Female; Humans; Keratan Sulfate; Knee Joint; Male; Middle Aged; Movement; Osteoarthritis; Osteocalcin; Pain Measurement; Pilot Projects; Radiography; Treatment Outcome

To evaluate symptom-modifying effects of a two-month parenteral therapy with chondroitin sulfate («Mucosat») in patients with knee and/or hip osteoarthritis (OA) in various combinations of adjuvant therapy.. There were 70 patients with primary and/or post-traumatic unilateral/bilateral knee and/or hip osteoarthritis (Kellgren-Lawrence grade I-II). Pain syndrome severity was assessed as ≥ 50 mm (100-mm VAS), total Leken's index - ≥ 5 points. The main group comprised 40 patients who received Mucosat for 60 days. NSAIDs were additionally prescribed in 9 (22.5%) of these patients. The control group included 30 patients with intra-articular injection of hyaluronic acid. All patients underwent clinical and functional examination (rating scales VAS, Leken's total index, WOMAC index, EQ-5D health questionnaire), laboratory diagnosis (IL-1, IL-6, TNF-α), X-ray examination, assessment of adverse events at 5 visits.. Administration of chondroitin sulfate is associated with reduced local pain syndrome and functional normalization of musculoskeletal system. Prolonged pain-free period with high safety profile due to reduced need for NSAIDs is an advantage of Mucosat therapy. Thus, this drug may be recommended for initial therapy. A combination of chondroitin sulfate with intra-articular injection of hyaluronic acid may be perspective for optimization of therapy and secondary prevention of exacerbations of OA. Further research is required.. Значительное количество исследований достаточно убедительно доказывает эффективность и безопасность монотерапии с применением хондроитина сульфата (ХС), однако варианты адъювантной терапии позволяют расширить возможности амбулаторного лечения ранних стадий остеоартроза.. Оценить симптом-модифицирующие эффекты двухмесячного лечения парентеральной формой ХС (Мукосат) у пациентов с остеоартритом (ОА) коленных и/или тазобедренных суставов при различных сочетаниях адъювантной терапии.. Обследованы 70 пациентов с первичным и/или посттравматическим односторонним/двусторонним ОА коленного и/или тазобедренного суставов I—II рентгенологической стадии по классификации Kellgren и Lawrence. Выраженность болевого синдрома по 100-миллиметровой ВАШ составила 50 мм и выше, по суммарному индексу Лекена — 5 баллов и более. В основную группу вошли 40 пациентов, которые получали Мукосат (60 сут), из них 9 (22,5%) больным дополнительно были назначены НПВП. В группу сравнения включили 30 пациентов, которым назначали внутрисуставное введение гиалуроновой кислоты. Всем пациентам были проведены: клиническо-функциональное обследование по оценочным шкалам (ВАШ, суммарный индекс Лекена, индекс WOMAC, опросник состояния здоровья EQ-5D), лабораторная диагностика (в том числе этапное определение ИЛ-1, ИЛ-6, ФНО-α), рентгенография, оценка нежелательных явлений при 5 визитах.. Применение ХС приводит к уменьшению суставной боли и нормализации функционального состояния опорно-двигательного аппарата. Достоверно более длительный период без боли при высоком профиле безопасности курса за счет снижения потребности в НПВП является преимуществом терапии препаратом «Мукосат» и обосновывает его применение для стартовой терапии. Перспективным для оптимизации терапии и вторичной профилактики обострений ОА может явиться комбинация ХС с внутрисуставным введением гиалуроновой кислоты. Целесообразно продолжение исследований в данном направлении.

Topics: Arthralgia; Chondroitin Sulfates; Humans; Hyaluronic Acid; Injections, Intra-Articular; Osteoarthritis, Hip; Osteoarthritis, Knee; Protective Agents; Treatment Outcome

Osteoarthritis is a painful, chronic joint disease affecting man and animals with no known curative therapies. Palliative nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used but they cause adverse side effects prompting the search for safer alternatives. To address this need, we evaluated the anti-inflammatory activity of avocado/soybean unsaponifiables (ASU), glucosamine (GLU), and chondroitin sulfate (CS) with or without the NSAID carprofen.. Canine chondrocytes were propagated in microcarrier spinner culture and incubated with (1) control medium, (2) ASU (8.3 µg/mL) + GLU (11 µg/mL) + CS (20 µg/mL) combination for 24 hours; and/or carprofen (40 ng/mL). Cultures were next incubated with control medium alone or IL-1β (10 ng/mL) for another 24 hours. Production of PGE. Chondrocytes proliferated in microcarrier spinner culture and produced type II collagen and aggrecan. Stimulation with IL-1β induced significant increases in PGE. The potentiating effect of [ASU+GLU+CS] on low-dose carprofen was identified in chondrocyte microcarrier spinner cultures. Our results suggest that the combination of low-dose NSAIDs like carprofen with [ASU+GLU+CS] could offer a safe, effective management for joint pain.

