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1.
Wiad Lek ; 72(9 cz 1): 1671-1675, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31586981

RESUMO

Osteoarthritis is the disease connected with aging which is characterised by progressive degeneration of all elements building the joint but also influencing the muscles constituting motor unit with the affected joint. The effective and unified therapy has not been yet introduced despite the broad multi-site studies concentrating on metabolic pathways responsible for the development of the disease. The reason of which is probably its multifactorial aetiology. The treatment methods are based on decreasing of cartilage destruction activity, retardation of proinflammatory factors activity and fighting with pain. Physiotherapy, movement rehabilitation, painkillers, anti-inflammatory drugs, glucosamine sulphates and hyaluronic acids are used as therapeutic strategies. The methods recently introduced are platelet rich plasma concentrates and stem cells injected directly into the affected joint. The aim of this review article was the presentation of differential therapeutic options offered to patients in different stages of osteoarthritis.


Assuntos
Envelhecimento , Cartilagem/patologia , Osteoartrite/terapia , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Glucosamina/uso terapêutico , Humanos , Ácido Hialurônico/uso terapêutico
2.
J Nutr Sci Vitaminol (Tokyo) ; 65(3): 242-250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31257264

RESUMO

Care of the musculoskeletal system, including the muscles, joints, and bones, is important for a healthy life expectancy in today's aging society. The aim of this randomized, double-blind, placebo-controlled study was to investigate the effect of consumption of milk-fat globule membrane (MFGM) and glucosamine on joint function and physical performance. Participants were healthy Japanese men and women, aged 60-74 y, with a history of mild knee or low back pain at rest. They were randomized to receive tablets containing MFGM 1.0 g+glucosamine 1.5 g or placebo tablets for 8 wk. We assessed passive range of motion, active range of motion (self-reported VAS score), JKOM and JLEQ, and physical performance. Data were available for analysis for 25 participants in the active treatment group and 28 in the placebo group. The active group showed significant improvements in passive range of motion at the knee and active range of motion at both the knee and low back. The active group also showed significant improvements in some physical performance, including obstacle walking speed and speed of ascending stairs. The findings of this study suggest that consumption of a combination of MFGM and glucosamine may improve joint function and physical performance.


Assuntos
Glucosamina/uso terapêutico , Glicolipídeos/uso terapêutico , Glicoproteínas/uso terapêutico , Amplitude de Movimento Articular/efeitos dos fármacos , Caminhada/fisiologia , Idoso , Artralgia/tratamento farmacológico , Suplementos Nutricionais , Método Duplo-Cego , Teste de Esforço/efeitos dos fármacos , Feminino , Glucosamina/farmacologia , Glicolipídeos/farmacologia , Glicoproteínas/farmacologia , Humanos , Articulação do Joelho/fisiologia , Dor Lombar/tratamento farmacológico , Masculino , Pessoa de Meia-Idade
3.
Clinics (Sao Paulo) ; 74: e722, 2019 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-31090795

RESUMO

OBJECTIVES: This study aimed to provide evidence for understanding how to treat osteoarthritis (OA) in our country. Therefore, it was necessary to match information and investigations related to the treatment of the disease from the three main types of specialists involved: physiatrists, orthopedists and rheumatologists. METHODS: The authors acted as a scientific advisory committee. From the initial discussions, a structured questionnaire was developed for use with a group of specialists on OA using the Delphi technique. The questionnaire was sent to 21 experts appointed by the authors, and the results obtained were critically analyzed and validated. RESULTS: The prevalence of OA was 33% in Brazil, corresponding to one-third of the individuals in the reference population, which included individuals over 25 years of age. Another significant finding was that most patients did not receive any form of treatment in the early stages of OA. CONCLUSION: The committee pointed to the need for early intervention and that the available medicinal resources can fulfil this important role, as is the case with SYSADOA treatments. Glucosamine-based medicinal products with or without chondroitin could also fulfill this need for early treatment. The other generated evidence and included investigations were then grouped together and are the subject of this publication.


