Effect of chondroitin sulphate on synovitis of knee osteoarthritic patients
Med Clin (Barc). 2017 Jul 7;149(1):9-16.
doi: 10.1016/j.medcli.2016.12.045.
Epub 2017 Feb 27.
[Article in
English,
Spanish]
Authors
Laura Tío
1
, Cristobal Orellana
2
, Selene Pérez-García
3
, Laura Piqueras
4
, Paula Escudero
5
, Yasmina Juarranz
3
, Natalia Garcia-Giralt
6
, Francisco Montañés
7
, Aina Farran
6
, Pere Benito
8
, Rosa P Gomariz
3
, María-Jesús Sanz
9
, Jordi Monfort
8
Affiliations
- 1 Instituto de Investigación Médica Hospital del Mar (IMIM), Barcelona, España. Electronic address: ltio@imim.es.
- 2 Unidad de Reumatología, Parc Taulí, Sabadell, Barcelona, España.
- 3 Departamento de Biología Celular, Facultad de Biología, Universidad Complutense de Madrid, Madrid, España.
- 4 Instituto de Investigación Sanitaria INCLIVA, Valencia, España.
- 5 Departamento de Farmacología, Facultad de Medicina, Universidad de Valencia, Valencia, España.
- 6 Instituto de Investigación Médica Hospital del Mar (IMIM), Barcelona, España.
- 7 Unidad de Reumatología, Hospital del Mar, Barcelona, España; Centro de Atención Primaria Vila Olímpica, PAMEM, Barcelona, España.
- 8 Instituto de Investigación Médica Hospital del Mar (IMIM), Barcelona, España; Unidad de Reumatología, Hospital del Mar, Barcelona, España.
- 9 Instituto de Investigación Sanitaria INCLIVA, Valencia, España; Departamento de Farmacología, Facultad de Medicina, Universidad de Valencia, Valencia, España.
Abstract
Objective:
To evaluate by ultrasonography the effect of chondroitin sulfate (CS) on synovitis in patients with knee osteoarthritis (KOA). To collaborate in the understanding of the biochemical mechanisms involved in the synovial inflammation process.
Methods:
Randomized, single-blind, controlled trial involving 70 patients with primary KOA treated for 6 months with CS or acetaminophen (ACT). Evaluation of KOA status at baseline, 6 weeks, 3 and 6 months included: ultrasonography to assess synovitis (following the OMERACT expertise group definition), visual analogue scale and Lequesne index to measure pain and function, and ELISA to quantify inflammatory mediators in serum and synovial fluid.
Results:
Synovitis presence was reduced by 50% in the CS group while a 123% increase was observed in ACT group. Conversely, patients without initial synovitis and treated with ACT reached 85.71% synovitis onset, but only 25% in CS group. Both therapies improved articular function, but only CS resulted in significant pain improvement at the end of the treatment. Changes in RANTES and UCN synovial fluid concentration were associated with CS treatment.
Conclusions:
Treatment with CS had a sustained beneficial effect, preventing synovitis onset or reducing its presence as well as reducing KOA symptoms. ACT ameliorated clinical symptoms but had no effect on inflammation. The CS anti-inflammatory effect could be related to the observed changes in RANTES and UCN concentration.
Keywords:
Artrosis de rodilla; Chondroitin sulfate; Condroitín sulfato; Dolor; Inflammatory mediators; Knee osteoarthritis; Mediadores inflamatorios; Pain; Sinovitis; Synovitis; Tratamiento; Treatment.
Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Publication types
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Comparative Study
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Randomized Controlled Trial
MeSH terms
-
Acetaminophen / therapeutic use
-
Aged
-
Aged, 80 and over
-
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
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Biomarkers / blood
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Biomechanical Phenomena
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Chondroitin Sulfates / therapeutic use*
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Female
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Follow-Up Studies
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Humans
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Male
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Middle Aged
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Osteoarthritis, Knee / complications*
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Pain Measurement
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Pilot Projects
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Single-Blind Method
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Synovitis / blood
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Synovitis / diagnostic imaging
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Synovitis / drug therapy*
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Synovitis / etiology
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Treatment Outcome
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Ultrasonography
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Biomarkers
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Acetaminophen
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Chondroitin Sulfates