Topics: Aggrecans; Animals; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Carbazoles; Cells, Cultured; Chemokine CCL2; Chondrocytes; Chondroitin Sulfates; Collagen Type II; Dinoprostone; Dogs; Drug Therapy, Combination; Glucosamine; Glycine max; Humans; Interleukin-1beta; Interleukin-6; Interleukin-8; Persea

Chondroitin sulfate (CS) is an important component of the extracellular matrix of cartilage and has been widely used as one of the main drugs for the treatment of joint pain-related nutraceuticals and medicines. Sturgeon bone (SB) is the main waste during deep processing of sturgeons in fishery production. The present study was evaluated the therapeutic effect of CS from SB (CSSB) on monosodium iodoacetate (MIA)-induced osteoarthritis (OA) pain and further explored the potential medicinal value of CSSB. The OA pain model was induced by intra-articular injection of MIA and then treated with CSSB. The results showed that, on the organismic level, CSSB can significantly reduce the joint swelling, reduce the pathological injury of the joints, decrease the levels of IL-1, TNF-α and PGE

Topics: Analgesics; Animals; Arthralgia; Arthritis, Experimental; Biological Products; Biomarkers; Chondroitin Sulfates; Cytokines; Disease Models, Animal; Inflammation Mediators; Iodoacetates; Male; Osteoarthritis; Rats

Prior studies provided conflicting results regarding the efficacy of these medications. This study offers evidence for discontinuing them.

Topics: Arthralgia; Chondroitin Sulfates; Double-Blind Method; Glucosamine; Humans; Osteoarthritis, Knee

Topics: Arthralgia; Chondroitin Sulfates; Double-Blind Method; Glucosamine; Humans; Osteoarthritis, Knee

Topics: Arthralgia; Chondroitin Sulfates; Double-Blind Method; Glucosamine; Humans; Osteoarthritis, Knee

To evaluate the incidence rate of relapse in patients with inflammatory bowel disease (IBD) undergoing chondroitin sulphate (CS) treatment and its effect on the concentrations of several pro-inflammatory proteins.. Prospective, observational, 12-month follow-up study in patients with IBD in remission, starting CS (Condrosan®, Bioiberica S.A.) treatment for osteoarthritis (OA). Crohn's Disease Activity Index and modified Truelove-Witts severity index were calculated for Crohn's disease and ulcerative colitis (UC) respectively. Levels of vascular endothelial growth factor (VEGFA), -C, fibroblast growth factor 2, hepatocyte growth factor, angiopoietin (Ang)-1, Ang-2, transforming growth factor beta, tumour necrosis factor alpha, interleukin (IL)-1β, IL-6, IL-12, IL-17, IL-23, intracellular adhesion molecule-1, vascular adhesion molecule-1, matrix metalloproteinase-3 and PGE2 were quantified by ELISA. OA joint pain was evaluated using a visual analogue scale.. A total of 37 patients (19 UC and 18 Crohn's disease) were included. The mean values for OA joint pain decreased after 12 months from 5.9 ± 2.8 to 3.0 ± 2.3 (p < 0.05). Only 1 patient (with UC) flared during follow-up. The incidence rate of relapse was 3.4% per patient-year of follow-up. Mean serum VEGFA levels increased between baseline (492 pg/ml) and 12-month treatment (799 pg/ml; p < 0.05).. The incidence of IBD relapse in patients under CS treatment was lower than that generally reported. This treatment might modulate VEGFA. CS decreases OA-related pain in patients with IBD.

Topics: Aged; Arthralgia; Chondroitin Sulfates; Female; Follow-Up Studies; Humans; Inflammation Mediators; Inflammatory Bowel Diseases; Intercellular Signaling Peptides and Proteins; Male; Middle Aged; Osteoarthritis; Pain Measurement; Prospective Studies; Recurrence; Severity of Illness Index; Time Factors; Vascular Endothelial Growth Factor A

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Chondroitin Sulfates; Data Interpretation, Statistical; Drug Therapy, Combination; Glucosamine; Humans; Osteoarthritis, Knee; Pain Measurement; Radiography; Randomized Controlled Trials as Topic; Self Medication

