Chondroitin sulfate improves hand arthritis in clinical trial
In an article published online on September 6, 2011 in the journal Arthritis & Rheumatism, Swiss researchers report the results of a trial which uncovered a benefit for supplementation with chondroitin sulfate in men and women aged 40 and older with osteoarthritis of the hand. Chondroitin sulfate is a component of joint cartilage, and sold as a prescription drug in Europe. The compound is available as an over the counter supplement in the United States, and is often coupled with glucosamine.
The Finger osteoArthritis Chondroitin Treatment Study (FACTS) enrolled 162 patients with osteoarthritis of the hand verified by x-ray, visual and functional evaluation. Lead researcher Cem Gabay, MD of University Hospitals of Geneva and his associates divided the participants to receive 800 milligrams chondroitin sulfate or a placebo daily for six months. At the end of the treatment period, subjects who received chondroitin sulfate had less hand pain, improved hand function and less morning stiffness compared to the placebo group. No significant adverse effects were attributed to treatment with chondroitin.
"Although hand osteoarthritis is highly prevalent among adults and can significantly impact the quality of life for sufferers, therapeutic options are still limited," Dr Gabay observed. "There are few trials examining therapeutic approaches specific to hand osteoarthritis and much of the available evidence has been extrapolated from studies investigating other forms of osteoarthritis."
"Our findings show chondroitin sulfate is a safe and effective treatment for patients with hand osteoarthritis," he concluded. "Alternative therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), provide similar pain reducing effects, but with considerably more long-term toxicities."
Unlike rheumatoid arthritis, which is characterized by systemic inflammation, osteoarthritis is a localized disease that occurs only in the affected joints.
With osteoarthritis, the thin layer of cartilage between the joints gradually erodes and wears away. As the protective layer of cartilage vanishes, the bone beneath becomes pitted and uneven, and the structural integrity of the joint is destroyed. Movement can become extremely painful and, in the worst cases, people who have severe osteoarthritis can no longer take care of themselves on a day-to-day basis.
Chondroitin sulfate is a major structural component of articular cartilage. It is a very large molecule, composed of repeated units of glucosamine sulfate. Like glucosamine, chondroitin sulfate stimulates the production of cartilage. Likewise, it has the ability to prevent enzymes from dissolving cartilage. Chondroitin sulfate inhibits free radicals that degrade joint cartilage and collagen. It improves blood circulation to joints, which enables antioxidants and glucosamine to enter inflamed joints to stimulate the repair process required for the regression of osteoarthritis. Although the intestinal absorption of chondroitin sulfate is much lower than that of glucosamine (10 to 15 percent versus 90 to 98 percent), a few studies have shown very good results (reducing pain and increasing range of motion) from long-term treatment with chondroitin sulfate.
A 3-year study investigated the effects of 800 mg of chondroitin sulfate on a group of people with osteoarthritis of finger joints. The results indicated that the chondroitin sulfate was well tolerated, significantly reduced pain, and increased joint mobility. In addition, the joints were protected from further erosive osteoarthritis (Verbruggen G et al 1998).
Improvement in walking time was studied in 80 patients with osteoarthritis of the knee. In this 6-month, double-blind study, the chondroitin sulfate dosage was 400 mg twice daily. The minimum time to perform a 20-meter walk showed a constant reduction of time only in the group who took chondroitin. Lower consumption of pain-killing drugs and excellent tolerability was also observed (Bucsi L et al 1998).
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