Chondroitin sulfate efficacy versus celecoxib on knee osteoarthritis structural changes using magnetic resonance imaging: a 2-year multicentre exploratory study.
Reviewer: Dr. Alan Gaby, MD
Author: Pelletier JP, et al
Reference: Chondroitin sulfate efficacy versus celecoxib on knee osteoarthritis structural changes using magnetic resonance imaging: a 2-year multicentre exploratory study. Arthritis Res Ther 2016;18:256.
Design: Randomized, double-blind trial.
Participants: One hundred ninety-four patients (mean age, 61 years) with osteoarthritis of the knee.
Study Medication and Dosage: Chondroitin sulfate (1,200 mg per day) or celecoxib (a nonsteroidal anti-inflammatory drug; 200 mg per day) for 2 years.
Primary Outcome Measures: Loss of cartilage volume, as determined by quantitative magnetic resonance imaging (MRI).
Key Findings: Among the 138 patients who had at least 1 post-treatment MRI measurement, mean cartilage volume loss was significantly less with chondroitin sulfate than with celecoxib in the medial compartment (-6.3% vs. -8.1%; p = 0.018) and the medial condyle (-5.5% vs. -7.7%; p = 0.008). Both groups experienced marked improvement in joint swelling and symptoms. The improvement in symptoms tended to be somewhat better with celecoxib than with chondroitin sulfate.
Practice Implications: Chondroitin sulfate is a term used to denote a group of structurally similar polysaccharides, which are typically comprised of sulfated and unsulfated residues of glucuronic acid and N-acetylglucosamine. Chondroitin sulfate is one of the components of proteoglycans, the macromolecules that contribute to the structural and functional properties of joint cartilage. Chondroitin sulfate stimulates the synthesis of proteoglycans by chondrocytes, and also exerts anti-inflammatory activity.
Many, but not all, randomized controlled trials have found that treatment with 800-1,200 mg per day of chondroitin sulfate decreased symptoms, slowed disease progression, or both, in patients with osteoarthritis of the knees, hips, or hands. The present study demonstrated that chondroitin sulfate was more effective than celecoxib for slowing disease progression (as assessed by cartilage volume loss).
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