Monday, November 4, 2013

Osteoarthritis Satellite Symposium at the ACR 2013 Meeting in San Diego

Very near to the end of the ACR 2013 Meeting in San Diego I went to a Satellite Symposium with the full title of "Prognosis and Treatment of Knee Osteoarthritis Update 2013". Let's have a closer look at some of the data presented at this event.

V. Byers Kraus presented a cell study that concluded: "Chondroitin sulfate ... suggesting that it may inhibit an inflammasome component, assembly, or action" and "this mechanism may also play a role in Osteoarthritis ...“ Too much suggesting and may!

J. Martel-Pelletier presented: "Effects of Glucosamine and Chondroitin Sulfate on Knee Osteoarthritis Structural Changes over Time: Data from the OAI Cohort". It isn't a blinded trial but retrospective data was used. Out of 1300 patients 600 were selected. The presentation showed charts with an extreme amount of numbers. Comparing joint space width (JSW) in patients not taking analgesics two parameters showed a significant difference, but ... 13 other parameters didn't show a significant difference! If you looked at MRI changes and JSW you also had some effects, but these were different, when examined at 12 and at 24 months! Conclusion: "Data from this study provide support for the structure-modifying effects of Glu/CS combination in knee osteoarthritis subjects. [...]". Please no; these effects are more likely to be due to chance. Besides, how can you tell if people taking glucosamine and chondroitin sulfate aren't more health orientated and do more exercises, change diet, and so on?

C.W. Wu presented a study on oral hyaluronic acid for the treatment of osteoarthritis knee pain. The study was small sized and of 51 patients only 40 completed the study. The WOMAC has been non significant or even identical at month 2 and conveniently made a big leap in the next four months to show a significant difference; now explanation for this inconsistent data. A comparison between hyaluronic acid turnover in placebo and verum group has been made, but only in nine placebo patients and ten verum patients. I'd be more careful with conclusions on this set of data. A test on 12 cytokines and chemokines has been done, placebo had an increase and verum a decrease in ALL parameters, but no values were given. Role of each in osteoarthritis? Significant changes or not?

There were other studies, but only on comorbidities, drug utilization, and a DNA-based test.

I don't think that the studies, which I've outlined above, prove anything that warrant the use of glucosamine and/or chondroitin sulfate in knee osteoarthritis. Or maybe they prove indirectly how in vain the drug companies try to find something to base their advertisements on.

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