Objectives The aim of this study was to assess the clinical, radiological and biological efficacy and tolerability of oral glucosamine sulfate associated with a selective COX 2 inhibitor, nimesulide, in patients suffering from Knee osteoarthritis (OA).
Methods There was a 6 month randomised, double blind study which included 35 patients of both sexes, aged between 45 and 72 years, with symptomatic knee OA, with Kellgren and Lawerence radiological scores I-II. Patients were treated only with oral glucosamine sulfate and 100 mg nimesulide daily or with a placebo (PBO) associated with 100 mg nimesulide per day. The main outcome criteria were the degree of spontaneous joint pain and the overall mobility capacity; secondary outcome criteria included the joint space measurement and the levels of biochemical markers of bone and joint metabolism (osteocalcin, deoxypyridoline, nitric oxyde, matrix-metalloproteinases).
Results The results of this study confirm that the association glucosamine sulfate- nimesulide was well tolerated and both reduces significantly pain and increase overall joint mobility; a stabilisation of the femoro-tibial joint narrowing (measured with a digitised image analyzer) was noted in these patients, whereas joint narrowing space increased in placebo-treated patients. in addition, the metabolism of bone and joint assessed by different biochemical parameters also stabilised in patients receiving glucosamine sulfate and nimesulide combination, while remained unchanged in the PBO patients.
Conclusion The association glucosamine sulfate – nimesulide is effective and safe; glucosamine sulfate is an effective symptomatic and structure modifying slow acting drug for the treatment of knee OA, that may be able to stabilise the joint space width and to modulate bone and joint metabolism.
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