For symptomatic osteoarthritis (OA) of the knee, recent guidelines have recommended maintenance therapy with symptomatic slow acting drugs for OA (SYSADOAa). As evidence suggests positive benefits of chondroitin sulfate (CS) and crystalline glucosamine sulfate, this study compared the efficacy of a NSAID with CS for OA of the knee.
METHODSSubjects were 604 adults over 50 years of age with primary knee OA, randomized to receive daily capsules containing a placebo, CS 800 mg, or Celecoxib 200mg. All were assessed for pain on a 100 mm Visual Analog Scale (VAS), with function measured with the Lequesne Index (LI). Secondary endpoints included the proportion of patients reaching Minimal Clinically Important Improvement (MCII), as well as scores on the Patient Acceptable Symptom State (PASS).
RESULTSImprovements in VAS pain scores were noted in all three groups as compared with baseline, with the CS and celecoxib groups demonstrating greater reductions than the placebo group (P＝0.001 and P＝0.009 after six months). No significant difference was found between the CS and celecoxib groups. The LI scores were also significantly improved as compared with placebo, with improvement noted at day 30 in the celecoxib group, but not until day 90 in the CS group. At six months, a greater (though statistically insignificant) proportion of patients reached MCII in the CS and celecoxib groups than in the placebo group.
CONCLUSIONThis study of patients with osteoarthritis of the knee found that 800 mg per day of chondroitin sulfate is similar to 200mg per day of celecoxib for reducing pain and improving function.