Glucosamine hydrochloride combined with celecoxib for the treatment of knee osteoarthritis: Randomized controlled trials

doi:10.3969/j.issn.2095-4344.2013.43.024

Abstract

Abstract:

BACKGROUND: Glucosamine hydrochloride is considered to have the role in the treatment of knee osteoarthritis. Whether it is effective for varying degrees of osteoarthritis and whether there are efficacy differences between the combinations nonsteroidal anti-inflammatory drugs and simple glucosamine hydrochloride need further clinical research.
OBJECTIVE: To compare the clinical effects between glucosamine hydrochloride capsules and combined with celecoxib for the treatment of knee osteoarthritis through prospective study.
METHODS: According to Lequesne score, 152 patients with knee osteoarthritis were divided into mild, moderate and severe groups, then each group was divided into groups treated just by glucosamine hydrochloride and groups treated by glucosamine hydrochloride combined with celecoxib randomly. The Lequesne score was recorded at 2, 4 and 6 weeks after drug administration and 8 and 12 weeks after drug withdrawal, and then the adverse reactions of glucosamine hydrochloride were compared between groups and before and after treatment.
RESULTS AND CONCLUSION: In the mild group, there was significant difference in Lequesne score of glucosamine hydrochloride group at 4 weeks after treatment and 12 weeks after drug withdrawal when compared with that before treatment; the Lequesne score was improved in the combined group at 2 weeks after treatment, and there was significant difference between two groups at 2 and 4 weeks after treatment, it showed that the combined group improved the score, which was more significant than the glucosamine hydrochloride group. In the moderate group, the Lequesne score in the glucosamine hydrochloride group was lower than that in the combined group at 2, 4 and 6 weeks after treatment and 8 weeks after drug withdrawal (P < 0.05). It showed that the effect of glucosamine hydrochloride combined with celecoxib for the treatment of medium knee osteoarthritis was better than that of glucosamine hydrochloride. In the serious group, there was no significant difference in Lequesne score between two groups before and after treatment. The results indicate that the clinical symptoms of mild knee osteoarthritis patients can be significantly improved by a single use of glucosamine hydrochloride. To moderate osteoarthritis, combination therapy with nonsteroidal anti-inflammatory drugs is recommended to improve clinical symptoms, and both of the two methods are invalid on severe knee osteoarthritis patients.

Key words: arthroplasty, replacement, hip, osteoarthritis, glucose, anti-inflammatory agents, non-steroidal

CLC Number:

R318

Li Ming-hui, Liu Yang, Wang Cai-min, You Hao, Huang Liang, Sun Kai. Glucosamine hydrochloride combined with celecoxib for the treatment of knee osteoarthritis: Randomized controlled trials[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.43.024.

