Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI
- Lukas Martin Wildi1,
- Jean-Pierre Raynauld1,
- Johanne Martel-Pelletier1,
- André Beaulieu2,
- Louis Bessette3,
- Frédéric Morin4,
- François Abram5,
- Marc Dorais6,
- Jean-Pierre Pelletier1
- 1Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Notre-Dame Hospital, Montreal, Canada
- 2Faculty of Medicine, University of Laval, Québec, Canada
- 3Groupe de Recherche en Rhumatologie et Maladies Osseuses (GRMO), Sainte-Foy, Canada
- 4Centre de Recherche Musculo-squelettique, Trois-Rivières, Canada
- 5ArthroVision Inc., Montreal, Canada
- 6StatSciences Inc., Notre-Dame de l'Île-Perrot, Canada
- Correspondence to Jean-Pierre Pelletier, Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Notre-Dame Hospital, 1560 Sherbrooke Street East, Y2616, Montreal, Québec, Canada H2L 4M1;
Contributors We have read and approved the manuscript and contributed to the study design, data analysis, interpretation of data and drafting and revision of the manuscript.
- Accepted 23 January 2011
- Published Online First 1 March 2011
Objective To determine the effect of chondroitin sulphate (CS) treatment on cartilage volume loss, subchondral bone marrow lesions (BML), synovitis and disease symptoms in patients with knee osteoarthritis (OA).
Methods In this pilot multicentre, randomised, double-blind, controlled trial in primary knee OA, 69 patients with clinical signs of synovitis were randomised to receive CS 800 mg or placebo once daily for 6 months followed by an open-label phase of 6 months in which patients in both groups received CS 800 mg once daily. Cartilage volume and BML were assessed by MRI at baseline and at 6 and 12 months; synovial membrane thickness was assessed at baseline and at 6 months.
Results The CS group showed significantly less cartilage volume loss than the placebo group as early as 6 months for the global knee (p=0.030), lateral compartment (p=0.015) and tibial plateaus (p=0.002), with significance persisting at 12 months. Significantly lower BML scores were found for the CS group at 12 months in the lateral compartment (p=0.035) and the lateral femoral condyle (p=0.044). Disease symptoms were similar between the two groups.
Conclusion CS treatment significantly reduced the cartilage volume loss in knee OA starting at 6 months of treatment, and BML at 12 months. These findings suggest a joint structure protective effect of CS and provide new in vivo information on its mode of action in knee OA.
Funding This investigator-initiated study was supported in part by a grant from Bioiberica (Barcelona, Spain). Bioiberica was involved only in the design of the study and the approval of the final manuscript.
Competing interests J-PR is a consultant for ArthroVision Inc. JM-P and J-PP are consultants for and shareholders in ArthroLab Inc. and ArthroVision Inc. AB, LB and FM received honoraria from ArthroLab Inc. FA is an employee of ArthroVision Inc. MD is a consultant for ArthroVision Inc.
Ethics approval This study was approved by the local ethics committees.
This paper is freely available online under the BMJ Journals unlocked scheme, see http://ard.bmj.com/info/unlocked.dtl