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.