Nutraceuticals in therapy of knee osteoarthritis: orthopaedic view

Czech version

Authors: Jiří Gallo
Authors‘ workplace: Ortopedická klinika LF UP a FN Olomouc
Published in: Vnitř Lék 2018; 64(2): 191-196
Category: Reviews

Overview

Knee osteoarthritis is one of the most frequent diagnoses of load-carrying joints encountered in orthopaedic surgeons’ offices. Depending on the clinical stage, the therapy starts with conservative treatment. Corrective osteotomy is indicated in younger patients without an extensive and serious impairment. Implantation of TKR (total knee replacement) is usually indicated in more advanced stages. One of the pillars of conservative therapy is analgesics and non-steroidal antirheumatic drugs. A specific group consists of perorally administered drugs for suppression of symptoms or even deceleration of knee osteoarthrosis. These products are popular mainly thanks to their good tolerance and minimal side effects. The clinical effect ranges between minimal and medium depending on the degree of osteoarthrosis, type of drug and study. Similar to rheumatologists, orthopaedic surgeons also find it difficult to identify candidates suitable for a particular type of therapy, except indication for TKR. By all means, nutraceuticals are still considered part of clinical practice.

Key words:
chondroitin sulphate – glucosamine sulphate – knee osteoarthrosis – methylsulfonylmethane – nutraceuticals – pharmaceutical intervention

Sources

1. Ahn H, Kim J, Lee MJ et al. Methylsulfonylmethane inhibits NLRP3 inflammasome activation. Cytokine 2015; 71(2): 223–231. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cyto.2014.11.001>.

2. Bond M, Davis A, Lohmander S et al. Responsiveness of the OARSI-OMERACT osteoarthritis pain and function measures. Osteoarthritis Cartilage 2012; 20(6): 541–547. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2012.03.001>.

3. Brien S, Prescott P, Bashir N et al. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis. Osteoarthritis Cartilage 2008; 16(11): 1277–1288. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2008.03.002>.

4. Bruyère O, Cooper C, Pelletier JP et al. A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life setting. Semin Arthritis Rheum 2016; 45(4 Suppl): S3-S11. Dostupné z DOI: <http://dx.doi.org/10.1016/j.semarthrit.2015.11.010>.

5. de Vos BC, Landsmeer MLA, van Middelkoop M et al. Long-term effects of a lifestyle intervention and oral glucosamine sulphate in primary care on incident knee OA in overweight women. Rheumatology (Oxford) 2017; 56(8): 1326–1334. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/kex145>.

6. Debbi EM, Agar G, Fichman G et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med 2011; 11: 50. Dostupné z DOI: <http://dx.doi.org/10.1186/1472–6882–11–50>.

7. Devji T, Guyatt GH, Lytvyn L et al. Application of minimal important differences in degenerative knee disease outcomes: a systematic review and case study to inform BMJ Rapid Recommendations. BMJ Open 2017; 7(5): e015587. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2016–015587>.

8. du Souich P. Absorption, distribution and mechanism of action of SYSADOAS. Pharmacol Ther 2014; 142(3): 362–374. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pharmthera.2014.01.002>.

9. Fransen M, Agaliotis M, Nairn L et al. Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Ann Rheum Dis 2015; 74(5): 851–858. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2013–203954>.

10. Gallagher B, Tjoumakaris FP, Harwood MI et al. Chondroprotection and the prevention of osteoarthritis progression of the knee: a systematic review of treatment agents. Am J Sport Med 2015; 43(3): 734–744. Dostupné z DOI: <http://dx.doi.org/10.1177/0363546514533777>.

11. Gommans YM, Runhaar J, Jacobs ML et al. The Effect of Prolonged Glucosamine Usage on HbA1c Levels and New-Onset Diabetes Mellitus in Overweight and Obese Middle-Aged Women. Am J Med 2017; 130(6): 731–737.e6. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2016.11.038>.

12. Hochberg MC. Structure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration. Osteoarthritis Cartilage 2010; 18(Suppl 1): S28-S31. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2010.02.016>.