Assuntos
Competência Clínica/normas , Técnica Delfos , Medicina Baseada em Evidências/normas , Osteoartrite/terapia , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Brasil , Sulfatos de Condroitina/uso terapêutico , Consenso , Quimioterapia Combinada , Feminino , Glucosamina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Ortopedia/normas , Osteoartrite/tratamento farmacológico , Osteoartrite do Joelho/terapia , Medicina Física e Reabilitação/normas , Guias de Prática Clínica como Assunto , Reumatologia/normas , Índice de Gravidade de Doença , Resultado do Tratamento
4.
J Fr Ophtalmol ; 42(7): 711-715, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31104873

RESUMO

PURPOSE: Glucosamine sulfate is one of the treatment options for patients with osteoarthritis of the knee. It has been postulated that glucosamine sulfate affects intraocular pressure (IOP). This study aimed to evaluate the effect of crystalline glucosamine sulfate on IOP in patients with osteoarthritis of the knee. METHODS: Forty-two patients with osteoarthritis of the knee were randomized into two groups. The first group of patients received 1500mg of crystalline glucosamine sulfate once daily for 6 months and the conventional treatment protocol. The second group of patients received only the conventional treatment protocol. IOP was recorded at the start of the study and at 6 weeks, 3 months, 6 months, and 9 months. RESULTS: The patient demographic data were not different between the two groups. There were no differences in the IOPs between the groups (P>0.05) nor differences in baseline IOPs within each group compared with each follow-up visit (P>0.05). CONCLUSIONS: Glucosamine sulfate is still an option without significant concern over elevated IOP in patients with osteoarthritis of the knee and normal ocular pressure.


Assuntos
Glucosamina/uso terapêutico , Pressão Intraocular/efeitos dos fármacos , Osteoartrite do Joelho/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Glucosamina/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/fisiopatologia , Tonometria Ocular , Resultado do Tratamento
5.
BMJ ; 365: l1628, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088786

RESUMO

OBJECTIVE: To prospectively assess the association of habitual glucosamine use with risk of cardiovascular disease (CVD) events. DESIGN: Prospective cohort study. SETTING: UK Biobank. PARTICIPANTS: 466 039 participants without CVD at baseline who completed a questionnaire on supplement use, which included glucosamine. These participants were enrolled from 2006 to 2010 and were followed up to 2016. MAIN OUTCOME MEASURES: Incident CVD events, including CVD death, coronary heart disease, and stroke. RESULTS: During a median follow-up of seven years, there were 10 204 incident CVD events, 3060 CVD deaths, 5745 coronary heart disease events, and 3263 stroke events. After adjustment for age, sex, body mass index, race, lifestyle factors, dietary intakes, drug use, and other supplement use, glucosamine use was associated with a significantly lower risk of total CVD events (hazard ratio 0.85, 95% confidence interval 0.80 to 0.90), CVD death (0.78, 0.70 to 0.87), coronary heart disease (0.82, 0.76 to 0.88), and stroke (0.91, 0.83 to 1.00). CONCLUSION: Habitual use of glucosamine supplement to relieve osteoarthritis pain might also be related to lower risks of CVD events.


Assuntos
Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais , Glucosamina/uso terapêutico , Dor/prevenção & controle , Doença das Coronárias/epidemiologia , Seguimentos , Humanos , Osteoartrite/complicações , Osteoartrite/tratamento farmacológico , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Reino Unido/epidemiologia
6.
Biomater Sci ; 7(7): 2716-2728, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31033977

RESUMO

Osteoarthritis (OA) is a chronic joint disease resulting from joint inflammation and damage. In this study, we employed a boundary lubricant known as a 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC) liposome for loading of an anti-inflammatory drug d-glucosamine sulphate (GAS) to construct a treatment strategy allowing for sustained anti-inflammation and reduced damage. This kind of drug-loaded nanocarrier integrates the anti-inflammatory effect of the GAS and the lubrication ability of DSPC liposomes without the involvement of complex synthesis processes leading to easier popularization. Our experimental results indicated that the GAS-loaded DSPC liposomes could release GAS in a sustained manner while providing good lubrication in pure water (H2O) and phosphate buffered saline (PBS). Moreover, the GAS-loaded DSPC liposomes prepared at a 2 : 8 molar ratio in PBS exhibited a greater entrapment efficiency, lower GAS release rate and smaller friction coefficient as compared to those prepared in H2O. The superiority of the drug release and lubrication ability achieved with the GAS-loaded DSPC liposomes in PBS were elucidated on the basis of salt-induced enhancement in liposomal stability and hydration lubrication by the hydrated salt ions. Such GAS release accelerated the viability and proliferation of primary mouse chondrocytes while also providing the anti-inflammatory and chondroprotective potential for tumor necrosis factor (TNF-α) induced chondrocyte degeneration through the down-regulation of pro-inflammatory cytokines, pain related gene and catabolic proteases, as well as the up-regulation of anabolic components. We envision that the GAS-loaded DSPC liposomes could represent a promising new strategy for clinical treatment of OA in the future.


