Chondroitin Sulfate
Articles
Trial Brings Hope for Millions Suffering from Arthritis
Painkillers Not As Effective As Glucosamine For Knee Arthritis
Glucosamine, Chondroitin Seem Effective And Safe, Review
A Metaanalysis of Chondroitin
Sulfate in the Treatment of Osteoarthritis
Glucosamine, Chondroitin, and Manganese Ascorbate for Degenerative Joint Disease of the Knee or Low Back
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Trial Brings Hope for Millions Suffering from Arthritis
The Glucosamine/Chondrotin Arthritis Intervention Trial (GAIT) reports that Glucosamine and Chondroitin is effective in treating moderate to severe osteoarthritis knee pain. This study, funded by The National Institute of Health (NIH) confirms nutritional supplements glucosamine and chondroitin are the right combination for effective knee pain relief. The trial rigorously evaluated the efficacy and safety of glucosamine and chondroitin in 1,258 people, concluding in its abstract that the "combination of glucosamine and chondroitin sulfate is effective in treating moderate to severe knee pain due to osteoarthritis."
"GAIT brings good news to adults suffering from the wear and tear of cartilage degeneration, particularly those who cannot tolerate the side effects of taking nonsteroidal anti-inflammatory drugs (NSAIDs)," said C. Thomas Vangsness, Jr., MD, Professor Orthopaedic Surgery, Keck School of Medicine, University of Southern California. "For years glucosamine and chondroitin have been well recognized alternative solutions to pharmaceutical options in treating osteoarthritis patients in Europe, Asia and Russia. In fact, preliminary results reported in the GAIT abstract indicated glucosamine and chondroitin were found to be more effective than Celebrex(R) in treating moderate to severe knee pain. Clearly, the GAIT abstract suggests glucosamine and chondroitin together may be a good non-surgical pain relief choice for arthritis patients," added Dr. Vangsness.
This $14 million GAIT study, funded by the NIH, is the largest placebo controlled, double blind, clinical trial ever conducted to test the effectiveness of glucosamine and chondroitin. All 1,258 patients who completed the study were over the age of 40 with knee pain and randomly assigned placebo; glucosamine 1500 mg; chondroitin 1200mg; glucosamine/chondroitin at above mentioned doses; or celecoxib (Celebrex) 200 mg daily for 6 months. The abstract published each treatment group's response rate to pain. Of note, the group taking the glucosamine/chondroitin combination experienced greater relief for the treatment of moderate to severe knee pain than the Celebrex group.
GAIT was designed to test the safety and efficacy of glucosamine and chondroitin alone and in combination in reducing knee pain associated with osteoarthritis. The study's abstract concluded that when taken together, "glucosamine and chondroitin is effective in treating moderate to severe knee pain due to OA [osteoarthritis]."
Naturally occurring in the body, glucosamine stimulates the production of cartilage, the connective tissue which cushions joints. Chondroitin is also naturally occurring in the body and like glucosamine stimulates the production of cartilage. Previous research indicates glucosamine is just as effective as non-steroidal anti-inflammatory drugs (NSAIDs) in reducing osteoarthritis pain and has fewer gastrointestinal side effects than NSAIDs.
Nearly 1 in 3 Americans (nearly 70 million) live with some form of arthritis, costing the United States $82.5 billion a year in healthcare costs related to treating the illness.(2) For arthritis knee pain sufferers who find relief in taking glucosamine and chondroitin, they will also find the supplements to be great values. Widely used in Europe for years to treat osteoarthritis, glucosamine and chondroitin are safe and effective nutritional supplements, as proven by the GAIT abstract.
http://www.rheumatology.org/annual/abstracts/search.asp
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Painkillers Not As Effective As Glucosamine For Knee Arthritis
Two long-awaited clinical trials on glucosamine have found the shellfish-derived substance to significantly reduce the pain of arthritic joints, and it may be better than a commonly used painkiller in Europe.
These first results come from the multi-centered Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) conducted by the US government-funded National Institutes of Health.
GAIT is the first mult-icenter clinical trial in the United States to test the effects of the dietary supplements glucosamine and chondroitin for treatment of knee osteoarthritis. The study was testing whether glucosamine and chondroitin used separately or in combination are effective in reducing pain and improving functional ability in patients with knee osteoarthritis.
Approximately 1,500 osteoarthritis patients were given a daily dose of either 1,500 mg of glucosamine hydrochloride, 1,200 mg of chondroitin sulphate, a combination of both supplements, 200 mg of the common prescription painkiller celecoxib (Celebrex) or a placebo for 24 weeks. The patients were evaluated at baseline and every four weeks thereafter.
Both celecoxib and the glucosamine-chondroitin combination significantly reduced knee pain compared to placebo.
The authors\' abstract says, "Combination glucosamine and chondroitin sulphate is effective in treating moderate to severe knee pain due to osteoarthritis,"
These studies will be presented at the American College of Rheumatology (ACR) meeting in San Diego on 14 November, by Daniel Clegg from the University of Utah.
The second study found glucosamine sulphate to be more effective than the over-the-counter painkiller acetaminophen on joint pain. Dr Herrero-Beaumont from the Fundacion Jimenez Diaz in Madrid will disclose the results of this multi-centre European study.