Figures/Tables 4

References

[1]        Lequesne M. Indices of severity and disease activity for osteoarthritis. Semin Arthritis Rheum. 1991;20(6 Suppl 2): 48-54.
[2]        Petersson IF, Boegard T, Saxne T, et al. Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis. 1997;56(8):493-496.
[3]        Li X, Ellman M, Muddasani P, et al. Prostaglandin E2 and its cognate EP receptors control human adult articular cartilage homeostasis and are linked to the pathophysiology of osteoarthritis. Arthritis Rheum. 2009;60(2):513-523.
[4]        Zhao SZ, Wentworth C, Burke TA, et al. Drug switching patterns among patients with rheumatoid arthritis and osteoarthritis using COX-2 specific inhibitors and non-specific NSAIDs. Pharmacoepidemiol Drug Saf. 2004; 13(5):277-287.
[5]        Verkleij SP, Luijsterburg PA, Bohnen AM, et al. NSAIDs vs acetaminophen in knee and hip osteoarthritis: a systematic review regarding heterogeneity influencing the outcomes. Osteoarthritis Cartilage. 2011;19(8):921-929.
[6]        Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010;69(8):1459- 1464.
[7]        Durmus D, Alayli G, Bayrak IK, et al. Assessment of the effect of glucosamine sulfate and exercise on knee cartilage using magnetic resonance imaging in patients with knee osteoarthritis: a randomized controlled clinical trial.J Back Musculoskelet Rehabil. 2012;25(4):275-284.
[8]        Nakasone Y, Watabe K, Watanabe K, et al.Effect of a glucosamine-based combination supplement containing chondroitin sulfate and antioxidant micronutrients in subjects with symptomatic knee osteoarthritis: A pilot study.Exp Ther Med. 2011;2(5):893-899.
[9]        Reginster JY, Neuprez A, Lecart MP, et al.Role of glucosamine in the treatment for osteoarthritis. Rheumatol Int. 2012;32(10):2959-2967.
[10]     Kanzaki N, Saito K, Maeda A, et al.Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study.J Sci Food Agric. 2012;92(4):862- 869.
[11]     Kanzaki N, Saito K, Maeda A,et al.Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study. J Sci Food Agric. 2012;92(4):862- 869.
[12]     陈德生,张志刚,曹靖.盐酸氨基葡萄糖对兔膝骨性关节炎的影响[J].中国修复重建外科杂志,2010,24(3):287-291.
[13]     Taniguchi S, Ryu J, Seki M, et al. Long-term oral administration of glucosemine or chondroitin sulfate reduces destruction of cartilage and up-regulation of MMP-3 mRNA in a model of spontaneous osteoarthritis in Hartley guinea pigs. J Orthop Res. 2012;30(5):673-678.
[14]     Altman RD. Glucosamine therapy for knee osteoarthritis: pharmacokinetic considerations.Expert Rev Clin Pharmacol. 2009;2(4):359-371.
[15]     Wang SX, Laverty S, Dumitriu M, et al. The effects of glucosamine hydrochloride on subchondral bone changes in an animal model of osteoarthritis. Arthritis Rheum. 2007;56(5): 1537-1548.
[16]     王大利,耿成燕,姜丽平,等.关节软骨及骨破坏模型大鼠经盐酸氨基葡萄糖干预的最佳剂量[J].中国组织工程研究与临床康复, 2011, 15(28):5145-5148.
[17]     Lee YH, Woo JH, Choi SJ, et al. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Rheumatol Int. 2010;30(3):357-363.
[18]     Vangsness CT Jr, Spiker W, Erickson J. A review of evidence-based medicine for glucoSam-ine and chondroitin sulfate use in knee osteoarthritis. Arthroscopy. 2009;25(1): 86-94.
[19]     aniguchi S, Ryu J, Seki M, et al.Long-term oral administration of glucosamine or chondroitin sulfate reduces destruction of cartilage and up-regulation of MMP-3 mRNA in a model of spontaneous osteoarthritis in Hartley guinea pigs. J Orthop Res. 2012;30(5):673-678.
[20]     Matsuno H, Nakamura H, Katayama K, et al.Effects of an oral administration of glucosamine-chondroitin-quercetin glucoside on the synovial fluid properties in patients with osteoarthritis and rheumatoid arthritis. Biosci Biotechnol Biochem. 2009;73(2):288-292.
[21]     Meulyzer M, Vachon P, Beaudry F, et al.Comparison of pharmacokinetics of glucosamine and synovial fluid levels following administration of glucosamine sulphate or glucosamine hydrochloride. Osteoarthritis Cartilage. 2008; 16(9):973-979.