Assuntos
Glucosamina/administração & dosagem , Glucosamina/uso terapêutico , Lipossomos/química , Lubrificantes/administração & dosagem , Lubrificantes/uso terapêutico , Osteoartrite/tratamento farmacológico , Fosforilcolina/química , Animais , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Preparações de Ação Retardada , Regulação da Expressão Gênica/efeitos dos fármacos , Glucosamina/farmacologia , Lubrificantes/farmacologia , Camundongos , Fator de Necrose Tumoral alfa/metabolismo , Água/química
7.
Aging Clin Exp Res ; 31(6): 807-813, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30982220

RESUMO

BACKGROUND: Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA and there is no effective treatment to stop its progression. Current pharmacologic treatments such as analgesics and non-steroidal anti-inflammatory drugs may improve the pain and offer some relief but they do not affect the progression of the disease. The chronic intake of these drugs may result in severe adverse events. The aim of this review is to revise the effects of nutrition on cartilage metabolism and OA progression. METHODS: A systematic literature search was performed including those related to macro- and micro-nutrients' actions on cartilage and OA outcome. We selected peer-reviewed articles reporting the results of human clinical trials. RESULTS: Glucosamine and chondroitin sulfate have shown to delay OA knee progression in several clinical trials. The effectiveness of some products considered nutraceuticals has been widely reviewed in the literature. This article presents a general description of the effectiveness and mechanism of action of nutrients, vitamins, antioxidants and other natural components considered as part of the normal diet. Many in vitro studies indicate the efficacy of specific nutrients in cartilage metabolism and its involvement in OA. However, rigorous clinical studies needed to evaluate the efficacy of these compounds in humans are still missing. The influence of nutrients and diet on the metabolism of cartilage and OA could represent a long-term coadjuvant alternative in the management of patients with OA. Effects of diet modifications on lipid and cholesterol profiles, adequate vitamin levels and weight reduction in obese patients could influence the course of the disease. CONCLUSION: This review demonstrates that nutrition can improve the symptoms of OA. Glucosamine and chondroitin sulfate have shown robustly to delay the progression of knee OA in several well-designed studies, however more controlled clinical trials are needed to conclude that nutritional changes slow down the progression of the disease.


Assuntos
Cartilagem/metabolismo , Progressão da Doença , Estado Nutricional , Osteoartrite , Cartilagem/efeitos dos fármacos , Sulfatos de Condroitina/uso terapêutico , Glucosamina/uso terapêutico , Humanos , Osteoartrite/dietoterapia , Osteoartrite/tratamento farmacológico , Vitaminas/uso terapêutico
8.
PLoS One ; 14(2): e0211999, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30794553