The Glucosamine Unum in Die Efficacy (GUIDE) trial compared a daily dose of 1500 mg of glucosamine sulphate and 3000 mg of the OTC drug to a placebo in 318 patients.
After 24 weeks, the glucosamine supplement showed strong evidence of its effectiveness on various pain and mobility.
The abstract concludes: "Glucosamine sulphate…might be the preferred symptomatic medication in knee osteoarthritis."
In both trials there were no differences among groups in safety.
Andrew Shao, in charge of scientific affairs at the US-based trade association the Council for Responsible Nutrition, noted that each trial can be considered "well-designed, well-conducted, gold-standard".
The glucosamine and chondroitin sulphate used in GAIT were required to meet pharmaceutical standards as it was conducted under an Investigational New Drug application.
Such high standards will be important if glucosamine makers are to attract new consumers that have been alerted to the risks of traditional treatments for arthritis by the makers of Cox-2 inhibitor drugs.
Indeed, the new findings on glucosamine and chondroitin sulphate will prove timely as the withdrawal of Cox-2 inhibitor drugs last year continues to prompt interest in natural substances to relieve joint pain.
This coincides with a high incidence of osteoarthritis quickly rising around the world due both to ageing populations and increasing levels of obesity.
www.nutraingredients
www.nccam.nih.gov
30/09/2005
Glucosamine, Chondroitin Seem Effective And Safe, Review
Taking oral glucosamine sulphate and chondroitin sulphate could be a safe and effective way of treating knee osteoarthritis, report a team of Belgian and French researchers.
A major review of randomized, placebo-controlled clinical trials published or performed between January 1980 and March 2002 found that both supplements had significant effects on joint space narrowing.
The researchers used 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 to perform the research, published in this month's Archives of Internal Medicine.
There was a "a highly significant efficacy of glucosamine on all outcomes", said the researchers, including the Lequesne Index, Western Ontario MacMaster University Osteoarthritis Index (WOMAC) and tests for pain, mobility and safety. Safety was "excellent" for both compounds.
"Our study demonstrates the structural efficacy of glucosamine and indistinguishable symptomatic efficacies for both compounds," the researchers concluded.
They added that the data on glucosamine and joint space narrowing is sparse and there is little data on structural effects of chondroitin, so further studies are needed before an accurate dose can be determined for the two supplements.
Nutraingredients.com
7/23/2003
A Metaanalysis of Chondroitin Sulfate in the Treatment of Osteoarthritis
Abstract
Objective
To examine the efficacy of chondroitin sulfate (CS) in the treatment of osteoarthritis (OA) on the basis of a metaanalysis of controlled clinical trials.
Methods
After personal, Medline, and Embase searches, a decision tree analysis of the available publications was performed, with respect to types of joint involvement studied, study designs, numbers of patients enrolled, and variables analyzed. The Lequesne index and pain rating on visual analog scale (VAS) were considered the main variables. Of a total of 16 publications found, 7 trials of 372 patients taking CS could be enrolled in the metaanalysis. Although all selected studies claimed to be randomized, double blind designs in parallel groups, it should be noted that CS was given along with analgesics or nonsteroidal antiflammatory drugs, making required dosage of comedication an important factor.
Results
Following patients to 120 or more days, CS was shown to be significantly superior to placebo with respect to the Lequesne index and pain VAS. Pooled data confirmed these results and showed at least 50% improvement in the study variables in the CS group compared to the placebo.
Conclusion
CS may be useful in OA, but further investigations in larger cohorts of patients for longer time periods are needed to prove its usefulness as a symptom modifying drug in OA. (J Rheumatol 2000;27:205-11)
Burkhard F. Leeb, Harald Schweitzer, Karin Montag, and Josef S. Smolen
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Glucosamine, Chondroitin, and Manganese Ascorbate for Degenerative Joint Disease of the Knee or Low Back: A Randomized, Double Blind, Placebo-Controlled Pilot Study
Objective
A 16-week randomized, double-blind, placebo-controlled crossover trial of a combination of glucosamine HCl (1,500 mg/day), chondroitin sulfate (1,200 mg/day), and manganese ascorbate (228 mg/day) in degenerative joint disease (DJD) of the knee or low back was conducted.
Methods
Thirty-four males from the U.S. Navy diving and special warfare community with chronic pain and radiographic DJD of the knee or low back were randomized. A summary disease score incorporated results of pain and functional questionnaires, physical examination scores and running times. Changes were presented as a percentage of the patient's average score.
Results
Knee osteoarthritis symptoms were relieved as demonstrated by the summary disease score (-16.3%; p=0.05), patient assessment of treatment effect (p=0.02), visual analog scale for pain recorded at clinic visits (-26.6%; p=0.05) and in a diary (-28.6%; p=0.02), and physical examination score (-43.3%; p=0.01). Running times did not change. The study neither demonstrated, nor excluded, a benefit for spinal DJD. Side effect frequency was similar to that at baseline. There were no hematologic effects.
Conclusions
The combination therapy relieves symptoms of knee osteoarthritis. A larger data set is needed to determine the value of this therapy for spinal DJD. Short-term combination therapy appears safe in this setting. Guarantor: LCDR Alan F. Philippi, MC USNR
Contributors
LT Christopher T. Leffler, MC USNR* LCDR Alan F. Phillippi, MC USNR* Susan G. Leffler, MD, James C. Mosure, MD Lt Peter D. Kim, USNR
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