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Chondroitin Sulfate Decreases Synovitis Quicker Than Acetaminophen in Patients With OA of the Knee: Presented at OARSI

By Louise Gagnon

MONTREAL -- September 20, 2009 -- Chondroitin sulfate (CS) alone or in combination with glucosamine sulfate resulted in quicker decreases in synovitis, compared with treatment with acetaminophen, in patients with osteoarthritis (OA) of the knee, according to a study presented here at the 2009 World Congress of the Osteoarthritis Research Society International (OARSI).

The retrospective study, presented in an oral presentation on September 12, compared the impact of 3 treatments, each administered daily, on patients with OA of the knee. A total of 115 patients received CS, CS combined with glucosamine sulfate, or acetaminophen (ACET).

Researchers used ultrasound to measure synovitis in the suprapatellar recess, with measures of 4 mm or more signifying the presence of synovitis. Knee pain was evaluated using a visual analogue scale, additional acetaminophen usage, and the presence of meniscal extrusion and Baker's cyst.

"There is an added value of detecting synovitis by ultrasound," said lead investigator Ingrid Möller, MD, Instituto Poal de Reumatologia, Barcelona, Spain, on September 13. "It can detect subclinical components of synovitis."

Researchers observed an improvement in synovitis in the course of treatment with a mean synovitis of 3.2 mm in the CS arm and 2.9 mm in the combination-treatment arm.

"The patients who were treated with acetaminophen who had bigger recesses of 6 mm or more did not reach this physiological barrier," explained Dr. Möller. "Those who were treated with chondroitin sulfate or chondroitin sulfate in combination with glucosamine sulfate reached this physiological barrier and maintained it over 6 months."

Synovitis scores and pain relief scores followed a similar pattern over 6 months. Specifically, a positive correlation between synovitis and knee pain was observed. Of note, there was a faster decline in knee pain with CS versus ACET (P = .000) and in the combination group versus ACET (P = .000).

The presence of a Baker's cyst or meniscal extrusion did not affect the synovitis scores or treatment response, noted Dr. Möller.

"There are limitations because it is a retrospective study," said Dr. Möller. Nevertheless, the study suggests that it is relevant for clinicians to monitor synovitis in the follow-up of patients with knee OA. "A decrease in synovitis correlates with a decrease in knee pain."

Funding for this study was provided by Bioiberica.

[Presentation title: Efficacy of Chondroitin Sulphate on Synovitis in Patients With Knee Osteoarthritis: An Ultrasound Study. Abstract 044]

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