[22]     皮俊杰,吕志伟,闫志荣,等.前交叉韧带切断诱导兔膝骨性关节炎模型：阿仑膦酸钠与盐酸氨基葡萄糖对其关节软骨和软骨下骨的保护作用[J].中国组织工程研究与临床康复,2010,15(28): 4702-4709.
[23]     邱贵兴,翁习生,张克等.盐酸/硫酸氨基葡萄糖治疗骨关节炎的平行对照临床研究[J].中华医学杂志,2005,85(43):3067-3070.
[24]     张伟滨,庄澄宇,李建民,等.盐酸氨基葡萄糖治疗骨性关节炎有效性与安全性评价[J].中华外科杂志,2007,45(14):998-1001.
[25]     Selvan T, Rajiah K, Nainar MS, et al.A clinical study on glucosamine sulfate versus combination of glucosamine sulfate and NSAIDs in mild to moderate knee osteoarthritis. ScientificWorldJournal. 2012,5(11):121-127.
[26]     Petersen SG, Beyer N, Hansen M, et al.Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Arch Phys Med Rehabil. 2011;92(8):1185-1193.
[27]     Zupanets IA, Tuliakov VA, Shebeko SK. Effect of glucosamine hydrochloride in combination with paracetamol on chondrocyte apoptosis under conditions of systemic steroidal arthritis development in rats. Eksp Klin Farmakol. 2012; 75(4):34-37.
[28]     Yue J, Yang M, Yi S,et al.Chondroitin sulfate and/or glucosamine hydrochloride for Kashin-Beck disease: a cluster-randomized, placebo-controlled study. Osteoarthritis Cartilage. 2012;20(7):622-629.
[29]     李春洁,贾源源,张绮,等.盐酸氨基葡萄糖片联合玻璃酸颞下颌关节骨关节炎的临床钠治疗随机对照试验[J].华西口腔医学杂志, 2011,9(6):632-639.
[30]     Rozendaal RM, Koes BW, van Osch GJ, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med. 2008;148(4):268-277.
[31]     Rozendaal RM, Uitterlinden EJ, van Osch GJ, et al. Effect of glucosamine sulphate on joint space narrowing, pain and function in patients with hip osteoarthritis; subgroup analyses of a randomized controlled trial. Osteoarthritis Cartilage. 2009;17(4):427-432.
[32]     Bruyere O, Pavelka K, Rovati LC, et al.Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomized, placebo-controlled trials. Osteoarthritis Cartilage.2008;16(2):254-260.
[33]     Wilkens P, Scheel IB, Grundnes O, et al.Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial.JAMA. 2010;304(1):45-52.
[34]     石锐,刘浩,胡韬,等.盐酸氨基葡萄糖联合非类固醇类抗炎药治疗小关节退变伴下腰痛[J].中国组织工程研究与临床康复,2011, 15(26):4895-4898.
[35]     石锐,胡韬,丁琛,等.盐酸氨基葡萄糖联合低剂量NSAIDS类药物与单纯用药治疗小关节骨关节炎伴下腰痛的随机对照研究[J].中国骨与关节外科,2012,5(1):36-42.
[36]     Burdett N, McNeil JD. Difficulties with assessing the benefit of glucosamine sulphate as a treatment for osteoarthritis. Int J Evid Based Healthc. 2012;10(3):222-226.
[37]     Felson DT. Glucosamine sulfate might have no effect on pain or structural changes associated with osteoarthritis.Nat Clin Pract Rheumatol. 2008;4(10):518-519.
[38]     Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010;69(8):1459- 1464.
[39]     Burdett N, McNeil JD. Difficulties with assessing the benefit of glucosamine sulphate as a treatment for osteoarthritis. Int J Evid Based Healthc. 2012;10(3):222-226.
[40]     Henrotin Y, Mobasheri A, Marty M. Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis?Arthritis Res Ther. 2012;14(1):201.
[41]     Chisholm T. Glucosamine for osteoarthritis. Select carefully for best results. Adv NPs PAs. 2011;2(4):25-26.
[42]     Muniyappa R.Glucosamine and osteoarthritis: time to quit? Diabetes Metab Res Rev. 2011;27(3):233-234.
[43]     McKenzie BA.What is the evidence? There is only very weak clinical trial evidence to support the use of glucosamine and chondroitin supplements for osteoarthritis in dogs. J Am Vet Med Assoc. 2010;237(12):1382-1133.
[44]     Bruyère O. Large review finds no clinically important effect of glucosamine or chondroitin on pain in people with osteoarthritis of the knee or hip but results are questionable and likely due to heterogeneity. Evid Based Med. 2011;16(2): 52-53.
[45]     Scholtissen S, Bruyère O, Neuprez A, et al. Glucosamine sulphate in the treatment of knee osteoarthritis: cost-effectiveness comparison with paracetamol. Int J Clin Pract. 2010;64(6):756-762.
[46]     Hart L. Are glucosamine and/or chondroitin sulfate effective for knee osteoarthritis?Clin J Sport Med. 2006;16(6):528-529.
[47]     冮相保,高李侠.盐酸氨基葡萄糖治疗膝退行性骨性关节炎的临床观察[J].中国修复重建外科杂志,2008,22(1):29-31.