|
 In the U.S., glucosamine and chondroitin are available as
over-the-counter supplements so their formulations are not regulated
like the prescription European version.
“The Europeans have an advantage on us in this regard as
glucosamine, chondroitin and the combination are all available as
medications,” said Dr. Allen Sawitzke of the Rheumatology Division
at the University of Utah in Salt Lake City, a coauthor of the new
study.
“As such, their reliable composition and chemistry are more like
assured,” he told Reuters Health by email.
The U.S. supplement versions are less reliable in quality and
quantity, Sawitzke said.
The new trial included 606 patients over age 40 with moderate to
severe pain from knee osteoarthritis living in France, Germany,
Poland or Spain.
Osteoarthritis, or wear and tear of the joints, affects more than a
third of adults over age 65 in the U.S., according to the Centers
for Disease Control and Prevention. There is no cure. Treatments
include physical therapy, medication and joint replacement.
The study participants were randomly divided into two groups, one
taking a daily combination of 400 milligrams chondroitin sulfate and
500 mg glucosamine hydrochloride (Droglican, made by Bioiberica
S.A.). The other group took 200 mg of celecoxib (marketed by Pfizer
as Celebrex, Celebra, Onsenal and others) every day.
After six months, both groups had knee pain about half as severe as
when they started, and similar reductions in joint swelling and
stiffness and increased function, according to results in the Annals
of the Rheumatic Diseases.
In U.S. drugstores, a three-month supply of glucosamine and
chondroitin supplement costs around $30. Prescription celecoxib, a
non-steroidal anti-inflammatory pain reliever, can cost $130 per
month, much more expensive than over-the-counter pain relievers,
according to Consumer Reports.
Both glucosamine and chondroitin are available by prescription in
Europe, but some advise against using them for osteoarthritis due to
lack of evidence, the authors note.
But the new study suggests that in combination they can be effective
for osteoarthritis patients, especially for people with heart or
gastrointestinal problems who may not be able to take an NSAID like
celecoxib, the authors write.
[to top of second column] |
Celecoxib can cause serious side effects like high fever, noted
coauthor Dr. Yves Henrotin, head of the Bone and Cartilage Research
Unit at the University of Liège in Belgium. It can also cause ulcers
and bleeding, according to the National Institutes of Health.
“My recommendation is to consider a patient’s (other diseases)
before treatment,” Henrotin told Reuters Health by phone.
“For countries where the prescription preparations are available,
the combination of glucosamine and chondroitin sulfate appears to be
as effective and at least as safe so might be the preferred way to
start,” Sawitzke said. It may be considered in other countries as
well, but will have to be monitored closely through the first months
of use, he said.
However, the prescription glucosamine and chondroitin formulation in
this European study cannot be generalized to the dietary supplement
versions available in the U.S. and U.K., they emphasize.
“I think many U.S. providers have quit recommending a trial of the
glucosamine and chondroitin to patients affected by osteoarthritis
as strong support was not available,” Sawitzke said. “In
distinction, the European market has remained strong and the
guidelines actually recommend their use.”
“We still have to consider financial constraints, a given patient's
adverse events risks, and the risks of the unknown in the
over-the-counter market,” he said.
SOURCE: http://bmj.co/16pfwMO Annals of the Rheumatic Diseases,
online January 14, 2015.
[© 2015 Thomson Reuters. All rights
reserved.] Copyright 2015 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
