Medical Evidence
Comparison of the Anti-inflammatory
Efficacy of Chondroitin Sulfate and Diclofenac Sodium in Patients
with Knee Osteoarthritis Pietro Morreale, Roberto
Manopulo, Michele Galati, Luciano Boccanera, Giorgio Saponati,
and Luigi Bocchi
Objective: To assess the
clinical efficacy of chondroitin sulfate (CS) in comparison with
the nonsteroidal anti-inflammatory drug (NSAID) diclofenac: sodium
(DS) in a medium/long-term clinical study in patients with knee
osteoarthritis (OA).
Methods: This was a randomized,
multicenter, double blind, double dummy study. 146 patients with
knee OA were recruited into 2 groups. During the first month,
patients in the NSAID group were treated with 3 x 50 mg DS tablets/day
and 3 x 400 mg placebo (for CS) sachets; from Month 2 to Month
3, patients were given placebo sachets alone. In the CS group,
patients were treated with 3 x 50 mg placebo (for diclofenac)
tablets/day and 3 x 400 mg CS sachets/day during the first month;
from Month 2 to Month 3, these patients received only CS sachets.
Both groups were treated with 3 x 400 mg placebo sachets from
Month 4 to Month 6. Clinical efficacy was evaluated by assessing
the Lesquesne Index, spontaneous pain (using the Huskisson visual
analog scale), pain on load (using a 4 point ordinal scale), and
paracetamol consumption.
Results: Patients treated
with the NSAID showed prompt and plain reduction of clinical symptoms,
which however, reappeared after the end of treatment; in the CS
group, the therapeutic response appeared later in time but lasted
for up to 3 months after the end of treatment.
Conclusion: CS seems to have
slow but gradually increasing clinical activity in OA; these benefits
last for a long period after the end of treatment. Source. Journal
of Rheumatology 1996;23:1385-91
Dr. Theo’s Comments: This
very well designed study proves that chondroitin is effective
for osteoarthritis and probably has disease-modifying effects
since the subjects improved even after treatment stopped. Diclofenac
is a prescription NSAID. This type of study design provides the
highest level of medical evidence.