As part of the National Institutes of Health (NIH)-sponsored Glucosamine/Chondroitin sulfate Arthritis Intervention Trial (GAIT) our objective here was to examine (1) the pharmacokinetics (PK) of glucosamine (GlcN) and chondroitin sulfate (CS) when taken separately or in combination as a single dose in normal individuals (n=29) and (2) the PK of GlcN and CS when taken as a single dose after 3 months daily dosing with GlcN, CS or GlcN+CS, in patients with symptomatic knee pain (n=28).. The concentration of GlcN in the circulation was determined by established fluorophore-assisted carbohydrate electrophoresis (FACE) methods. The hydrodynamic size and disaccharide composition of CS chains in the circulation and dosage samples was determined by Superose 6 chromatography and FACE.. We show that circulating levels of CS in human plasma are about 20 microg/ml. Most significantly, the endogenous concentration and CS disaccharide composition were not detectably altered by ingestion of CS, when the CS was taken alone or in combination with GlcN. On the other hand, the Cmax (single-dose study) and AUC values (multiple-dose study) for ingested GlcN were significantly reduced by combination dosing with CS, relative to GlcN dosing alone.. We conclude that pain relief perceived following ingestion of CS probably does not depend on simultaneous or prior intake of GlcN. Further, such effects on joint pain, if present, probably do not result from ingested CS reaching the joint space but may result from changes in cellular activities in the gut lining or in the liver, where concentrations of ingested CS, or its breakdown products, could be substantially elevated following oral ingestion. Moreover, since combined dosing of GlcN with CS was found to reduce the plasma levels seen with GlcN dosing alone, any improved pain relief by combination dosing cannot be explained by higher circulating concentrations of GlcN.

Topics: Administration, Oral; Adult; Arthralgia; Chondroitin Sulfates; Clinical Trials as Topic; Dose-Response Relationship, Drug; Drug Combinations; Drug Therapy, Combination; Female; Glucosamine; Humans; Male; Middle Aged; Osteoarthritis; Pain Measurement; Treatment Outcome; Young Adult

Evidence that combined glucosamine sulfate and chondroitin sulfate (Gluchon) or isolated glucosamine (Glu) modifies joint damage in osteoarthritis (OA) is still lacking. We studied joint pain and cartilage damage using the anterior cruciate ligament transection (ACLT) model. Wistar rats were subjected to ACLT of the right knee (OA) or sham operation. Groups received either Glu (500 mg/kg), Gluchon (500 mg/kg glucosamine +400 mg/kg chondroitin) or vehicle (non-treated--NT) per os starting 7 days prior to ACLT until sacrifice at 70 days. Joint pain was evaluated daily using the rat-knee joint articular incapacitation test. Structural joint damage was assessed using histology and biochemistry as the chondroitin sulfate (CS) content of cartilage by densitometry (microgram per milligram dried cartilage), comparing to standard CS. The molar weight (Mw) of the CS samples, used as a qualitative biochemical parameter, was obtained by comparing their relative mobility on a polyacrylamide gel electrophoresis to standard CS. Gluchon, but not Glu, significantly reduced joint pain (P < 0.05) compared to NT. There was an increase in CS content in the OA group (77.7 +/- 8.3 microg/mg) compared to sham (53.5 +/- 11.2 microg/mg) (P < 0.05). The CS from OA samples had higher Mw (4:62 +/- 10(4) g/mol) compared to sham (4:18 +/- 0.19 x 10(4) g/mol) (P < 0.05). Gluchon administration significantly reversed both the increases in CS content (54.4 +/- 12.1 microg/mg) and Mw (4:18 +/- 0.2 x 10(4) g/mol) as compared to NT. Isolated Glu decreased CS content though not reaching statistical significance. Cartilage histology alterations were also significantly prevented by Gluchon administration. Gluchon provides clinical (analgesia) and structural benefits in the ACLT model. This is the first demonstration that biochemical alterations occurring in parallel to histological damage in OA are prevented by Gluchon administration.

Topics: Animals; Anterior Cruciate Ligament; Arthralgia; Cartilage, Articular; Chondroitin Sulfates; Disease Models, Animal; Drug Therapy, Combination; Glucosamine; Male; Osteoarthritis, Knee; Rats; Rats, Wistar

Topics: Arthralgia; Arthritis; Chondroitin Sulfates; Delayed-Action Preparations; Humans; Meta-Analysis as Topic; Review Literature as Topic

This article documents the outcome of treatment of intraosseous ganglia and simple bone cysts of the carpal bones by curettage and injectable calcium phosphate bone cement (CPC) grafting. The patients consisted of five men and three women. One had a cystic lesion in the scaphoid, one in the hamate, and five in the lunate. Curettage of the lesions was performed, and CPC was injected into the cavity. Five patients were diagnosed with a ganglion and three with a simple bone cyst. Among the five patients with wrist pain, the pain disappeared completely in four. Radiographs showed apparent partial absorption of CPC in four patients and no absorption in other four. There were no recurrence of tumours and no other complications were encountered. We conclude that calcium phosphate bone cement is a useful material for repairing bone defect after curettage of an intraosseous ganglion or bone cyst of a carpal bone.

Topics: Adolescent; Adult; Arthralgia; Bone Cements; Bone Cysts; Carpal Bones; Chondroitin Sulfates; Curettage; Female; Ganglion Cysts; Humans; Hydroxyapatites; Injections; Male; Middle Aged; Range of Motion, Articular; Succinates; Young Adult

Topics: Arthralgia; Chondroitin Sulfates; Clinical Trials as Topic; Dietary Supplements; Glucosamine; Humans; Osteoarthritis; Placebo Effect; Treatment Outcome