RESUMO

OBJECTIVE: This pilot study assessed the efficacy of a knee guard device, which used magnetophoresis to transdermally deliver Glucosamine, Chondroitin and Hyaluronic Acid in a cohort of individuals with prior knee injury. The aim was to determine if the change in physical function and pain with the knee guard device was equivalent to the change produced by an established topical NSAID formulation containing diclofenac sodium 1%. METHODS: A randomized, controlled, equivalence trial evaluated outcomes following treatment with the knee guard device or NSAID formulation. The study recruited 114 male participants (aged 40-55 years). Participants were randomly allocated to wear the knee guard device or to use a NSAID gel daily for two weeks. The primary outcomes were the knee injury osteoarthritis function score (KOOS-F) and an aggregated function score (AFS). The lower extremity functional scale (LEFS), pain numerical rating scale (PNRS), global rating of change (GROC) and other KOOS scores were also evaluated. RESULTS: Multiple linear regression analyses indicated that there were no significant differences between the interventions for changes in the primary outcomes of AFS and KOOS_F. The 95% confidence interval (-2.89 to 5.15) of the estimated treatment difference for KOOS-F was within the lower (-5.61) and upper (5.61) bounds of the 7% equivalence margin for that measure, The mean value for the AFS was within, but the 95% CI (-3.11 to 7.37) exceeded the 7% equivalence margin (-2.97 to 2.97) for that measure. There was a significant difference in PNRS, which favored the knee guard device. CONCLUSION: The knee guard device demonstrated equivalence for the KOOS-F measure but not the AFS measure of function over the two week trial period when compared to a widely available NSAID gel that has been shown to be superior to placebo. The knee guard produced a greater reduction in pain report (p = 0.002) than the NSAID gel. Users of the knee guard device experienced more skin irritation than participants using the NSAID gel. Further research is required to fully evaluate the therapeutic potential of this innovative treatment approach.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Desenho de Equipamento/instrumentação , Traumatismos do Joelho/terapia , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Condroitina/administração & dosagem , Condroitina/uso terapêutico , Composição de Medicamentos , Glucosamina/administração & dosagem , Glucosamina/uso terapêutico , Humanos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/uso terapêutico , Fenômenos Magnéticos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Projetos Piloto , Resultado do Tratamento
9.
J Biol Chem ; 294(2): 608-622, 2019 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-30455348

RESUMO

The aim of the current study was to investigate the effects of glucosamine (GlcN) on septic lethality and sepsis-induced inflammation using animal models of mice and zebrafish. GlcN pretreatment improved survival in the cecal ligation and puncture (CLP)-induced sepsis mouse model and attenuated lipopolysaccharide (LPS)-induced septic lung injury and systemic inflammation. GlcN suppressed LPS-induced M1-specific but not M2-specific gene expression. Furthermore, increased expressions of inflammatory genes in visceral tissue of LPS-injected zebrafish were suppressed by GlcN. GlcN suppressed LPS-induced activation of mitogen-activated protein kinase (MAPK) and NF-κB in lung tissue. LPS triggered a reduction in O-GlcNAc levels in nucleocytoplasmic proteins of lung, liver, and spleen after 1 day, which returned to normal levels at day 3. GlcN inhibited LPS-induced O-GlcNAc down-regulation in mouse lung and visceral tissue of zebrafish. Furthermore, the O-GlcNAcase (OGA) level was increased by LPS, which were suppressed by GlcN in mouse and zebrafish. OGA inhibitors suppressed LPS-induced expression of inflammatory genes in RAW264.7 cells and the visceral tissue of zebrafish. Stable knockdown of Oga via short hairpin RNA led to increased inducible nitric oxide synthase (iNOS) expression in response to LPS with or without GlcN in RAW264.7 cells. Overall, our results demonstrate a protective effect of GlcN on sepsis potentially through modulation of O-GlcNAcylation of nucleocytoplasmic proteins.


Assuntos
Glucosamina/uso terapêutico , Inflamação/tratamento farmacológico , Inflamação/etiologia , Lesão Pulmonar/tratamento farmacológico , Lesão Pulmonar/etiologia , Sepse/complicações , Sepse/tratamento farmacológico , Animais , Anti-Inflamatórios/uso terapêutico , Modelos Animais de Doenças , Inflamação/patologia , Lesão Pulmonar/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Infiltração de Neutrófilos/efeitos dos fármacos , Células RAW 264.7 , Sepse/patologia , Peixe-Zebra
10.
J Knee Surg ; 32(1): 46-54, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30477045

RESUMO

The goal of the practitioner managing a patient with knee osteoarthritis (OA) is to minimize pain and optimize their function. Several noninterventional (noninjectable) therapies are available for these individuals, each having varying levels of efficacy. An individualized approach to the patient is most beneficial in individuals with knee OA and the treatment plan the practitioner chooses should be based on this principle. The focus of this article is to provide an up-to-date overview of the treatment strategies available, evidence to support them, and in whom these treatments would be most appropriate. These include exercise (aerobic and resistance), weight loss, bracing and orthotics, topical and oral analgesic medications, therapeutic modalities, and oral supplements.


