Chondroitin Sulfate 'Helps Knee Osteoarthritis'
Chrondroitin sulfate is as good as a common anti-inflammatory drug for knee osteoarthritis, according to a new European study.
The findings have been published online in the Annals of the Rheumatic Diseases and the researchers are suggesting that chrondroitin sulfate is considered as a treatment, especially for older people.
Previous studies for the supplement have shown mixed results. Some have found it does have some benefit for people with osteoarthritis whilst other results have been less promising.
What Is Chondroitin Sulfate?
Chondroitin occurs naturally in the connective tissues of people and animals.
Often sold as a dietary supplement, chondroitin sulfate usually comes from animal or marine cartilage.
It is popular, often combined with the supplement glucosamine, as a treatment for the pain of osteoarthritis.
Osteoarthritis is the most common form of arthritis, affecting around 8.5 million people in the UK. It is a degenerative joint condition causing pain, loss of function, and often some degree of disability.
There is no cure for arthritis but it is usually treated with painkillers like paracetamol and non-steroidal anti-inflammatory drugs ( NSAIDs). However, these are not suitable for everyone and regularly taking high doses of paracetamol or NSAIDs can be associated with side effects.
The research team was, therefore, looking for effective and safe alternatives.
They carried out a clinical trial in which 604 patients with knee arthritis, from 5 European countries were randomly assigned to 1 of 3 daily treatments involving chondroitin sulfate, the NSAID celecoxib, and placebo pills.
Chondroitin sulfate is available as an over the counter supplement but the level of active ingredient can vary. So for the study highly purified, pharmaceutical grade, chondroitin sulfate was used.
Pain, joint function and overall acceptability to the patients were assessed over 6 months.
The results showed that knee pain and joint function improved significantly with all 3 treatments by day 30 (1 month), and this effect persisted over the 6 months.
However, the reductions in pain and improvements in joint function were significantly greater after 3 and 6 months in patients treated with either chondroitin sulfate or celecoxib.
Joint function improved more quickly in patients taking celecoxib, but there were no overall differences in the effectiveness of either active treatment.
Reginster JY, Dudler J, Blicharski T, Pavelka K. Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT). Ann Rheum Dis. 2017 May 22. pii: annrheumdis-2016-210860. doi: 10.1136/annrheumdis-2016-210860.
Chondroitin sulfate 800 mg/day (CS) pharmaceutical-grade in the management of symptomatic knee osteoarthritis consistent with the European Medicines Agency guideline.
A prospective, randomised, 6-month, 3-arm, double-blind, double-dummy, placebo and celecoxib (200 mg/day)-controlled trial assessing changes in pain on a Visual Analogue Scale (VAS) and in the Lequesne Index (LI) as coprimary endpoints. Minimal-Clinically Important Improvement (MCII), Patient-Acceptable Symptoms State (PASS) were used as secondary endpoints.
604 patients (knee osteoarthritis) diagnosed according to American College of Rheumalogy (ACR) criteria, recruited in five European countries and followed for 182 days. CS and celecoxib showed a greater significant reduction in pain and LI than placebo. In the intention-to-treat (ITT) population, pain reduction in VAS at day 182 in the CS group (-42.6 mm) and in celecoxib group (-39.5 mm) was significantly greater than the placebo group (-33.3 mm) (p=0.001 for CS and p=0.009 for celecoxib), while no difference observed between CS and celecoxib. Similar trend for the LI, as reduction in this metric in the CS group (-4.7) and celecoxib group (-4.6) was significantly greater than the placebo group (-3.7) (p=0.023 for CS and p=0.015 for celecoxib), no difference was observed between CS and celecoxib. Both secondary endpoints (MCII and PASS) at day 182 improved significantly in the CS and celecoxib groups. All treatments demonstrated excellent safety profiles.
A 800 mg/day pharmaceutical-grade CS is superior to placebo and similar to celecoxib in reducing pain and improving function over 6 months in symptomatic knee osteoarthritis (OA) patients. This formulation of CS should be considered a first-line treatment in the medical management of knee OA.