Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study

Abstract

BackgroundUndenatured type II collagen (UC-II) is a nutritional supplement derived from chicken sternum cartilage. The purpose of this study was to evaluate the efficacy and tolerability of UC-II for knee osteoarthritis (OA) pain and associated symptoms compared to placebo and to glucosamine hydrochloride plus chondroitin sulfate (GC).MethodsOne hundred ninety one volunteers were randomized into three groups receiving a daily dose of UC-II (40 mg), GC (1500 mg G & 1200 mg C), or placebo for a 180-day period. The primary endpoint was the change in total Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) from baseline through day 180 for the UC-II group versus placebo and GC. Secondary endpoints included the Lequesne Functional Index (LFI), the Visual Analog Scale (VAS) for pain and the WOMAC subscales. Modified intent-to-treat analysis were performed for all endpoints using analysis of covariance and mixed model repeated measures, while incremental area under the curve was calculated by the intent-to-treat method.ResultsAt day 180, the UC-II group demonstrated a significant reduction in overall WOMAC score compared to placebo (p = 0.002) and GC (p = 0.04). Supplementation with UC-II also resulted in significant changes for all three WOMAC subscales: pain (p = 0.0003 vs. placebo; p = 0.016 vs. GC); stiffness (p = 0.004 vs. placebo; p = 0.044 vs. GC); physical function (p = 0.007 vs. placebo). Safety outcomes did not differ among the groups.ConclusionUC-II improved knee joint symptoms in knee OA subjects and was well-tolerated. Additional studies that elucidate the mechanism for this supplement’s actions are warranted.Trial registration CTRI/2013/05/003663; CTRI/2013/02/003348.

A systematic review and meta‐analysis of nutrition interventions for chronic noncancer pain

“…After the removal of duplicates, a total of 7080 studies was identified in the search. Following full‐text screening, 71 studies were identified for inclusion, with 23 eligible for meta‐analysis. The abstracts for the majority of the papers were not sufficiently detailed to determine whether the full text should be retrieved.…”

“…Approximately 30% ( n = 21) of the studies were conducted in the USA , with five undertaken in Australia , four conducted in each of Germany , Japan and Spain , and three conducted in each of Denmark , Finland , Sweden , Iran and the Netherlands . Of the included studies, 47 were randomised controlled trials (RCT) , eight were nonrandomised trials , nine were pre–post studies , six were randomised cross‐over trials and one a longitudinal study .…”

“…Assessment of study quality rated 31 studies as of positive quality , 36 as neutral and four studies were classified as being of negative study quality . Of the 33 studies classified as neutral, information regarding the randomisation process ( n = 29) or the intervention description ( n = 13) was lacking.…”

Daily oral consumption of hydrolyzed type 1 collagen is chondroprotective and anti-inflammatory in murine posttraumatic osteoarthritis

“…A series of reports further substantiate this idea, demonstrating that various preparations of orally administered type 2 collagen effectively ameliorate collagen-induced arthritis in mice [51], in obese arthritic dogs [36], and in equine OA [52]. Remarkably, they have also been shown to have therapeutic efficacy in managing symptoms in human OA [53]. Similarly, oral supplementation with a type 1 collagen hydrolysate has been shown to structurally improve the thickness of articular cartilage in OA via gadolinium-enhanced MRI [54], suggesting potential disease-modifying capability of this agent.…”

Nutraceutical Supplements in the Management and Prevention of Osteoarthritis

“…Data in the literature show that the treatment of OA patients with UC-II increases the mobility and the functionality of the joints and reduces pain [49,50,51,52]. In an animal model, UC-II influences the humoral and cellular immune response through the T-regulatory cell secreting cytokines such as IL-10 and transforming growth factor-β which inhibit the immune response to collagen type II present in the extracellular matrix of the articular cartilage [53,54].…”