Background Interleukin-1β (IL-1β) and other inflammatory mediators plays a pivotal role in driving the pathways associated with osteoarthritis (OA) pathogenesis and promotes cartilage degradation . Glucosamine sulphate (GS) possesses anti-inflammatory efficacies against OA in animals and humans and is suggested to delay damage of cartilage and long-term progression of OA as a disease modifying anti-OA drug through its chondroprtective effect . Despite the increased use of GS in the treatment of OA, the mechanisms accounting for its in vivo antiarthritic activity are still unclear.
Objectives to identify the effect of α-D GS on serum level of IL-1β in patients with symptomatic primary knee OA.
Methods Sixty patients (mean age=52.2±8.6 years), fulfilling the American College of Rheumatology criteria of idiopathic knee OA, were randomized to receive either 1500 mg α-D GS and 1200 mg Ibuprofen (group I), or only 1200 mg Ibuprofen (group II) daily for 12 weeks. Patients were followed up by Visual Analogue knee pain Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) functional index and quantitative detection of IL-1 β serum levels. Reference serum level of IL-1 β was determined in 20 matched healthy volunteers.
Results Group I showed significant progressive improvement in pain VAS and total WOMAC scale, pain, stiffness and function subscales during the follow up visits compared to group II. At baseline, both groups had significantly higher IL-1β serum level than control group. On follow up group I showed significant progressive reduction in IL-1β serum level with a final level that was significantly lower than group II and was not significantly higher than control group. In group II the reductions in IL-1β serum level did not reach level of statistical significance and the final level persisted significantly higher than that of control group.
Conclusions adding α-D GS to treatment of primary symptomatic knee OA could relieve symptoms, improve function and affect some of the disease mechanisms.
Attur M, Belitskaya-Lévy I, Oh C, et al. Increased IL-1 beta gene expression in peripheral blood leukocytes is associated with increased pain and predicts risk for progression of symptomatic knee osteoarthritis. Arthritis Rheum 2011; 63: 1908-17.
Rovati L C, Girolami F, Persiani S. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties. Ther Adv Musculoskelet Dis 2012; 4: 167- 80.
Disclosure of Interest None declared