Medical Evidence
Efficacy and Tolerability of Oral Chondroitin
Sulfate as a Symptomatic Slow-Acting Drug for Osteoarthritis (SYSADOA)
in the Treatment of Knee Osteoarthritis Laszlo Bucsi
and Gyula Poor Orthopaedic Department, Semmelweis Medical University
Budapest, Hungary; and National Institute of Rheumatology and
Physiotherapy Budapest (ORFI), Hungary
Summary: Patients with osteoarthritis
(OA) of the knee were treated with chondroitin sulfate (CS, Condrosulf®,
IBSA, Lugano, CH) in a randomized, double-blind, placebo-controlled
study, performed in two centres. The efficacy and tolerability
of oral CS capsules 2 x 400 mg/day vs placebo was assessed in
a 6-month study period. Patients with idiopathic or clinically
symptomatic knee OA, with Kellgren and Lawrence radiological scores
I-III, were included in this trial. Clinical controls were performed
at months 0, 1, 3 and 6. Eighty patients completed the 6-month
treatment period. Lequesne's Index and spontaneous joint pain
(VAS) decreased constantly in the CS group; on the contrary, slight
variations of the scores were reported in the placebo group. The
walking time, defined as the minimum time to perform a 20-meter
walk, showed a statistically significant constant reduction only
in the CS group. ANOVA with repeated measures showed a statistically
significant difference in favor of the CS group for these three
parameters. During the study, patients belonging to the placebo
group reported a higher paracetamol consumption, but this consumption
was not statistically different between the two treatment groups.
Efficacy judgements were significant in favor of the CS group.
Both treatments were very well tolerated. All these results strongly
suggest that chondroitin sulfate acts as a symptomatic slow-acting
drug in knee OA.
Source: Osteoarthritis and
Cartilage (1998) 6, (Supplement A), 31-36 Osteoarthritis Research
Society
Dr. Theo’s Comments: This
excellent study proves that chondroitin sulfate can significantly
improve the symptoms of osteoarthritis in the long term. This
type of study design provides the highest level of medical evidence.
The graphs of the results are fascinating in that the patients
in the chondroitin-treated group continued to improve for a time
after the chondroitin supplementation was halted. This helps explain
the everyday clinical findings that most people lower their dose
of supplements of glucosamine/chondroitin over time, and some
can even stop the supplements.