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Medical Evidence

Efficacy of a New Class of Agents (Glucosamine Hydrochloride and Chondroitin Sulfate) in The Treatment of a Osteoarthritis of the Knee Amal M Das, Jr., MD, Hendsonville, NC, Jennifer Eitel, Tarek Hammad, MD, PhD

Background: NSAIDS are the most popular drug for the treatment of osteoarthritis of the knee. They are safe and effective. However they are not entirely without side effects. Some NSAIDS inhibit glycosaminoglycan synthesis and are thus postulated to accelerate osteoarthritis. The agents studied herein have no known side effects and have been shown to accelerate glycosaminoglycan synthesis. This is the first North American study the efficacy of these agents.

Methods: A randomized double-blind placebo-controlled clinical trial of 93 patients with Kellgren and Lawrence grade II, III and IV osteoarthritis of the knee is presented. The intervention group received glucosamine 1000 mg and chondroitin sulfate 800 mg. PO BID. The Lesquesne scale of osteoarthritis of the knee (IS10 was the primary outcomes study used.

Results: The ISK improved from 10.2 (0.4) to 7.4 (0.6) in die intervention group and 10.4 (0.4) to 9.0 (0.6) in the placebo group. The difference in improvement between the two groups (3.2 for intervention and I.4 for placebo) is significant (p=0.03). Twenty-eight percent (28%) of the placebo group responded compared to 52% of the intervention group (p=0.04). There was also a significant drop in the pain medication requirement in the intervention group. 19% of the placebo group and 17% of the intervention group suffered adverse reactions.

Discussion and Conclusion: The agents studied are effective for the treatment of pain and loss of function associated with osteoarthritis of the knee. They have no known side effects. Other studies have suggested that they may be disease-modifying agents.

Source: American Association of Hip and Knee Surgeons; Eighth Annual Fall Meeting. November 6 - 8, 1998. Dallas/Fort Worth Hilton. Executive Conference Center, paper #18. To be published in Military Medicine, February, 1999 issue.

Dr. Theo’s Comments: This very well designed U.S. study proves that the combination of glucosamine HCL and chondroitin sulfate is an effective treatment for osteoarthritis. Not only did patients improve, they reduced their pain medicine at the same time. This type of study provides the highest level of medical evidence.


 
 

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