The study of the efficacy and safety of glucosamine sulfate in the treatment of patients with knee joint osteoarthritis
Keywords:knee osteoarthritis, pain, inflammation, structural modification effect, glucosamine sulfate
Objective: To study the effectiveness and safety of treatment patients with knee joint osteoarthritis (OA) with glucaminoglycans and its impact on the dynamics of indicators of inflammation, hepatic, renal markers, purine, carbohydrate and lipid metabolism.
Methods: The study included 30 patients (18 female and 12 male) in the age of 29 to 80 years old with knee OA Kellgren Lawrence I-III radiographic stage. Glucosamine sulphate used in a dose of 400 mg three times weekly for 1.5 months. Efficiency of the drug assessed using visual analog scale VAS algofunctional Lequesne and WOMAC indexes. The effect of glucosamine sulfate at the level of either cytokine (IL1β, IGF1, NO), C reactive protein (CRP), erythrocyte sedimentation rate, metabolic rate (lipid, carbohydrate, liver function markers, uric acid) analyzed. Statistic data analyses performed with «SPSS Statistics» application program.
Results: after 1.5 months of treatment a significant decrease in VAS scores and Lequesne and WOMAC indexes revealed. Also, there was a significant decline of CRP, pro-inflammatory cytokines (IL1), free radical (NO) and raising of anabolic cytokines (IGF1) levels. At the end of the study dynamics laboratory parameters of hepatic markers, uric acid, creatinine didn't change, which in majority of the patients were within the normal range prior to inclusion in the study. It should be emphasized absence of glucose increase and a significant decrease blood cholesterol levels during treatment with glucosamine sulfate.Conclusions: it is found significant therapeutic effect of glucosamine sulfate in the treatment of gonarthrosis, patients had pain relief, decreased stiffness in the knee joints, and increased functional activity. The drug was more effective in a early stage of disease. Revealed a pronounced anti-inflammatory (indication CRP, IL1, NO) and anabolic (on the level of IGF1) effect of glucosamine sulfate. The drug has no effect on the level of bilirubin, ALT, AST, creatinine, glucose and uric acid, indicating the safety of its use in patients with concomitant diseases.
Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet 2011;377:2115–26. doi: 10.1016/S0140-6736(11)60243-2.
Kovalenko VM, Shuba NM. National textbook of rheumatology. Kyiv: Morion, 2013. 672 p.
Bruyère O, Cooper C, Pelletier JP, Branco J, Luisa Brandi M, Guillemin F, Hochberg MC, Kanis JA, Kvien TK, Martel-Pelletier J, Rizzoli R, Silverman S, Reginster JY. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum. 2014 Dec;44(3):253-63. doi: 10.1016/j.semarthrit.2014.05.014.
Osteoarthritis. Care and management in adults. NICE Clinical Guidelines, No. 177. National Clinical Guideline Centre (UK). London: National Institute for Health and Care Excellence (UK); 2014 Feb. http://www.ncbi.nlm.nih.gov/books/NBK248069/pdf/Bookshelf_NBK248069.pdf.
Bannuru RR, Dasi UR, McAlindon TE. Reassessing the role of acetaminophen in osteoarthritis: systematic review and meta-analysis. Osteoarthritis Cartilage 2010;18(Suppl. 2):S250. DOI: http://dx.doi.org/10.1016/S1063-4584(10)60585-7.
Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco J. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 2007;56: 555–67.
Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P. OARSI recommendations for the management of hip and knee osteoarthritis,part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 2010;18(4):476–99. doi: 10.1016/j.joca.2010.01.013
Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, Hochberg MC, Wells G. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;(2):CD002946.
Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco J. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 2007;56(2): 555–67.
Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, Gossett C. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357(9252):251–6.
Pavelká K, Gatterová J, Olejarová M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002;162(18):2113–23.
Bjordal JM, Klovning A, Ljunggren AE, Slordal L. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a metaanalysis of randomised placebo-controlled trials. Eur J Pain 2007;11(2):125–38.
Copyright (c) 2016 Neonila Shuba, Tetiana Voronova, Tetiana Khambir
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available after 6 months from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.
Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.
The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).