A group of Canadian researchers led by Prof. Jean-Pierre Pelletier, Director of the Osteoarthritis Research Unit, University of Montreal, has published a clinical trial, confirming for the first time resonance (MRI) quantitative, the structure-modifying effect of chondroitin sulfate, a symptomatic slow acting drug for osteoarthritis (symptomatic slow acting drug for osteoarthritis-SYSADOA-). This trial, published in the prestigious Annals of the Rheumatic Diseases (impact factor 8111) determined the effect of treatment with chondroitin sulfate (CS) on the volume loss of cartilage, subchondral bone lesions (BML) and synovitis patients with knee osteoarthritis. "The study," says Prof. Pelletier, "has focused on quantifying over time by NMR, the major structural changes observed in cartilage, bone and synovial membrane.
The researcher says that after only six months of treatment with CS, patients have a significant reduction in the loss of articular cartilage volume compared with the placebo group and for the first time, a significant reduction in subchondral bone lesions after 12 months. In the opinion of Prof.
Pelletier, these data highlight not only the importance of the interrelationship between the cartilage and subchondral bone in osteoarthritis, but also its potential role in the disease process and response to treatment with SYSADOA. Prof. Pelletier
concludes that "the CS is a safe drug with an overall positive effect on osteoarthritis, significantly reducing the volume of cartilage loss in osteoarthritis of the knee, and for the first time provides new information on its effect positive in vivo on other structural changes observed in this disease. "
Jean-Pierre Pelletier explains that clinical trial results show that CS is able to slow the progression of osteoarthritis, but that does not mean it is able to cure. "The cure is the regression of all injuries related to osteoarthritis," he says, "and that's not the case. CS slows the progression of the disease. This is an important finding given that a reduction in the progression of cartilage loss in patients with knee osteoarthritis, as seen by NMR, could potentially reduce the need for total knee replacement "phenomenon has been observed in other trials clinical by NMR. "
-Confirmation of previous studies
The trial of Prof. Jean-Pierre Pelletier is consistent with findings of previous studies describing the positive effects of CS on the pathophysiology of osteoarthritis (Kwan S et al 2007, Monfort J et al 2005; Bassleer et al 1998; Ronca, 1998, etc.) and support the ability of CS to alter the natural disease process, as previous clinical trials have shown developed by Kahan (2009), Michel (2005), or Uebelhart (1998 and 2004), and 2 meta-analysis of Hochberg (2008 and 2010).
Similarly, Professor Pelletier says that all these findings refute the conclusions reached by S. Wandel et al. in a meta-analysis published by the British Medical Journal in 2010, which claims that the SYSADOA not offer benefits in the treatment of patients with osteoarthritis.
In this regard, Prof. Pelletier says the methodology used by Wandel et al. is questionable, based on the opinion of various experts in the field of osteoarthritis, as reflected by the various letters to the editor published about it in the online edition of British Medical Journal, some of which have also been published in the print edition magazine. The results of the meta-analysis of Wandel et al. contradict those of other meta-analysis by scientific experts in this field have shown CS is an effective symptomatic treatment for arthritis and can slow its progression. "" In line with my earlier comments, it is noteworthy that after the publication of this meta-analysis, one of the editors of the British Medical Journal made an official statement contained in the website of the magazine, which questioned some of the article's claims and even cited a possible conflict of interest by the statistical editor of the magazine, so the validity and reliability of this meta-analysis has been seriously compromised, "Prof. Pelletier specified. Future objectives
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The expert says the results of this trial Pilot clinical MRI are performed by highly positive and promising. Given the proven efficacy and safety of CS, undoubtedly represents a valuable treatment option for arthritic patients. However, it noted: "It is important that patients take CS highly purified pharmaceutical grade, as used in this study, since it is the only one who can guarantee these results for efficacy and, especially, safety."
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