The usefulness of chondroitin in the treatment of osteoarthritis (OA) has long been debated, but new research coming out of the American College of Rheumatology Annual Meeting, reports that for the first time, chondroitin sulfate was shown to be more effective in reducing long-term progression of knee OA than celecoxib, a drug often used as first-line therapy in the disease.   

In this study,  Dr. Jean-Pierre Pelletier; professor of medicine, University of Montreal; director, Rheumatic Disease Unit, Department of Medicine, University of Montreal School of Medicine; head, Arthritis Division, University of Montreal Hospital Centre (CHUM); head, Chair in Osteoarthritis of the University of Montreal; and director, Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM) and his team evaluated 194 patients with knee OA and inflammation of the synovial membrane in the knee. The patients were divided into two groups (chondroitin [pharmacological preparation] 1200mg daily vs. celecoxib 200mg daily) and were followed for two years.

Patients were evaluated using MRI to detect loss of cartilage, changes in bone marrow lesions and thickening of the synovial membrane in the knee, as well as swelling and fluid in the knee and overall symptoms.  Compared to those on celecoxib, researchers found that at both one and two years, patients on chondroitin had a better reduction of cartilage loss in the whole knee; some of the patients on chondroitin also had a decrease in synovial membrane thickness. “These findings are most important as they demonstrate that chondroitin, in contrast to celecoxib, can reduce the loss of cartilage, at least in part, by reducing synovial inflammation (thickness),” Dr. Pelletier says.

Over the course of the study, both groups showed similar effectiveness in lowering OA symptoms; a marked reduction in swelling and fluid in the knee, as well as a reduction in acetaminophen use was also observed. Both treatments were well tolerated.

“This study demonstrates that both chondroitin sulfate and celecoxib are equally effective at reducing the symptoms of knee OA patients. However, only chondroitin sulfate was found to be capable of slowing down the progression of the disease by reducing the loss of cartilage,” said Dr. Pelletier.

The authors conclude by noting that in this study pharmaceutical-grade chondroitin was used and that results may not be comparable to chondroitin found in food supplements. Dr. Pelletier recommends that patients consult with their physicians before making any therapy changes.

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