Comparison of efficacy of glucosamine, chondroitin sulfate and a fixed dose combination of glucosamine and chondroitin sulfate in the treatment of osteoarthritis
DOI:
https://doi.org/10.18203/2320-6012.ijrms20263092Keywords:
Chondroitin sulfate, Glucosamine, Osteoarthritis, Pain, Physical function, Stiffness, WOMACAbstract
Background: The study aimed to compare the efficacy of glucosamine, chondroitin sulfate and a fixed dose combination (FDC) of glucosamine and chondroitin sulfate in patients with osteoarthritis (OA) of the knee.
Methods: This was an open-label prospective comparative cohort study conducted from November 2023 to April 2024. Subjects were recruited consecutively from the orthopaedics outpatient department of GCMCH, Chidambaram, and assigned to one of three treatment groups based on the treating physician's prescription. Study tools including a patient data collection form and Western Ontario McMaster Universities Arthritis Index (WOMAC) questionnaires were used to measure outcomes at baseline and at monthly intervals over 4 months.
Results: After 4 months, the fixed dose combination group showed a statistically significant reduction in WOMAC pain score compared to glucosamine and chondroitin sulfate monotherapy groups (p=0.009). No significant differences were observed among the groups for stiffness (p=0.234) or physical function (p=0.439). The fixed dose combination consistently produced the greatest numerical improvement across all WOMAC domains.
Conclusions: The fixed dose combination of glucosamine 750 mg and chondroitin sulfate 600 mg is slightly more effective than either agent used alone, demonstrating greater relief of pain in patients with osteoarthritis of the knee.
References
Yao Q, Wu X, Tao C, Gong W, Chen M, Qu M, et al. Osteoarthritis: pathogenic signaling pathways and therapeutic targets. Signal Transduction and Targeted Therapy. 2023;8(1):56.
Singh A, Das S, Chopra A, Danda D, Paul BJ, March L, et al. Burden of osteoarthritis in India and its states, 1990–2019: findings from the Global Burden of Disease study. Osteoarthritis Cartilage. 2022;30(8):1070-8.
Mobasheri A, Batt M. An update on the pathophysiology of osteoarthritis. Ann Phy Rehabilit Medi. 2016;59(5-6):333-9.
Lila AM, Alekseeva LI, Baranov AA, Taskina EA, Kashevarova NG, Lapkina NA, et al. Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis: a long-term observational study in Russia. World J Orthopedics. 2023;14(6):443-57.
Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. The Lancet. 2001;357(9252):251-6.
Bortoluzzi A, Furini F, Scire CA. Osteoarthritis and its management epidemiology, nutritional aspects and environmental factors. Autoimm Revi. 2018;17(11):1097-1104.
Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-59.
Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P. Occupational activity and osteoarthritis of the knee. Ann Rheumat Dis. 1994;53(2):90-3.
Sulzbacher I. Osteoarthritis: histology and pathogenesis. Wiener Medizinische Wochenschrift. 2013;163(9-10):212-9.
Zhu X, Sang L, Wu D, Rong J, Jiang L. Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. J Orthopaed Surg Res. 2018;13(1):170.
Meng Z, Liu J, Zhong N. Efficacy and safety of the combination of glucosamine and chondroitin for knee osteoarthritis: a systematic review and meta-analysis. Arch Orthopaed Trauma Surg. 2023;143(1):409-21.
Roman‐Blas JA, Castañeda S, Sánchez‐Pernaute O, Largo R, Herrero‐Beaumont G, CS/GS Combined Therapy Study Group, et al. Combined treatment with chondroitin sulfate and glucosamine sulfate shows no superiority over placebo for reduction of joint pain and functional impairment in patients with knee osteoarthritis: a six-month multicentre, randomized, double-blind, placebo-controlled clinical trial. Arthr Rheumatol. 2017;69(1):77-85.
Rabade A, Viswanatha GL, Nandakumar K, Kishore A. Evaluation of efficacy and safety of glucosamine sulfate, chondroitin sulfate and their combination regimen in the management of knee osteoarthritis: a systematic review and meta-analysis. Inflammopharmacol. 2024;32(3):1759-75.