First-line analysis of the effects of treatment on progression of structural changes in knee osteoarthritis over 24 months: data from the osteoarthritis initiative progression cohort.

Abstract

OBJECTIVE:

To determine, using data from participants enrolled in the progression cohort of the OAI, the effects of conventional osteoarthritis (OA) pharmacological treatment and those of the combination of glucosamine and chondroitin sulfate (Glu/CS) on knee structural changes.

METHODS:

Six hundred patients with knee OA were stratified based on whether or not they received for 24 consecutive months the OA conventional pharmacological treatment and/or Glu/CS. The main outcomes were knee structural changes, including the loss of joint space width (JSW) and of cartilage volume measured by quantitative MRI.

RESULTS:

Participants reported taking (+) (n=300) or not taking (-) (n=300) OA treatment (analgesic/NSAIDs). The +analgesic/NSAIDs participants had higher Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (p<0.001) and smaller JSW (p=0.01), reflecting more severe disease at baseline. In the -analgesic/NSAIDs group, participants taking Glu/CS had significantly reduced loss of cartilage volume at 24 months in the medial central plateau (p=0.007). Further subdivision revealed that this effect of Glu/CS occurred in participants with a higher severity of the disease (JSW≤median). In the +analgesic/NSAIDs group, those taking Glu/CS had significantly reduced loss of cartilage volume in the global plateau at 12 months (p=0.05), and in the central plateau at 24 months (p=0.05). These effects occurred in participants with less disease severity (JSW>median). By contrast, no significant reduction in JSW was found between all groups.

CONCLUSIONS:

In +analgesic/NSAIDs groups and -analgesic/NSAIDs groups, participants who took Glu/CS had reduced loss of cartilage volume over 24 months in subregions when assessed with qMRI, arguing for a disease-modifying effect of Glu/CS which could not be identified by X-rays.

• Authors: Johanne Martel-Pelletier, Camille Roubille, François Abram, Marc C Hochberg, Marc Dorais, Philippe Delorme, Jean-Pierre Raynauld, Jean-Pierre Pelletier
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 74 Issue 3 Pg. 547-56 (Mar 2015) ISSN: 1468-2060 [Electronic] England
• PMID: 24336337 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• Analgesics
• Anti-Inflammatory Agents, Non-Steroidal
• Chondroitin Sulfates
• Glucosamine

Topics

• Aged
• Analgesics (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Cartilage, Articular (pathology)
• Chondroitin Sulfates (therapeutic use)
• Disease Progression
• Female
• Glucosamine (therapeutic use)
• Humans
• Longitudinal Studies
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Organ Size
• Osteoarthritis, Knee (diagnostic imaging, drug therapy, pathology)
• Pain Measurement
• Radiography
• Treatment Outcome