Update on the role of pharmaceutical‑grade chondroitin sulfate in the symptomatic management of knee osteoarthritis

[en] Osteoarthritis (OA) is the most prevalent musculoskeletal disease and a major cause of negative relevant outcomes, associated with an ever-increasing societal burden. Pharmaceutical-grade chondroitin sulfate (CS) was repeatedly reported to reduce pain and improve function in patients with knee OA. This treatment was also shown to be cost-effective, compared to placebo, up to 24 months. However, controversies still persist regarding the usefulness of CS for patients with knee OA, mainly due to inconsistent reports from various clinical trials. In this literature review, we aimed to summarize the main most recent findings on the efficacy and safety of CS in OA. Based on the results of studies presenting a low risk of bias, the most recent meta-analysis shows that only the pharmaceutical-grade CS may be considered as an appropriate background treatment for the management of knee OA. Evidence from another recent meta-analysis, using data from full safety reports, confirms the good safety profile of CS in OA. This new evidence on efficacy and safety suggests that recommendations for the use of CS in patients with knee OA cannot be extrapolated to other low-grade preparations as generics, nutraceuticalgrade or over-the-counter preparations.

Disciplines :

Public health, health care sciences & services
General & internal medicine

Author, co-author :

Honvo, Germain ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie clinique

Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé

Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé

Language :

English

Title :

Update on the role of pharmaceutical‑grade chondroitin sulfate in the symptomatic management of knee osteoarthritis

Publication date :

June 2019

Journal title :

Aging Clinical and Experimental Research

ISSN :

1594-0667

eISSN :

1720-8319

Publisher :

Springer, Germany

Volume :

Issue :

Pages :

1163-1167

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 16 July 2019

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Bibliography

Reginster JY (2002) The prevalence and burden of arthritis. Rheumatology (Oxford) 41:3–6
Hochberg MC, Altman RD, April KT et al (2012) American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res 64:465–474. 10.1002/acr.21596
McAlindon TE, Bannuru RR, Sullivan MC et al (2014) OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil 22:363–388. 10.1016/j.joca.2014.01.003
Jordan KM, Arden NK, Doherty M et al (2003) EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 62:1145–1155. 10.1136/ard.2003.011742
Bruyere O, Cooper C, Pelletier JP et al (2016) A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-from evidence-based medicine to the real-life setting. Semin Arthritis Rheum 45:S3–S11. 10.1016/j.semarthrit.2015.11.010
Hiligsmann M, Cooper C, Arden N et al (2013) Health economics in the field of osteoarthritis: an expert’s consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 43:303–313. 10.1016/j.semarthrit.2013.07.003
Reginster JY, Cooper C, Hochberg M et al (2015) Comments on the discordant recommendations for the use of symptomatic slow-acting drugs in knee osteoarthritis. Curr Med Res Opin 31:1041–1045. 10.1185/03007995.2015.1027183
Cutolo M, Berenbaum F, Hochberg M et al (2015) Commentary on recent therapeutic guidelines for osteoarthritis. Semin Arthritis Rheum 44:611–617. 10.1016/j.semarthrit.2014.12.003
Martel-Pelletier J, Farran A, Montell E et al (2015) Discrepancies in composition and biological effects of different formulations of chondroitin sulfate. Molecules 20:4277–4289. 10.3390/molecules20034277
Reginster JY (2018) Differentiation between various Chondroitin sulfate formulations in symptomatic knee osteoarthritis. Ann Rheum Dis 77:e55. 10.1136/annrheumdis-2017-212460
Bruyere O, Cooper C, Al-Daghri NM et al (2018) Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res 30:111–117. 10.1007/s40520-017-0861-1
Eriksen P, Bartels EM, Altman RD et al (2014) Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken) 66:1844–1855. 10.1002/acr.22376
Honvo G, Bruyere O, Geerinck A et al (2019) Efficacy of chondroitin sulfate in patients with knee osteoarthritis: a comprehensive meta-analysis exploring inconsistencies in randomized, placebo-controlled trials. Adv Ther 36:1085–1099. 10.1007/s12325-019-00921-w
Honvo G, Reginster JY, Rabenda V et al (2019) Safety of symptomatic slow-acting drugs for osteoarthritis: outcomes of a systematic review and meta-analysis. Drugs Aging 36:65–99. 10.1007/s40266-019-00662-z
Bourgeois P, Chales G, Dehais J et al (1998) Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3 × 400 mg/day vs placebo. Osteoarthr Cartil 6:25–30
Bucsi L, Poor G (1998) Efficacy and tolerability of oral chondroitin sulfate as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) in the treatment of knee osteoarthritis. Osteoarthr Cartil 6:31–36
Kahan A, Uebelhart D, De Vathaire F et al (2009) Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 60:524–533. 10.1002/art.24255
Michel BA, Stucki G, Frey D et al (2005) Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial. Arthritis Rheum 52:779–786. 10.1002/art.20867
Reginster JY, Dudler J, Blicharski T et al (2017) Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT). Ann Rheum Dis 76:1537–1543. 10.1136/annrheumdis-2016-210860
Uebelhart D, Thonar EJ, Delmas PD et al (1998) Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthr Cartil 6:39–46
Uebelhart D, Malaise M, Marcolongo R et al (2004) Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo. Osteoarthr Cartil 12(4):269–276
Zegels B, Crozes P, Uebelhart D et al (2013) Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study. Osteoarthr Cartil 21:22–27. 10.1016/j.joca.2012.09.017
Gabay C, Medinger-Sadowski C, Gascon D et al (2011) Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial at a single center. Arthritis Rheum 63:3383–3391. 10.1002/art.30574
Lequesne MG (1997) The algofunctional indices for hip and knee osteoarthritis. J Rheumatol 24(4):779–781
Bellamy N, Buchanan WW, Goldsmith CH et al (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840
Singh JA, Noorbaloochi S, MacDonald R et al (2015) Chondroitin for osteoarthritis. Cochrane Database Syst Rev 1:CD005614. 10.1002/14651858.cd005614.pub2
Zeng C, Wei J, Li H et al (2015) Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee. Sci Rep 5:16827. 10.1038/srep16827
Tat SK, Pelletier JP, Mineau F et al (2010) Variable effects of 3 different chondroitin sulfate compounds on human osteoarthritic cartilage/chondrocytes: relevance of purity and production process. J Rheumatol 37:656–664. 10.3899/jrheum.090696
Bruyere O, Scholtissen S, Neuprez A et al (2009) Impact of chondroitin sulphate on health utility in patients with knee osteoarthritis: towards economic analysis. J Med Econ 12:356–360. 10.3111/13696990903438617
Bruyere O (2018) Pharmaceutical-grade chondroitin sulfate in the management of knee osteoarthritis. Expert Opin Pharmacother 19:409–412. 10.1080/14656566.2018.1442438