Meta-analysis: Chondroitin for Osteoarthritis of the Knee or Hip

Reichenbach, Stephan; Sterchi, Rebekka; Scherer, Martin; Trelle, Sven; Bürgi, Emil; Bürgi, U; Dieppe, Paul; Jüni, Peter

doi:10.7326/0003-4819-146-8-200704170-00009

Cited by 292 publications

(228 citation statements)

References 36 publications

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“…One example is that of conditionally recommending against the use of glucosamine and chondroitin sulfate for patients with knee OA. The TEP relied initially on the results of the Glucosamine/Chondroitin Arthritis Intervention Trial (40) and meta-analyses that demonstrated significant heterogeneity in effect size (41)(42)(43) coupled with the lack of availability of prescription-quality preparations evaluated and approved for the indication of OA by the FDA. This original decision was reaffirmed after reviewing the results of a more recent network meta-analysis that also failed to demonstrate clinically important efficacy for these agents (44).…”

Section: Discussionmentioning

confidence: 99%

American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee

Hochberg

Altman

April

et al. 2012

Arthritis Care & Research

2,513

1,840

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Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) Results. Both "strong" and "conditional" recommendations were made for OA management. Modalities conditionally recommended for the management of hand OA include instruction in joint protection techniques, provision of assistive devices, use of thermal modalities and trapeziometacarpal joint splints, and use of oral and topical nonsteroidal antiinflammatory drugs (NSAIDs), tramadol, and topical capsaicin. Nonpharmacologic modalities strongly recommended for the management of knee OA were aerobic, aquatic, and/or resistance exercises as well as weight loss for overweight patients. Nonpharmacologic modalities conditionally recommended for knee OA included medial wedge insoles for valgus knee OA, subtalar strapped lateral insoles for varus knee OA, medially directed patellar taping, manual therapy, walking aids, thermal agents, tai chi, selfmanagement programs, and psychosocial interventions. Pharmacologic modalities conditionally recommended for the initial management of patients with knee OA included acetaminophen, oral and topical NSAIDs, tramadol, and intraarticular corticosteroid injections; intraarticular hyaluronate injections, duloxetine, and opioids were conditionally recommended in patients who had an inadequate response to initial therapy. Opioid analgesics were strongly recommended in patients who were either not willing to undergo or had contraindications for total joint arthroplasty after having failed medical therapy. Recommendations for hip OA were similar to those for the management of knee OA. Conclusion. These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines, informed by available evidence, balancing the benefits and harms of both nonpharmacologic and pharmacologic modalities, and incorporating their preferences and values. It is hoped that these recommendations will be utilized by health care providers involved in the management of patients with OA.

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Section: Discussionmentioning

confidence: 99%

American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee

Hochberg

Altman

April

et al. 2012

Arthritis Care & Research

2,513

1,840

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“…Chondroitin sulfate is a glycosaminoglycan involved in the formation of cartilage and other joint matrix structures. Evidence supporting the clinical benefits of chondroitin sulfate for the improvement of osteoarthritis symptoms is inconsistent (Reichenbach et al, 2007). In a recent meta-analysis of 10 large-scale placebo-controlled trials of chondroitin, glucosamine, or their combination (n = 3,803), Wandel and colleagues found that none of these therapies were associated with significant improvements in pain, as measured on a 10-cm visual analog scale, nor were they associated with any significant reduction in joint-space narrowing compared with placebo (Wandel et al, 2010).…”

Section: Dietary Supplementsmentioning

confidence: 99%

Long-Term Treatment of Osteoarthritis Pain: Achieving a Balance Between Efficacy and Tolerability for a Successful Chronic Therapy

Etropolski¹

2012

Osteoarthritis - Diagnosis, Treatment and Surgery

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“…Various meta-analyses [Reichenbach et al 2007;Richy et al 2003;Leeb et al 2000 However, the largest trial, the GAIT study, reported no effect on these endpoints.…”

Section: Symptomatic Slow-acting Drug For Oa Effectsmentioning

confidence: 99%

Chondroitin sulfate in the treatment of osteoarthritis: from in vitro studies to clinical recommendations

Henrotin

Mathy

Sanchez

et al. 2010

Therapeutic Advances in Musculoskeletal

144

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Chondroitin sulfate (CS) is recommended as a therapeutic intervention in the multimodal approach of osteoarthritis (OA) management. CS has been studied extensively to describe its pharmacology (pharmacokinetic, in vitro and in vivo effects) and its clinical efficacy. Various results have been reported depending on the system of evaluation (model, dosage and duration) and the source of CS (origin and quality). The purpose of this review was to gather most of the available information about CS and to discuss its potency in OA management.

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Meta-analysis: Chondroitin for Osteoarthritis of the Knee or Hip

Abstract: Large-scale, methodologically sound trials indicate that the symptomatic benefit of chondroitin is minimal or nonexistent. Use of chondroitin in routine clinical practice should therefore be discouraged.

Cited by 292 publications

References 36 publications

American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee

American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee

Long-Term Treatment of Osteoarthritis Pain: Achieving a Balance Between Efficacy and Tolerability for a Successful Chronic Therapy

Chondroitin sulfate in the treatment of osteoarthritis: from in vitro studies to clinical recommendations

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