Assuntos
Osteoartrite do Joelho/terapia , Terapia por Acupuntura , Analgésicos não Entorpecentes/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Braquetes , Sulfatos de Condroitina/uso terapêutico , Curcuma , Terapia por Exercício , Órtoses do Pé , Glucosamina/uso terapêutico , Humanos , Sobrepeso/terapia , Treinamento de Resistência , Terapia por Ultrassom , Perda de Peso
11.
Int J Rheum Dis ; 22(3): 376-385, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28332780

RESUMO

Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium- to long-term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay joint structural changes. Among SYSADOAs, evidence is greatest for the patented crystalline glucosamine sulfate (pCGS) formulation (Mylan). Glucosamine is widely available as glucosamine sulfate (GS) and glucosamine hydrochloride (GH) preparations that vary substantially in molecular form, pharmaceutical formulation and dose regimen. Only pCGS is given as a highly bioavailable once-daily dose (1500 mg), which consistently delivers the plasma levels of around 10 µmol/L required to inhibit interleukin-1-induced expression of genes involved in the pathophysiology of joint inflammation and tissue destruction. Careful consideration of the evidence base reveals that only pCGS reliably provides a moderate effect size on pain that is higher than paracetamol and equivalent to non-steroidal anti-inflammatory drugs (NSAIDs), while non-crystalline GS and GH fail to reach statistical significance for pain reduction. Chronic administration of pCGS has disease-modifying effects, with a reduction in need for total joint replacement lasting for 5 years after treatment cessation. Pharmacoeconomic studies of pCGS demonstrate long-term reduction in additional pain analgesia and NSAIDs, with a 50% reduction in costs of other OA medication and healthcare consultations. Consequently, pCGS is the logical choice, with demonstrated medium-term control of pain and lasting impact on disease progression. Physician and patient education on the differentiation of pCGS from other glucosamine formulations will help to improve treatment selection, increase treatment adherence, and optimize clinical benefit in OA.


Assuntos
Antirreumáticos/uso terapêutico , Glucosamina/uso terapêutico , Osteoartrite/tratamento farmacológico , Patentes como Assunto , Animais , Antirreumáticos/efeitos adversos , Antirreumáticos/economia , Antirreumáticos/farmacocinética , Análise Custo-Benefício , Cristalização , Composição de Medicamentos , Custos de Medicamentos , Glucosamina/efeitos adversos , Glucosamina/economia , Glucosamina/farmacocinética , Humanos , Osteoartrite/diagnóstico , Osteoartrite/economia , Educação de Pacientes como Assunto , Resultado do Tratamento
12.
JAMA ; 320(24): 2564-2579, 2018 12 25.
Artigo em Inglês | MEDLINE | ID: mdl-30575881

