The dietary supplements chondroitin and glucosamine, separately or in combination, have been widely used to treat the pain of osteoarthritis of the knee. But do they work? When I wrote about glucosamine and chondroitin and in the evidence was mostly negative. Some studies supported the combination of glucosamine and chondroitin, but many others didn’t; and there was little evidence that chondroitin alone had any effect. After reviewing all the published studies, the American Academy of Orthopaedic Surgeons. Published in the BMJ Annals of the Rheumatic Diseases contradicts several previous studies: it found that chondroitin was effective, as effective as celecoxib, a non-steroidal anti-inflammatory drug (NSAID).

A common objection when a dietary supplement fails testing is that they didn’t use the right dose or the right formulation. This reasoning might be valid, but it could easily lead to an unending and unproductive proliferation of studies each using slightly different regimens. This new study avoided that objection by using the dose and the specific formulation that had been shown effective in the most positive studies. Previous studies of chondroitin had suffered from idiosyncratic trial design. This new study followed the guidelines of the European Medicines Agency: • a minimum 6-month study • a three-arm design including a placebo and an active comparator (i.e. An oral NSAID) • two primary endpoints evaluating pain and function Is chondroitin really as effective as NSAIDs?

The goal of the present study is to investigate the effectiveness of Condrosulf® 800 mg tablets vs. Placebo once a day for 6 months in the symptomatic treatment of finger joint osteoarthritis. Primary endpoints of the study are the evaluation of global spontaneous pain.

If it is, it might be the best choice for osteoarthritis pain, since it doesn’t have the side effects that are problematic for other osteoarthritis medications. Should we discount the previous negative studies?

Should we rely on this new study to guide clinical treatment? I’m skeptical. The new study 604 patients with pain from knee osteoarthritis were recruited from 5 European countries. It was a prospective 6-month, double-blind, double-dummy trial of chondroitin sulfate (CS) vs. Subjects were randomly assigned to one of three groups: • Real CS and placebo celecoxib • Placebo CS and real celecoxib • Placebo CS and placebo celecoxib Meds were taken once daily for 6 months.

CS tablets contained 800 mg of highly purified chondroitin 4 & 6 sulfate in a concentration not less than 95% (European patents E 1582214 and EP 1705192) Condrosulf (other brand name: Chondrosulf, Condral); IBSA Institut Biochimique SA; Pambio-Noranco, Switzerland. The study was sponsored by the manufacturer of Condrosulf. Results: A 800 mg/day pharmaceutical-grade CS is superior to placebo and similar to celecoxib in reducing pain and improving function over 6 months in symptomatic knee osteoarthritis (OA) patients.

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This formulation of CS should be considered a first-line treatment in the medical management of knee OA. Previous double blind studies of chondroitin for knee osteoarthritis had mixed results found that Condrosulf 800 mg was an effective and safe slow-acting drug that reduced pain, increased mobility, and “might” be able to influence the natural course of osteoarthritis. Compared Condrosulf 800 mg to placebo. It had no effect on symptoms, but appeared to slow joint space narrowing on x-ray.

Found that 800 mg of Condrosulf slowed joint space narrowing and improved pain faster than placebo. Used an Australian formulation of CS, 800 mg. Along with glucosamine 1,500 mg. The combination didn’t relieve pain better than placebo, but it reduced joint space narrowing. Was a multicenter double-blind placebo-controlled study of 1,583 patients with knee osteoarthritis published in the highly respected New England Journal of Medicine ( NEJM) in 2006.

It used 1,500 mg glucosamine hydrochloride and 1,200 mg sodium chondroitin sulfate. It found that “glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices.