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Chondroitin Is as Effective as Celecoxib for Knee Arthritis

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The search continues for even partial solutions to symptomatic knee osteoarthritis. Near the top of the dietary supplement list for this is glucosamine hydrochloride (or sulfate), which is usually paired with chondroitin sulfate. Rarely is chondroitin mentioned in its own sentence. That is, until this clinical trial.

In this double-blind trial, 604 people with knee osteoarthritis were randomized to 800 mg of chondroitin sulfate (and a placebo celecoxib capsule; n = 199), 200 mg of celecoxib (and a placebo chondroitin capsule; n = 199), or two placebo capsules (n = 205) for six months. The patients were selected from several European countries, and needed to be older than 50 years of age and with medial or lateral femorotibial compartment arthritis as per the American College of Rheumatology clinical and radiologic criteria. The “target” knee was the side with a greater score on a 0 to 100 visual analog scale (VAS) for pain. Exclusion criteria were referenced from a prior trial (but not detailed in the current study), or having grade 4 knee osteoarthritis, having intra-articular injections in the last six months, taking any dietary supplements for knee pain in the last three months, taking nonsteroidal anti-inflammatory drugs (NSAIDs) in the last five days, or taking paracetamol in the 10 hours before study enrollment. The primary endpoints were patient VAS pain rating and the Lequesne Index (LI), a pain and function score from 0 to 24. Also, several secondary endpoints were recorded, as were adverse events and abnormal laboratory values. Paracetamol 500 mg tablets were allowed up to a maximum of 3 grams daily for breakthrough pain control.

The authors made a point to draw a stark contrast between pharmaceutical-grade chondroitin, and what is available as a nutraceutical, the latter being less reliable with respect to label claims and product content. They...