Methods and Findings in Experimental and Clinical Pharmacology
Vol. 24, Suppl. A, 2002, pp. 35
ISSN 0379-0355
Copyright 2002 Prous Science, S.A.
CCC: 0379-0355/2002
http://www.prous.com

Benefits of the Use of Chondroitin Sulfate for the Treatment of Osteoarthritis: Clinical Review

J. Vergés

Clinical Pharmacologist, Scientific Medical Director, Bioibérica Laboratorios, Barcelona, Spain

Chondroitin sulfate (CS) is a sulfated glycosaminoglycan present predominantly in the extracellular matrix surrounding cells and is most abundant in the connective tissues of the body such as cartilage. It has a great affinity towards cartilage and synovial fluid following oral administration in humans. CS belongs to the group of symptomatic slow-acting drugs for osteoarthritis (SYSADOAs). Despite having a slow onset of action, CS gradually increases its clinical efficacy reaching a global efficacy similar to that of nonsteroidal antiinflammatory drugs (NSAIDs) such as diclofenac (150 mg/day). The reduction of symptoms lasts longer, even for a few months after suppressing the treatment. The therapeutic activity of CS in osteoarthritic patients could be due to at least four action mechanisms:

­ Antiinflammatory activity at the cellular components of inflammation level
­ Metabolic effects on the synthesis of proteoglycans and hyaluronic acid favoring its synthesis
­ Decrease of the catabolic activity of chondrocytes inhibiting some proteolytic activities (collagenase, elastase, proteoglycanase, etc.)
­ Inhibition of nitric oxide in the joint

Several randomized, double-blind, placebo-con- trolled clinical trials in more than 1300 osteoarthritic patients, and three meta-analyses have confirmed its clinical efficacy in reducing pain and increasing articular mobility. The clinical effect of CS is 40-50% higher than the effect of placebo. CS has also evidenced a similar level of efficacy when compared with sodium diclofenac, although CS offers the additional advantage of high safety. Recent clinical trials have also evidenced possible disease-modifying properties for CS. To conclude, it can be stated that CS is a valuable tool for the treatment of osteoarthritis.

Methods and Findings in Experimental and Clinical Pharmacology Vol. 24, Suppl. A, 2002, pp. 35
ISSN 0379-0355 Copyright 2002 Prous Science, S.A. CCC: 0379-0355/2002 http://www.prous.com