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Ann Rheum Dis. 2016 Jan;75(1):37-44. doi: 10.1136/annrheumdis-2014-206792. Epub 2015 Jan 14.

Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.

Author information

1
University of Maryland School of Medicine, Baltimore, Maryland, USA.
2
Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
3
Servei de Reumatologia, Hospital del Mar, Barcelona, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
4
Instituto Poal de Reumatología, Barcelona, Spain.
5
Clinical Pharmacology Unit, Virgen del Rocío University Hospital, Seville, Spain.
6
Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Arthritis Research UK, Centre for Sports, Exercise and Osteoarthritis, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
7
Department of Rheumatology, Sorbonne University, INSERM UMR S938, UPMC, University of Paris 06, DHU i2B, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France.
8
INIBIC-Complejo Hospitalario Universitario A Coruña, A Coruña, Spain.
9
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
10
Asociación Hipótesis Alternativa (H1), Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
11
Bone and Cartilage Research Unit, Arthropôle Liège, University of Liège, Institute of Pathology, CHU Sart-Tilman, Liège, Belgium Physical Therapy and Rehabilitation Department, Princess Paola Hospital, Marche-en-Famenne, Belgium.
12
Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany.
13
Université Paris Diderot, UFR Médicale; Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, Paris, France INSERM 1132, Université Paris-Diderot, Hôpital Lariboisière, Paris, France.
14
University of Utah School of Medicine, Salt Lake City, Utah, USA.
15
Department of Pharmacology, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.

Abstract

OBJECTIVES:

To compare the efficacy and safety of chondroitin sulfate plus glucosamine hydrochloride (CS+GH) versus celecoxib in patients with knee osteoarthritis and severe pain.

METHODS:

Double-blind Multicentre Osteoarthritis interVEntion trial with SYSADOA (MOVES) conducted in France, Germany, Poland and Spain evaluating treatment with CS+GH versus celecoxib in 606 patients with Kellgren and Lawrence grades 2-3 knee osteoarthritis and moderate-to-severe pain (Western Ontario and McMaster osteoarthritis index (WOMAC) score ≥301; 0-500 scale). Patients were randomised to receive 400 mg CS plus 500 mg GH three times a day or 200 mg celecoxib every day for 6 months. The primary outcome was the mean decrease in WOMAC pain from baseline to 6 months. Secondary outcomes included WOMAC function and stiffness, visual analogue scale for pain, presence of joint swelling/effusion, rescue medication consumption, Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) criteria and EuroQoL-5D.

RESULTS:

The adjusted mean change (95% CI) in WOMAC pain was -185.7 (-200.3 to -171.1) (50.1% decrease) with CS+GH and -186.8 (-201.7 to -171.9) (50.2% decrease) with celecoxib, meeting the non-inferiority margin of -40: -1.11 (-22.0 to 19.8; p=0.92). All sensitivity analyses were consistent with that result. At 6 months, 79.7% of patients in the combination group and 79.2% in the celecoxib group fulfilled OMERACT-OARSI criteria. Both groups elicited a reduction >50% in the presence of joint swelling; a similar reduction was seen for effusion. No differences were observed for the other secondary outcomes. Adverse events were low and similarly distributed between groups.

CONCLUSIONS:

CS+GH has comparable efficacy to celecoxib in reducing pain, stiffness, functional limitation and joint swelling/effusion after 6 months in patients with painful knee osteoarthritis, with a good safety profile.

TRIAL REGISTRATION NUMBER:

NCT01425853.

KEYWORDS:

Analgesics; NSAIDs; Osteoarthritis

PMID:
25589511
PMCID:
PMC4717399
DOI:
10.1136/annrheumdis-2014-206792
[Indexed for MEDLINE]
Free PMC Article

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