Clinical Studies
References

Chondroitin sulfate belongs to a class of very large molecules called glucosaminoglycans (GAGs), which are made up of glucuronic acid and galactosamine. Chondroitin is manufactured from natural sources such as shark and bovine cartilage. People use chondroitin for osteoarthritis because it is found in cartilaginous tissues of most mammals and has a function in the formation of the joint matrix structure. It may slow down the progression of osteoarthritis and osteoporosis.

Published Clinical Studiescl top
Chondroitin Sulphate

• The pathobiology of osteoarthritis and the rationale for using the chondroitin sulfate for its treatment.
• Clinical and histopathological improvement of psoriasis with oral chondroitin sulfate: A serendipitous finding.
• Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo.
• Glucosamine and chondroitin sulfate are effective in the management of osteoarthritis.

1
The pathobiology of osteoarthritis and the rationale for using the chondroitin sulfate for its treatment.

Volpi N.

Department of Biologia Animale, Biological Chemistry Section, University of Modena and Reggio Emilia, Italy. volpi@unimo.it

Structure-modifying osteoarthritis (OA) drugs are agents that reverse, retard, or stabilize the pathology of OA, thereby providing symptomatic relief in the long-term treatment. The objective of this review is to evaluate the literature on chondroitin sulfate (CS) with respect to the pathobiology of OA to ascertain whether this agent should be classified as a symptomatic slow-acting drug (SYSADOA), a compound that has a slow onset of action and improve OA symptoms after a couple of weeks. CS exhibits a wide range of biological activities and from a pharmacological point of view it produces a slow but gradual decrease of the clinical symptoms of OA and these benefits last for a long period after the end of treatment. Many literature data show that CS could have an anti-inflammatory activity and a chondroprotective action by modifying the structure of cartilage. These properties are also related to the oral adsorption of this molecule as high-molecular mass compounds having clusters of sulfate groups and high charge density capable of exert their chondroprotective activity in vivo.

Publication Types:

• Review
• Review, Tutorial

PMID: 15180452 [PubMed - indexed for MEDLINE]

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2
Clinical and histopathological improvement of psoriasis with oral chondroitin sulfate: A serendipitous finding.

Verges J, Montell E, Herrero M, Perna C, Cuevas J, Perez M, Moller I.

Clinical Research Unit, Scientific Medical Department, Bioiberica, S.A., Barcelona, Spain. jverges@bioiberica.com.

We describe the clinical and histopathological results of plaque psoriasis in eleven adult patients with knee osteoarthritis and long-standing, moderate to severe psoriasis resistant to conventional therapy treated with chondroitin sulfate. Patients received 800 mg per day of chondroitin sulfate for 2 months. Skin biopsies were obtained before and after treatment. All patients but one presented a dramatic improvement of the condition of the skin, with a reduction of swelling, redness, flaking, and itching (clearance of psoriasis in one patient), increase in the hydration and softening of the skin, and amelioration of scaling. Histopathologically, there was a statistically significant decrease in epidermal thickness, a decrease in the thickness between the stratum basale and the stratum granulosum, a significant improvement of the degree of psoriasis activity, and a decrease in the number of keratinocytes stained with Ki-67. The confirmation of these serendipitous findings in controlled prospective studies could represent an important advance in the therapeutic armamentarium for patients with psoriasis given the excellent safety profile of chondroitin sulfate.

PMID: 15748570 [PubMed - in process]

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3
Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo.

Uebelhart D, Malaise M, Marcolongo R, DeVathaire F, Piperno M, Mailleux E, Fioravanti A, Matoso L, Vignon E.

Department of Rheumatology, Institute of Physical Medicine, University Hospital Zurich, Switzerland. daniel.uebelhart@usz.ch

OBJECTIVE: To investigate the efficacy and tolerability of a 3-month duration, twice a-year, intermittent treatment with oral chondroitin sulfate (CS) in knee osteoarthritis (OA) patients. DESIGN: A total of 120 patients with symptomatic knee OA were randomized into two groups receiving either 800mg CS or placebo (PBO) per day for two periods of 3 months during 1 year. Primary efficacy outcome was Lequesne's algo-functional index (AFI); secondary outcome parameters included VAS, walking time, global judgment, and paracetamol consumption. Radiological progression was assessed by automatic measurement of medial femoro-tibial joint space width on weight-bearing X-rays of both knees. Clinical and biological tolerability was assessed. RESULTS: One hundred and ten of 120 patients were included in the ITT analysis. AFI decreased significantly by 36% in the CS group after 1 year as compared to 23% in the PBO group. Similar results were found for the secondary outcomes parameters. Radiological progression at month 12 showed significantly decreased joint space width in the PBO group with no change in the CS group. Tolerability was good with only minor adverse events identically observed in both groups. CONCLUSION: This study provides evidences that oral CS decreased pain and improved knee function. The 3-month intermittent administration of 800mg/day of oral CS twice a year does support the prolonged effect known with symptom-modifying agents for OA. The inhibitory effect of CS on the radiological progression of the medial femoro-tibial joint space narrowing could suggest further evidence of its structure-modifying properties in knee OA.

Publication Types:

• Clinical Trial
• Multicenter Study
• Randomized Controlled Trial

PMID: 15023378 [PubMed - indexed for MEDLINE]

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Glucosamine and chondroitin sulfate are effective in the management of osteoarthritis.5

Hungerford DS, Jones LC.

Division of Arthritis Surgery, Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, G-1 Good Samaritan Professional Building, 5601 Loch Raven Boulevard, Baltimore, MD 21239, USA.

The use of glucosamine and chondroitin sulfate for the symptomatic treatment of osteoarthritis has been a subject of controversy for several reasons. First, the medical community in general took offense at the title of Theodosakis' book, The Arthritis Cure. Second, the medical community is becoming divided into "traditional" and "alternative" camps with deep skepticism between them. Third, the whole nutraceutical industry is essentially unregulated, with manufacturers making outrageous claims on products that have never been tested at all, are often of poor quality, and occasionally lacking in any active ingredient. However, for the nutriceuticals evaluated here, there is abundant in vitro, in vivo, animal clinical, and human clinical evidence of both their efficacy and safety. They deserve a prominent place in the armamentarium of nonsurgical treatment of osteoarthritis. Copyright 2003 Elsevier Inc. All rights reserved.

Publication Types:

• Review
• Review, Tutorial

PMID: 12730919 [PubMed - indexed for MEDLINE]

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Referencesre

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19. Ronca F, Palmieri L, Panicucci P, et al. Anti-inflammatory activity of chondroitin sulfate. Osteoarthritis Cartilage 1998;6 Suppl A:14-21.
20. Silvestro L, Lanzarotti E, Marchi E, et al. Human pharmacokinetics of glycosaminoglycans using deuterium-labeled and unlabeled substances: evidence for oral absorption. Semin Thromb Hemost 1994;20:281-92.