Chondroitin: Difference between revisions

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Chondroitin has been studied as a treatment for [[osteoarthritis]]. A [[meta-analysis]] of [[randomized controlled trial]]s found no benefit.<ref name="pmid17438317">{{cite journal |author=Reichenbach S, Sterchi R, Scherer M, ''et al'' |title=Meta-analysis: chondroitin for osteoarthritis of the knee or hip |journal=Ann. Intern. Med. |volume=146 |issue=8 |pages=580-90 |year=2007 |pmid=17438317 |url=http://www.annals.org/cgi/content/full/146/8/580|doi=}}</ref> This [[meta-analysis]] included the GAIT  [[randomized controlled trial]] of Clegg et al that was sponsorered by the U.S. [[National Institutes of Health]].<ref name="pmid16495392">{{cite journal |author=Clegg DO, Reda DJ, Harris CL, ''et al'' |title=Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis |journal=N. Engl. J. Med. |volume=354 |issue=8 |pages=795–808 |year=2006 |month=February |pmid=16495392 |doi=10.1056/NEJMoa052771 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=16495392&promo=ONFLNS19 |issn=}}</ref> A longer followup of the GAIT show no benefit from sodium chondroitin on reduction in loss of joint space width.<ref name="pmid18821708">{{cite journal |author=Sawitzke AD, Shi H, Finco MF, ''et al'' |title=The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial |journal=Arthritis Rheum. |volume=58 |issue=10 |pages=3183–91 |year=2008 |month=October |pmid=18821708 |doi=10.1002/art.23973 |url=http://dx.doi.org/10.1002/art.23973 |issn=}}</ref>
Chondroitin has been studied as a treatment for [[osteoarthritis]]. A [[meta-analysis]] of [[randomized controlled trial]]s found no benefit.<ref name="pmid17438317">{{cite journal |author=Reichenbach S, Sterchi R, Scherer M, ''et al'' |title=Meta-analysis: chondroitin for osteoarthritis of the knee or hip |journal=Ann. Intern. Med. |volume=146 |issue=8 |pages=580-90 |year=2007 |pmid=17438317 |url=http://www.annals.org/cgi/content/full/146/8/580|doi=}}</ref> This [[meta-analysis]] included the GAIT  [[randomized controlled trial]] of Clegg et al that was sponsorered by the U.S. [[National Institutes of Health]].<ref name="pmid16495392">{{cite journal |author=Clegg DO, Reda DJ, Harris CL, ''et al'' |title=Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis |journal=N. Engl. J. Med. |volume=354 |issue=8 |pages=795–808 |year=2006 |month=February |pmid=16495392 |doi=10.1056/NEJMoa052771 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=16495392&promo=ONFLNS19 |issn=}}</ref> A longer followup of the GAIT show no benefit from sodium chondroitin on reduction in loss of joint space width.<ref name="pmid18821708">{{cite journal |author=Sawitzke AD, Shi H, Finco MF, ''et al'' |title=The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial |journal=Arthritis Rheum. |volume=58 |issue=10 |pages=3183–91 |year=2008 |month=October |pmid=18821708 |doi=10.1002/art.23973 |url=http://dx.doi.org/10.1002/art.23973 |issn=}}</ref>


A more recent trial is positive. A trial sponsored by the manufacturer reports less loss of joint space with chondroitins 4 and 6.<ref name="pmid19180484">{{cite journal |author=Kahan A, Uebelhart D, De Vathaire F, Delmas PD, Reginster JY |title=Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: The study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial |journal=Arthritis Rheum. |volume=60 |issue=2 |pages=524–33 |year=2009 |month=February |pmid=19180484 |doi=10.1002/art.24255 |url=http://dx.doi.org/10.1002/art.24255 |issn=}} [http://general-medicine.jwatch.org/cgi/content/full/2009/219/3 ''Trial registration not provided''. Summary at JournalWatch.org]</ref>
Two more recent trials are positive. A trial sponsored by the manufacturer reports less loss of joint space with chondroitins 4 and 6.<ref name="pmid19180484">{{cite journal |author=Kahan A, Uebelhart D, De Vathaire F, Delmas PD, Reginster JY |title=Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: The study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial |journal=Arthritis Rheum. |volume=60 |issue=2 |pages=524–33 |year=2009 |month=February |pmid=19180484 |doi=10.1002/art.24255 |url=http://dx.doi.org/10.1002/art.24255 |issn=}} [http://general-medicine.jwatch.org/cgi/content/full/2009/219/3 ''Trial registration not provided''. Summary at JournalWatch.org]</ref> A trial by authors who have received fees from industry suggested benefit for patients with arthritis of the hand.<ref name="pmid21898340">{{cite journal| author=Gabay C, Medinger-Sadowski C, Gascon D, Kolo F, Finckh A| title=Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: A randomized, double-blind, placebo-controlled clinical trial at a single center. | journal=Arthritis Rheum | year= 2011 | volume= 63 | issue= 11 | pages= 3383-91 | pmid=21898340 | doi=10.1002/art.30574 | pmc= | url= }} </ref>


