Chondroitin and glucosamine as effective as cox-2 inhibitors in treatment of osteoarthritis

Study shows that a particular chondroitin/glucosamine formula has comparable efficacy to celecoxib in reducing pain, stiffness and joint swelling in patients with painful knee OA

A study published in the Annals of the Rheumatic Diseases suggests that chondroitin and glucosamine, two widely available natural agents, offer effective pain relief for osteoarthritis (OA) at the level of cox-2 inhibitors such as Celebrex — but without the harmful side-effects.

In this randomised, double-blind substudy of the Multicentre Osteoarthritis interVEntion trial with Symptomatic slow-acting drugs for osteoarthritis (MOVES) conducted in France, Germany, Poland and Spain, 606 patients (mean age 63 years) with radiographic evidence of knee arthritis and moderate to severe pain were randomised into two groups.

In the first group, participants received 400mg of chondroitin sulfate plus 500mg of glucosamine hydrochloride (Droglican, Bioiberica, SA, Spain) three times daily. In the second group, participants received 200mg of celecoxib (Celebrex, Pfizer, USA) every day for 6 months. Patients were also allowed up to 3g per day of acetaminophen as supplemental pain relief.

The study team measured changes in knee pain via the Western Ontario and McMaster osteoarthritis index (WOMAC) score 6 months into the trial. Secondary measures included self-reported stiffness, joint swelling and the use of acetaminophen, which were evaluated at 1, 2, 4 and 6 months.

At first, celecoxib was found to be more effective than the chondroitin/glucosamine formula in lowering the WOMAC pain score (at 1, 2 and 4 months), and acetaminophen use was higher in the chondroitin/glucosamine group after 1 month.

Surprisingly, though, at 6 months, the mean change from baseline in WOMAC pain score was -186.8 (a 50.2% decrease) in the celecoxib group and -185.7 (a 50.1% decrease) in the supplement group. At the time, 79.7% of patients in the chondroitin/glucosamine formula group and 79.2% in the celecoxib group reported pain relief, and both groups reported reductions greater than 50% in joint swelling.

This MOVES substudy is the first to find that a particular chondroitin/glucosamine formula has comparable efficacy to celecoxib in reducing pain, stiffness and joint swelling in patients with painful knee OA. The most encouraging aspect of this study is that chondroitin and glucosamine produce none of the side-effects associated with celecoxib use.

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