Efficacy of a New Class of Agents (Glucosamine Hydrochloride
and Chondroitin Sulfate) in The Treatment of a Osteoarthritis of
Amal M Das, Jr., MD, Hendsonville, NC, Jennifer
Eitel, Tarek Hammad, MD, PhD
Introduction: 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
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
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.