Liège, Belgium—A supplement readily available on drugstore shelves is as effective for treating the pain of knee osteoarthritis as a prescription anti-inflammatory medication, according to a new study.

The report in the Annals of Rheumatic Diseases suggests that chondroitin sulfate appears to work as well as celecoxib, a widely prescribed nonsteroidal anti-inflammatory drug. The catch: The chondroitin sulfate has to be high quality pharmaceutical grade.

Liège State University–led researchers point out that chondroitin sulfate can be used for long-term treatment, especially in older patients, because of its effectiveness and safety.

To reach that conclusion, researchers conducted a clinical trial in which 604 patients from five European countries with symptomatic knee osteoarthritis were randomly assigned to one of three daily treatments and then monitored for 6 months:
• In the first group, 199 patients were given one 800-mg tablet of chondroitin sulfate and one 200-g tablet of fake celecoxib.
• In the second group, 200 patients were given one dummy chondroitin sulfate tablet and one capsule of celecoxib, marketed as Celebrex.
• In the third group, 205 patients were given two dummy tablets.

The chondroitin tablets contained a highly purified active ingredient, according to the study authors, who caution that active ingredients can vary considerably in OTC supplements.

On Days 30, 91, and 182, pain, joint function, and overall acceptability to the patient were measured using validated scoring systems. Results indicate that pain and joint function improved significantly with all three treatments as early as Day 30, and that the effect persisted through Day 182.

Reductions in pain and improvements in joint function were significantly greater after 6 and 3 months, respectively, in patients treated with either chondroitin sulfate or celecoxib, however.

While joint function appeared to improve more quickly in patients taking celecoxib, no overall differences were detected in the effectiveness of either active treatment, both of which were highly rated by patients.

“This compelling benefit-risk profile, in light of the known clinical risks associated with chronic usage of NSAIDS and paracetamol, underscores the potential importance of pharmaceutical-grade [chondroitin sulfate] in the management of knee [osteoarthritis], especially in the older population requiring long-term treatment,” the study authors conclude.

Because a daily dose of 800 mg of pharmaceutical-grade chondroitin sulfate is better than placebo and performs similarly to celecoxib in reducing pain and improving joint function in symptomatic knee osteoarthritis, the researchers recommended that it be considered first for treatment.

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