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Review
. 2021 Jan;33(1):37-47.
doi: 10.1007/s40520-020-01643-8. Epub 2020 Jul 7.

Highly purified chondroitin sulfate: a literature review on clinical efficacy and pharmacoeconomic aspects in osteoarthritis treatment

Jean-Yves Reginster  1   2   3 , Nicola Veronese  4
Affiliations
Review

Highly purified chondroitin sulfate: a literature review on clinical efficacy and pharmacoeconomic aspects in osteoarthritis treatment

Jean-Yves Reginster et al. Aging Clin Exp Res. 2021 Jan.

Abstract

Osteoarthritis (OA) is the most prevalent musculoskeletal disease and a major cause of negative relevant outcomes, associated with an ever-increasing societal burden. Pharmaceutical-grade chondroitin sulfate (CS) was repeatedly reported to reduce pain and improve function in patients with OA. This article aims to review the evidence for the role of highly purified (hp) CS (Condrosulf®, IBSA) in the treatment of OA. We collected and reported evidence concerning (1) efficacy of hpCS 800 mg/day in the treatment of OA affecting the knee, hand and hip; (2) efficacy and safety of hpCS 1200 mg/day also in the oral gel formulation; (3) the safety profile of hpCS; (4) the difference of hpCS and pharmaceutical-grade formulations versus food supplements; (5) pharmacoeconomic added value of hpCS. The data support that hpCS is an effective and safe treatment of OA, with its effect already evident at 30 days; in addition, its beneficial action is prolonged, being maintained for at least 3 months after the drug is discontinued. Full safety reports' analyses confirm that CS is safe to use and has almost no side effects, in particular, it showed better gastrointestinal tolerance if compared with non-steroidal anti-inflammatory drugs (NSAIDs). Moreover, the therapeutic strategy has proved to be cost-effective: treatment with CS reduced the use of NSAIDs and their side effects.

Keywords: Chondroitin sulfate; Economic analysis; Hand osteoarthritis; Hip osteoarthritis; Knee osteoarthritis; Osteoarthritis.

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Conflict of interest statement

Dr. Reginster reports grants and personal fees from IBSA-GENEVRIER, grants and personal fees from MYLAN, grants and personal fees from RADIUS HEALTH, personal fees from PIERRE FABRE, personal fees from FAES PHARMA, personal fees from REJUVENATE BIOMED, personal fees from SAMUMED, personal fees from TEVA, personal fees from THERAMEX, personal fees from PFIZER, personal fees from MITHRA PHARMACEUTICALS, grants and personal fees from CNIEL, personal fees from DAIRY RESEARCH COUNCIL (DRC), personal fees from NUTRICIA, personal fees from DANONE, personal fees from AGNOVOS, grants from TRB, outside the submitted work. Dr. Veronese reports personal fees from IBSA, during the conduct of the study; personal fees from Mylan, personal fees from Fidia, outside the submitted work.

The original forms filled by the authors on conflict of interest/competing interests are available on request.

Figures

Fig. 1
Fig. 1
Updated ESCEO stepwise treatment algorithm for knee osteoarthritis. COX-2, cyclooxygenase-2; CS, chondroitin sulfate; CV, cardiovascular; GI, gastrointestinal; GS, glucosamine sulfate; IA, intra-articular; NSAID, non-steroidal anti-inflammatory drug; PPI, proton pump inhibitor; SYSADOA, symptomatic slow-acting drugs in osteoarthritis; OA, osteoarthritis. Reproduced from Bruyère et al. [10] with permission from BMJ Publishing Group Ltd
Fig. 2
Fig. 2
Formula of CS monomer
Fig. 3
Fig. 3
Reduction of pain in hip measured by a VAS scale; *p < 0.01, **p < 0.001, NS Not Significant; drawn based on data reported in Conrozier and Vignon [33]
Fig. 4
Fig. 4
Reduction of pain in knee measured by a VAS scale. Reproduced from Reginster et al. [42] with permission from Elsevier
See this image and copyright information in PMC

References

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