Chondroitin Sulfate: S/DMOAD (Structure/Disease
Modifying Anti-Osteoarthritis Drug) in the Treatment of Finger
Joint OA Gust Verbruggen, Stefan Goemaere and Eric
M. Veys Department of Rheumatology, Ghent University Hospital,
Summary: A total of 119 patients
were included in a randomized, double-blind, placebo-controlled
trial in order to assess the S/DMOAD properties in OA of chondroitin
sulfate (CS 4&6, 3 x 400 mg/day, Condrosulf® IBSA, Lugano, CH).
Posteranterior roentgenographies of the interphalangeal (IP) joints
were carried out at the start of the study and at yearly intervals.
This enabled the investigators to document the radiological progression
of the anatomical lesions in the pathological finger joints over
a 3-year period. It was shown that the progression of OA in the
IP finger joints in an individual can be determined by the evolution
of his finger joints through previously described anatomical phases:
ĪNā (not affected), 'S' (classical OA), ĪJā (loss of joint space),
ĪEā (erosive OA) and ĪRā (remodeled joint). Structure/disease-modifying
anti-OA drug (S/DMOAD) properties were searched for by assaying
the number of patients developing OA in previously normal IP joints
('N' > 'S'), or progressing through the described anatomical phases
of the disease ('S' > ĪJā, 'S' > ĪEā, ĪJā > ĪEā, 'S' > ĪRā, ĪJā
> ĪRā, ĪEā > ĪRā). In the CS 4&6 group we observed a significant
decrease in the number of patients with new 'erosive' OA finger
joints. This result is particularly important since OA of the
finger joints becomes a clinical problem (pain, functional loss)
when 'S' joints progress to ĪJā and especially 'E' phases. During
and after these ĪEā phases, joints will remodel and show the nodular
deformities characteristic of Heberden's and Bouchard's nodes.
Treated patients were protected against erosive evolution.
Source: Osteoarthritis and
Cartilage (1998) 6, (Supplement A), 37-38 Osteoarthritis Research
Dr. Theo's Comments: This
very well designed Belgium study proves that chondroitin sulfate
can modify cartilage erosion and may prevent osteoarthritis in
the finger joints. This erosion is what leads to crooked and enlarged
finger joints. This type of study design provides the highest
level of medical evidence.