Clinical significance of the long-term symptom-modifying effects of glucosamine sulfate: comment on the article by Brandt and Mazzuca

in Arthritis and Rheumatism (2006), 54(7), 2339-2341

Responders to glucosamine sulfate in knee osteoarthritis

in Arthritis and Rheumatism (2004), 50(suppl.1), 29

Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two large, randomised, placebo-controlled, double-blind, 3-year studies

in Osteoporosis International (2003, November), 14(Suppl. 7), 62

Five-year follow-up patients issued from a previous 3-year randomised, controlled trial of glucosamine sulfate in knee osteoarthritis

in Osteoporosis International (2003, November), 14(Suppl 7), 9

Relief in mild-to-moderate pain is not a confounder in joint space narrowing assessment of full extension knee radiographs in recent osteoarthritis structure-modifying drug trials

in Osteoarthritis and Cartilage (2003), 11(10), 730-737

Objective: To assess whether improvement in knee pain biased the determination of the structure-modifying effect reported for glucosamine sulfate in two recent 3-year, randomised, placebo-controlled ... [more ▼]

Objective: To assess whether improvement in knee pain biased the determination of the structure-modifying effect reported for glucosamine sulfate in two recent 3-year, randomised, placebo-controlled clinical trials, in which conventional standing antero-posterior full extension knee radiographs were used for the measurement of joint space narrowing, and in which pain relief might have improved knee full extension. Design: Patients completing the 3-year treatment course were selected based on a WOMAC pain decrease at least equal to the mean improvement in the glucosamine sulfate arms in either of the original studies, irrespective of treatment with glucosamine sulfate or placebo (drug responders or placebo responders). In a second approach, 3-year completers were selected if their baseline standing knee pain (item #5 of the WOMAC pain scale) was 'severe' or 'extreme' and improved by any degree at the end of the trials. In both cases, changes in minimum joint space width were compared between treatment groups. Results: Global knee pain was rnild-to-moderate in the two study populations and in all patient subsets identified. There were obviously more pain improvers in the glucosamine sulfate subsets (N=76 in the two studies combined) than in the placebo subsets (N=57), but WOMAC pain scores improved to the same extent, which was as large as over 50% relative to baseline. Nevertheless, the placebo subsets in both studies underwent an evident mean (SD) joint space narrowing, which in the pooled analysis of both studies was -0.22 (0.80) mm, and was not observed with glucosamine sulfate: +0.15 (0.60) mm (P=0.003 vs placebo). Similar results were found in the smaller subsets with greater than or equal to severe baseline standing knee pain that improved after 3 years, with a joint space narrowing nevertheless of -0.28 (0.76) mm with placebo (N=26), not observed with glucosamine sulfate: +0.21 (0.68) mm (N=31; P=0.014 vs placebo). Conclusions: Knee pain relief did not bias the report of a structure-modifying effect of glucosamine sulfate in two recent long-term trials using conventional standing antero-posterior radiographs, possibly due to the mild-to-moderate patient characteristics. (C) 2003 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved. [less ▲]

Biochemical markers of bone and cartilage remodeling in prediction of longterm progression of knee osteoarthritis

in Journal of Rheumatology (2003), 30(5), 1043-50

OBJECTIVE: To investigate the relationship between biochemical markers of bone and cartilage remodeling and severity or progression (symptoms and structure) of knee osteoarthritis (OA). METHODS: Mean and ... [more ▼]

OBJECTIVE: To investigate the relationship between biochemical markers of bone and cartilage remodeling and severity or progression (symptoms and structure) of knee osteoarthritis (OA). METHODS: Mean and minimal joint space width (JSW) of the femorotibial joint were measured from standardized radiographs taken at baseline and at the end of a 3-year longitudinal study of patients with knee OA. Pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index were assessed at the same time points. Biochemical markers [serum keratan sulfate (KS), serum hyaluronic acid (HA), urine pyridinoline (PYD) and deoxypyridinoline (DPD), serum osteocalcin (OC), cartilage oligomeric matrix protein (COMP)] were assessed at baseline and after 1 year. RESULTS: At baseline, no significant correlations were observed between values of biochemical markers and JSW or any of the WOMAC scores. Baseline markers were not correlated with 3-year percentage changes observed in mean or minimal JSW and WOMAC scores. Changes observed after 1 year in OC and HA were significantly correlated with 3-year progression in mean JSW (r = -0.24, p = 0.04 and r = 0.27, p = 0.02, respectively) and in minimal JSW (r = -0.31, p = 0.01 and r = 0.24, p = 0.04, respectively). In patients from the lowest quartile of 1-year changes in HA (< -21.22 ng/ml), mean JSW decreased after 3 years by 0.76 (1.23) mm compared to an increase of 0.11 (0.83) mm in patients in the highest quartile (> +14.34 ng/ml) (p = 0.03). CONCLUSION: The 3-year radiological progression of knee OA could be predicted by a 1-year increase in OC or a 1-year decrease in HA levels. [less ▲]

Clinical severity of knee osteoarthritis poorly predicts long-term radiographic outcomes

in Osteoporosis International (2002, November), 13(Suppl.3), 51

Glucosamine sulfate slows-down osteoarthritis progression in postmenopausal women: pooled analysis of two large, independent, randomised, placebo-controlled, double-blind, prospective 3-year trials

in Osteoporosis International (2002, November), 13(Suppl.3), 60

Joint space narrowing is poorly correlated with symptoms worsening in knee-osteoarthritis: results from the prospective follow-up of 106, placebo-treated patients for three years

in Annals of the Rheumatic Diseases (2002, June), 61(Suppl.1), 121

Correlation between mean and minimum joint space measurements in a long-term trial with glucosamine sulfate, an osteoarthritis modifying agent

in Annals of the Rheumatic Diseases (2002, June), 61(Suppl.1),