Symptom-modifying effect of chondroitin sulfate in knee osteoarthritis: a meta-analysis of randomized placebo-controlled trials performed with structum(®)

Abstract

Objective: To perform a meta-analysis of randomized double-blind placebo-controlled clinical trials to assess the efficacy of a specific chondroitin sulfate preparation (Structum®, Laboratoires Pierre Fabre, Castres; France) as a symptom-modifying drug in osteoarthritis (OA) of the knee.

Methods: A Medline search was conducted up to October 2010 and two articles reporting two trials were identified; one additional trial was identified through contacting the producer of Structum®. There was no evidence of heterogeneity across the trials and results were pooled using a fixed effects model.

Results: Pooled results demonstrated a modest, but significant effect of Structum® (1 g daily) over placebo on the reduction of pain during activity following a treatment period of 3-6 months of 6 mm (95% confidence interval (CI) -9.50, -1.72, p=0.005) on the visual analog scale (VAS) and a reduction in the algo-functional Index (AFI) by a weighted mean difference of -0.73 (95% CI -1.28 to -0.18, p=0.01). In addition, the pooled analysis demonstrated a statistically significant increase in OMERACT-OARSI responders in the Structum®-treated patients by 20% (RR of 1.20 (95% CI 1.06 to 1.36, p=0.003)), compared to placebo.

Conclusion: These results demonstrate that this chondroitin sulfate preparation (Structum®) is effective on symptoms in patients with OA of the knee compared to placebo, and may therefore have a role in the management of patients with knee osteoarthritis of Kellgren-Lawrence grades II and III.

Keywords: Osteoarthritis; chondroitin; knee; pain; structum..

Fig. (1)

Differences in pain intensity during activity measured on visual analogue scale (VAS) between Structum^® interventions and placebo at study end.

Fig. (2)

Differences in Lequesne’s algo-functional index (AFI) between Structum® interventions and placebo at study end measured as change from baseline.

Fig. (3)

Differences in the percentage of OMERACT-OARSI responders between Structum^® interventions and placebo at study end.

Fig. (4)

Differences in pain intensity during activity measured on visual analogue scale (VAS) between Structum^® interventions and placebo at 3 months.