Written by Jessica Patella, ND. Both the chondroitin sulfate group and the celecoxib group of participating subjects experienced significant improvement in pain and functioning scores following six months of supplementation compared to placebo, demonstrating that chondroitin sulfate is safe and effective as a treatment option.
Osteoarthritis is the most common type of arthritis and it is primarily due to “wear and tear” 1. It is also the most prevalent musculoskeletal cause of pain, decreased functioning and disability 2. Over 30 million US adults are affected by osteoarthritis, making it a major public health concern 1,2. The knees and hips are the most commonly affected areas. A recent study found chondroitin sulfate as effective as prescription pain medicine in the treatment of osteoarthritis 2.
Chondroitin is naturally occurring in cartilage tissue in the body 3. Chondroitin sulfate is typically derived from cow cartilage and is used as a supplement to improve arthritis symptoms 3. Celecoxib is a common pharmaceutical non-steroidal anti-inflammatory medication for arthritis, but it has a black box warning for causing serious cardiovascular and gastrointestinal side effects 4. For this reason, many people search for more natural options, without the serious side effects.
The recent research included 604 participants, with an average age of 65.5 years. The participants were randomly assigned to one of three groups:
- Chondroitin group: 1 tablet (800mg) Chondroitin sulfate and 1 placebo (n=199)
- Celecoxib group: 1 tablet celecoxib (Celebrex Pfizer, 200 mg) and 1 placebo (n=199)
- Placebo group: 2 tablets placebo (n=205)
All tablets were taken once daily, every evening with a glass of water, for 6 months. The participants were allowed to take rescue pain medication when needed (paracetamol 500 mg tablets- max dose 3 grams/day). No other pharmacological or non-pharmacological interventions for osteoarthritis were allowed during the study 2.
The following results were observed:
- Pain scores improved significantly in all three groups compared with baseline at day 30, 91 and 182 (all p<0.001).
- Both the chondroitin sulfate and celecoxib group showed a statistically greater reduction in pain compared with the placebo group (p=0.001 for chondroitin and p=0.009 for celecoxib) after 6 months, without any significant difference between the two groups.
- At day 91 and 182, both the chondroitin sulfate and celecoxib group showed a significant improvement in the Lequesne Index (a score of pain & functioning) compared to placebo (p=0.05 for chondroitin and p=0.027 for celecoxib at day 91; p=0.023 for chondroitin and p=0.015 for celecoxib at day 182), without any significant difference between the two groups.
- At the end of the study significantly more patients and investigators scored the global assessment as excellent or good in the chondroitin and celecoxib groups compared with placebo (p=0.027 for chondroitin and p=0.013 for celecoxib), while there was no significant difference between the two groups.
In conclusion, 800 mg of chondroitin sulfate is superior to placebo and has similar effects to the pharmaceutical drug celecoxib in reducing pain and improving functioning in osteoarthritis over 6 months 2. This was the first study of its kind and it is important to note that chondroitin, while as effective as the drug celecoxib, it had a safety profile similar to the placebo. The researchers state chondroitin sulfate should be considered a safe and effective first-line treatment in knee osteoarthritis 2.
Source: Reginster, Jean-Yves, Jean Dudler, Tomasz Blicharski, and Karel Pavelka. “Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT).” Annals of the Rheumatic Diseases (2017): annrheumdis-2016.
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Posted August 3, 2017.
Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health. She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at www.awarenesswellness.com.
References:
- (CDC) CfDCaP. Osteoarthritis Fact Sheet. 2017; Overview of osteoarthritis. Available at: https://www.cdc.gov/arthritis/basics/osteoarthritis.htm. Accessed July 1, 2017, 2017.
- Reginster J-Y, Dudler J, Blicharski T, Pavelka K. Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT). Annals of the Rheumatic Diseases. 2017:annrheumdis-2016-210860.
- Foundation A. Chondroitin Sulfate. 2017; Overview of chondroitin sulfate for osteoarthritis. Available at: http://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/chondroitin-sulfate.php. Accessed July 1, 2017, 2017.
- RxList. Celebrex. 2017; Overview of Celebrex. Available at: http://www.rxlist.com/celebrex-drug.htm. Accessed July 1, 2017, 2017.