RESUMO

Importance: Even though osteoarthritis is a chronic and progressive disease, pharmacological agents are mainly studied over short-term periods, resulting in unclear recommendations for long-term disease management. Objective: To search, review, and analyze long-term (≥12 months) outcomes (symptoms, joint structure) from randomized clinical trials (RCTs) of medications for knee osteoarthritis. Data Sources and Study Selection: The databases of MEDLINE, Scopus, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched until June 30, 2018 (MEDLINE alerts through August 31, 2018) for RCTs of patients with knee osteoarthritis that had treatment and follow-up lasting 1 year or longer. Data Extraction and Synthesis: Data at baseline and at the longest available treatment and follow-up of 12 months' duration or longer (or the change from baseline) were extracted. A Bayesian random-effects network meta-analysis was performed. Main Outcomes and Measures: The primary outcome was the mean change from baseline in knee pain. Secondary outcomes were physical function and joint structure (the latter was measured radiologically as joint space narrowing). Standardized mean differences (SMDs) and mean differences with 95% credibility intervals (95% CrIs) were calculated. Findings were interpreted as associations when the 95% CrIs excluded the null value. Results: Forty-seven RCTs (22 037 patients; mean age range, mostly 55-70 years; and a higher mean proportion of women than men, around 70%) included the following medication categories: analgesics; antioxidants; bone-acting agents such as bisphosphonates and strontium ranelate; nonsteroidal anti-inflammatory drugs; intra-articular injection medications such as hyaluronic acid and corticosteroids; symptomatic slow-acting drugs in osteoarthritis such as glucosamine and chondroitin sulfate; and putative disease-modifying agents such as cindunistat and sprifermin. Thirty-one interventions were studied for pain, 13 for physical function, and 16 for joint structure. Trial duration ranged from 1 to 4 years. Associations with decreases in pain were found for the nonsteroidal anti-inflammatory drug celecoxib (SMD, -0.18 [95% CrI, -0.35 to -0.01]) and the symptomatic slow-acting drug in osteoarthritis glucosamine sulfate (SMD, -0.29 [95% CrI, -0.49 to -0.09]), but there was large uncertainty for all estimates vs placebo. The association with pain improvement remained significant only for glucosamine sulfate when data were analyzed using the mean difference on a scale from 0 to 100 and when trials at high risk of bias were excluded. Associations with improvement in joint space narrowing were found for glucosamine sulfate (SMD, -0.42 [95% CrI, -0.65 to -0.19]), chondroitin sulfate (SMD, -0.20 [95% CrI, -0.31 to -0.07]), and strontium ranelate (SMD, -0.20 [95% CrI, -0.36 to -0.05]). Conclusions and Relevance: In this systematic review and network meta-analysis of studies of patients with knee osteoarthritis and at least 12 months of follow-up, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo. Larger RCTs are needed to resolve the uncertainty around efficacy of medications for knee osteoarthritis.


Assuntos
Corticosteroides/uso terapêutico , Analgésicos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Celecoxib/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico , Manejo da Dor/métodos , Idoso , Conservadores da Densidade Óssea/uso terapêutico , Feminino , Seguimentos , Glucosamina/uso terapêutico , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade
13.
Clin Interv Aging ; 13: 2119-2126, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30498336

RESUMO

Purpose: Osteoarthritis (OA) is an age-related disease caused by the wear and tear of the joints. Presently, there is no known cure for OA, but its management involves the use of high doses of pain killers and antiinflammatory agents with different side and dependency effects. Alternative management strategies involve the use of high doses of glucosamine-chondroitin (GC). This study was carried out to evaluate the efficacy of Q-Actin™, an aqueous extract of Cucumis sativus (cucumber; CSE) against GC in the management of moderate knee OA. Patients and methods: Overall, 122 patients (56 males and 66 females) aged between 40 and 75 years and diagnosed with moderate knee OA were included in this randomized double-blind, parallel-group clinical trial that took place in three different centers. The 180 day intervention involved two groups of 61 participants in each: the GC group, which received orally the generally prescribed dose of 1,350 mg of GC twice daily and the CSE group, which received orally10 mg twice daily of CSE. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog scale, and Lequesne's Functional Index were used to evaluate pain, stiffness, and physical function of knee OA in participants at baseline (Day 0) and on Days 30, 60, 90, 120, 150, and 180. Results: In the CSE group, the WOMAC score was decreased by 22.44% and 70.29% on Days 30 and 180, respectively, compared to a 14.80% and 32.81% decrease in the GC group. Similar trends were observed for all the other pain scores. No adverse effect was reported during the trial period. Conclusion: The use of 10 mg CSE, twice daily, was effective in reducing pain related to moderate knee OA and can be potentially used in the management of knee pain, stiffness, and physical functions related to OA.


Assuntos
Condroitina/uso terapêutico , Cucumis sativus/química , Glucosamina/uso terapêutico , Dor Musculoesquelética/tratamento farmacológico , Osteoartrite do Joelho/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Adulto , Idoso , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Osteoartrite do Joelho/complicações , Medição da Dor , Fitoterapia , Resultado do Tratamento , Escala Visual Analógica
15.
Pak J Pharm Sci ; 31(4(Special)): 1617-1621, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30203748

RESUMO

The aim of the stuy was to observe and analyze the effect of glucosamine hydrochloride tablets on patients with cervical spondylosis. This study was conducted on 130 patients diagnosed with cervical spondylosis who were treated in our hospital. The time period was from June 2015 to December 2017. The subjects were randomly divided into a reference group treated with cervical vertebra exercises and cervical occipital belt traction therapy and the study group was further treated with glucosamine hydrochloride tablets. The treatment efficacy of both groups was observed. Comparison of the overall treatment efficiency of patients showed that compared with the reference group, the study group has more significant advantages, P<0.05; comparison of the overall patient satisfaction rate showed that the study group was also superior to the reference group, P<0.05; In addition, statistical analysis of adverse reactions showed no statistically significant difference, P<0.05. The treatment of glucosamine hydrochloride tablets in patients with cervical spondylosis can achieve ideal results, improve the overall treatment efficiency, and thus, has important application significance.