13. Hochberg MC, Martel-Pelletier J, Monfort J et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis 2016; 75(1): 37–44. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2014–206792>.

14. Karsdal MA, Michaelis M, Ladel C et al. Disease-modifying treatments for osteoarthritis (DMOADs) of the knee and hip: lessons learned from failures and opportunities for the future. Osteoarthritis Cartilage 2016; 24(12): 2013–2021. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2016.07.017>.

15. Kucharz EJ, Kovalenko V, Szanto S et al. A review of glucosamine for knee osteoarthritis: why patented crystalline glucosamine sulfate should be differentiated from other glucosamines to maximize clinical outcomes. Curr Med Res Opin 2016; 32(6): 997–1004. Dostupné z DOI: <http://dx.doi.org/10.1185/03007995.2016.1154521>.

16. Li MH, Xiao R, Li JB et al. Regenerative approaches for cartilage repair in the treatment of osteoarthritis. Osteoarthritis Cartilage 2017; 25(10): 1577–1587. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2017.07.004>.

17. Lubis AMT, Siagian C, Wonggokusuma E et al. Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial. Acta Med Indones 2017; 49(2): 105–111.

18. Magrans-Courtney T, Wilborn C, Rasmussen C et al. Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program. J Int Soc Sport Nutr 2011; 8(1): 8. Dostupné z DOI: <http://dx.doi.org/10.1186/1550–2783–8-8>.

19. McAlindon TE, Bannuru RR, Sullivan MC et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 22(3): 363–388. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2014.01.003>.

20. Michel BA, Stucki G, Frey D et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial. Arthritis Rheum 2005; 52(3): 779–786. Dostupné z DOI: <http://dx.doi.org/10.1002/art.20867>.

21. Nuovo J, Melnikow J, Chang D. Reporting number needed to treat and absolute risk reduction in randomized controlled trials. JAMA 2002; 287(21): 2813–2814.

22. Raynauld JP, Pelletier JP, Abram F et al. Long-Term Effects of Glucosamine and Chondroitin Sulfate on the Progression of Structural Changes in Knee Osteoarthritis: Six-Year Followup Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2016; 68(10): 1560–1566. Dostupné z DOI: <http://dx.doi.org/10.1002/acr.22866>.

23. Reginster JL, Bruyere O, Cooper C. Different glucosamine sulfate products generate different outcomes on osteoarthritis symptoms. Ann Rheum Dis 2017. pii: annrheumdis-2017–212251. <http://dx.doi.org/10.1136/annrheumdis-2017–212251>.

24. Reginster JY, Dudler J, Blicharski T et al. Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT). Ann Rheum Dis 2017; 76(9): 1537–1543. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2016–210860>.

25. Reichenbach S, Sterchi R, Scherer M et al. Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Ann Intern Med 2007; 146(8): 580–590.

26. Sawitzke AD, Shi H, Finco MF et al. 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 2008; 58(10): 3183–3191. Dostupné z DOI: <http://dx.doi.org/10.1002/art.23973>.

27. Sayers A, Wylde V, Lenguerrand E et al. A unified multi-level model approach to assessing patient responsiveness including; return to normal, minimally important differences and minimal clinically important improvement for patient reported outcome measures. BMJ Open 2017; 7(7): e014041. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2016–014041>.

28. Singh JA, Noorbaloochi S, MacDonald R et al. Chondroitin for osteoarthritis. Cochrane Database Syst Rev 2015; 1: CD005614. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD005614.pub2>.

29. Tonge DP, Pearson MJ, Jones SW. The hallmarks of osteoarthritis and the potential to develop personalised disease-modifying pharmacological therapeutics. Osteoarthritis Cartilage 2014; 22(5): 609–621. Dostupné z DOI: <http://dx.doi.org/10.1016/j.joca.2014.03.004>.

30. Wandel S, Juni P, Tendal B et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ 2010; 341: c4675. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.c4675>.