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  • Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT)

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Clinical and epidemiological research
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Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT)
  1. Jean-Yves Reginster1,
  2. Jean Dudler2,
  3. Tomasz Blicharski3,
  4. Karel Pavelka4
  1. 1 Department of Public Health, Epidemiology and Health Economics, Liège State University, Liège, Belgium
  2. 2 HFR Fribourg, Hôpital Cantonal, Fribourg, Switzerland
  3. 3 Lublin Medical University, Åšwidnik, Poland
  4. 4 Institute of Rheumatology, Charles University, Prague, Czech Republic
  1. Correspondence to Professor Jean-Yves Reginster, Department of Public Health, Epidemiology and Health Economics, Liège State University, Liège, Belgium, Quartier Hôpital – CHU B23, venue Hippocrate, 13, 4000 Liège, Belgium; jyr.ch{at}bluewin.ch

Abstract

Objectives Chondroitin sulfate 800 mg/day (CS) pharmaceutical-grade in the management of symptomatic knee osteoarthritis consistent with the European Medicines Agency guideline.

Methods A prospective, randomised, 6-month, 3-arm, double-blind, double-dummy, placebo and celecoxib (200 mg/day)-controlled trial assessing changes in pain on a Visual Analogue Scale (VAS) and in the Lequesne Index (LI) as coprimary endpoints. Minimal-Clinically Important Improvement (MCII), Patient-Acceptable Symptoms State (PASS) were used as secondary endpoints.

Results 604 patients (knee osteoarthritis) diagnosed according to American College of Rheumalogy (ACR) criteria, recruited in five European countries and followed for 182 days. CS and celecoxib showed a greater significant reduction in pain and LI than placebo. In the intention-to-treat (ITT) population, pain reduction in VAS at day 182 in the CS group (−42.6 mm) and in celecoxib group (−39.5 mm) was significantly greater than the placebo group (−33.3 mm) (p=0.001 for CS and p=0.009 for celecoxib), while no difference observed between CS and celecoxib. Similar trend for the LI, as reduction in this metric in the CS group (−4.7) and celecoxib group (−4.6) was significantly greater than the placebo group (−3.7) (p=0.023 for CS and p=0.015 for celecoxib), no difference was observed between CS and celecoxib. Both secondary endpoints (MCII and PASS) at day 182 improved significantly in the CS and celecoxib groups. All treatments demonstrated excellent safety profiles.

Conclusion A 800 mg/day pharmaceutical-grade CS is superior to placebo and similar to celecoxib in reducing pain and improving function over 6 months in symptomatic knee osteoarthritis (OA) patients. This formulation of CS should be considered a first-line treatment in the medical management of knee OA.

  • knee osteoarthritis
  • treatment
  • chondroitin sulfate
  • pain
  • function

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/annrheumdis-2016-210860

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    Footnotes

    • Contributors All authors agreed to correct the manuscript as per the reviewers recommendations.

    • Funding The study was sponsored by IBSA Institut Biochimique SA, Pambio- Noranco, Switzerland, a pharmaceutical company marketing Chondroitin Sulfate. The manuscript was entirely written by the first Author (JYR) who received an editorial assistance from IBSA. However, IBSA has no influence on the content of the manuscript. The editorial assistance was limited to the final editing of the manuscript and the submission process through the ARD website.

    • Competing interests None declared.

    • Ethics approval Belgium, Italy, Switzerland, Czech Republic, Poland.

    • Provenance and peer review Not commissioned; externally peer reviewed.