Dr. Jean-Yves Reginster of Liege State University in Belgium and
colleagues recruited 604 people over age 50 with knee osteoarthritis
from five European countries and randomly assigned them to take 800
mg of the extra-pure chondroitin sulfate (Chondrosulf), 200 mg of
celecoxib (Celebrex) or a placebo every day for six months.
Those who took chondroitin sulfate or celecoxib had similar levels
of pain relief at the end of the study, and in both groups the
improvement was greater than for those taking just a placebo,
according to the report in Annals of the Rheumatic Diseases.
Reginster told Reuters Health the findings are in line with earlier
studies showing pharmaceutical-grade chondroitin sulfate could
significantly decrease the progression of knee osteoarthritis over a
period of three years.
He stressed that pharmaceutical-grade chondroitin is not the same as
over-the-counter supplements, which are made differently and can’t
get into the joint in high enough concentrations to combat the
causes of cartilage degradation and pain.
European regulatory bodies recommend pharmaceutical-grade
chondroitin sulfate as well as pharmaceutical-grade glucosamine
sulfate as first-line treatments for osteoarthritis, Reginster said
by email, because of the side effects associated with celecoxib and
other non-steroidal inflammatory drugs (NSAIDs) including stomach
ulcers, bleeding, liver and kidney problems.
Dr. Michael Shepard of Hoag Orthopedic Institute in Orange,
California, noted that the study had a relatively low number of
participants and that most U.S. studies of this type would run two
years rather than six months.
In addition, U.S.-based studies of chondroitin have had mixed
results, said Shepard, who wasn’t involved in the study. Some have
found the supplements to be as effective as ibuprofen (also an NSAID),
and some have found that chondroitin sulfate is no more effective
than placebo, he told Reuters Health.
“I tell my patients, ‘buyer beware,’” Shepard said in an email. “I
tell them about the mixed results of chondroitin in the literature.
I tell them to try chondroitin for one month as a trial and if they
like it and feel better with it, then keep taking it.”
If chondroitin doesn’t work for them, he suggests taking an NSAID
“periodically,” and to be aware of the side effects.
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“If you are going to stay on an NSAID for a prolonged period then
you need regular follow up with your doctor,” Shepard cautioned.
Dr. Rachel Wolfe of Wake Forest Baptist Medical Center in
Winston-Salem, North Carolina, agreed that chondroitin is
“reasonable to try” for some people, especially those with
contraindications to NSAIDs.
“However, it should not replace other therapy such as quad
strengthening exercises, and weight loss, which we know will provide
benefit. It should be used in conjunction with these measures,” said
Wolfe, who wasn’t involved in the study.
“Chondroitin is not a miracle pill, but if it allows people to feel
less pain and be more active, thereby losing weight and
strengthening muscles, then I think there may benefit,” Wolfe told
Reuters Health by email. “Studies like this highlight that medicine
is still an art - we do not have perfect answers, and we have to
individualize for each patient.”
The study was sponsored by IBSA Institut Biochimique SA, a
pharmaceutical company based in Lugano, Switzerland, that makes the
chondroitin sulfate supplements used in the test.
SOURCE: http://bit.ly/2rcPLh0 Annals of the Rheumatic Diseases,
online May 22, 2017.
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