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Latest revision as of 04:11, 9 November 2011

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In biochemistry, chondroitin is a "mucopolysaccharide constituent of chondrin."[1]

Clinical studies

Chondroitin has been studied as a treatment for osteoarthritis. A meta-analysis of randomized controlled trials found no benefit.[2] This meta-analysis included the GAIT randomized controlled trial of Clegg et al that was sponsorered by the U.S. National Institutes of Health.[3] A longer followup of the GAIT show no benefit from sodium chondroitin on reduction in loss of joint space width.[4]

Two more recent trials are positive. A trial sponsored by the manufacturer reports less loss of joint space with chondroitins 4 and 6.[5] A trial by authors who have received fees from industry suggested benefit for patients with arthritis of the hand.[6]

Selected randomized controlled trials of chondroitin
Trial Patients Intervention Outcome Results
Chondroitin Placebo
GAIT[3]
2007
1583 patients with knee osteoarthritis 1200 mg of chondroitin sulfate daily Response of 20% decrease in WOMAC pain score[7] at 24 weeks All subjects: 65%
Mild OA: 67%
Moderate/severe OA: 61%‡
All subjects: 60%
Mild OA: 62%
Moderate/severe OA: 54%
GAIT[4]
2008
1583 patients with knee osteoarthritis 1200 mg of chondroitin sulfate daily Loss of joint space width at two years 0.107 mm 0.166 mm
Kahan[5]
2009
Sponsored by manufacturer and trial registration not provided
622 patients with knee osteoarthritis
32% dropped out
800 mg of chondroitin sulfate daily Loss at minimum joint space width
Used last observation carried forward for dropouts
0.07 mm† 0.31 mm
† p < 0.05
‡ All comparisons were insignificant and less than occurred with celecoxib; however, the combination of glucosamine hydrochloride and chondroitin gave significant 79% improvement among moderate/severe patients. However, longer follow-up of GAIT showed the combination group tended to have the most loss of joint space.[4]

References

  1. Anonymous (2024), Chondroitin (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Reichenbach S, Sterchi R, Scherer M, et al (2007). "Meta-analysis: chondroitin for osteoarthritis of the knee or hip". Ann. Intern. Med. 146 (8): 580-90. PMID 17438317[e]
  3. 3.0 3.1 Clegg DO, Reda DJ, Harris CL, et al (February 2006). "Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis". N. Engl. J. Med. 354 (8): 795–808. DOI:10.1056/NEJMoa052771. PMID 16495392. Research Blogging.
  4. 4.0 4.1 4.2 Sawitzke AD, Shi H, Finco MF, et al (October 2008). "The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial". Arthritis Rheum. 58 (10): 3183–91. DOI:10.1002/art.23973. PMID 18821708. Research Blogging.
  5. 5.0 5.1 Kahan A, Uebelhart D, De Vathaire F, Delmas PD, Reginster JY (February 2009). "Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: The study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial". Arthritis Rheum. 60 (2): 524–33. DOI:10.1002/art.24255. PMID 19180484. Research Blogging. Trial registration not provided. Summary at JournalWatch.org
  6. Gabay C, Medinger-Sadowski C, Gascon D, Kolo F, Finckh A (2011). "Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: A randomized, double-blind, placebo-controlled clinical trial at a single center.". Arthritis Rheum 63 (11): 3383-91. DOI:10.1002/art.30574. PMID 21898340. Research Blogging.
  7. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (December 1988). "Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee". J. Rheumatol. 15 (12): 1833–40. PMID 3068365[e]