Assuntos
Glucosamina/uso terapêutico , Espondilose/tratamento farmacológico , Administração Oral , Adulto , Idoso , Terapia Combinada/efeitos adversos , Feminino , Glucosamina/administração & dosagem , Glucosamina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Modalidades de Fisioterapia , Tração , Resultado do Tratamento , Adulto Jovem
16.
Curr Rheumatol Rep ; 20(11): 72, 2018 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-30232562

RESUMO

PURPOSE OF REVIEW: Osteoarthritis, the most common joint disease, is associated with substantial medical costs, lost productivity, and reduced quality of life. However, available pharmaceutical treatments have limitations in terms of efficacy and long-term safety. RECENT FINDINGS: In vitro evidence suggests that some natural products may possess anti-inflammatory and anti-oxidative properties and may inhibit the release of key osteoarthritis-related cytokines. There is, therefore, ongoing interest in identifying natural products that safely promote joint health and treat osteoarthritis. Numerous plant extracts, including curcumin, Boswellia extract, and pycnogenol, have shown effect sizes (ES) for reducing pain and functional disability larger than those observed with analgesics and products such as glucosamine and chondroitin. The ES for methylsulfonylmethane and avocado/soybean unsaponifiables are also considered to be clinically relevant. Data from a small number of studies using natural products for treating osteoarthritis are promising but require confirmation in further well-designed clinical trials.


Assuntos
Produtos Biológicos/uso terapêutico , Osteoartrite/terapia , Fitoterapia/métodos , Anti-Inflamatórios não Esteroides/uso terapêutico , Boswellia , Condroitina/uso terapêutico , Curcumina/uso terapêutico , Suplementos Nutricionais , Dimetil Sulfóxido/uso terapêutico , Flavonoides/uso terapêutico , Glucosamina/uso terapêutico , Humanos , Manejo da Dor , Extratos Vegetais/uso terapêutico , Salix , Sulfonas/uso terapêutico
17.
Eur Rev Med Pharmacol Sci ; 22(17): 5424-5428, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30229812

RESUMO

OBJECTIVE: Osteoarthritis is a joint degeneration and proliferative inflammatory disease caused by obesity, joint deformities, trauma, and other factors. C-terminal collagen (CTX) is associated with cartilage degradation, and healthy cartilage state is one of the factors that affect osteoarthritis. microRNA-98 (miRNA-98) plays a role in inflammation. This study aims to investigate the levels of CTX-III and miRNA-98 in patients with osteoarthritis and their potential clinical usage. PATIENTS AND METHODS: Osteoarthritis was diagnosed according to the inclusion and exclusion criteria for osteoarthritis. Patients with osteoarthritis admitted to Jining No. 1 People's Hospital and healthy volunteers were included in this study. ELISA and Western blot analysis were used to detect levels of type III collagen CTX (CTX-III). Real time PCR was used to measure levels of miRNA-98 in the serum of both patients and healthy volunteers. RESULTS: Levels of CTX-III protein in osteoarthritis patients were significantly higher than that of healthy volunteers (p = 0.0013). Levels of miRNA-98 in the serum of osteoarthritis patients were significantly higher compared to that of healthy volunteers (p = 0.0065). After treatment, levels of CTX-III protein and serum miRNA-98 in patients with osteoarthritis were significantly decreased (p = 0.014, p = 0.021). Levels of CTX-III protein and serum miRNA-98 in patients with osteoarthritis were significantly higher compared to that of healthy volunteers (p = 0.0013). CONCLUSIONS: Both of the CTX-III and microRNA-98 are potential diagnostic indicators for the osteoarthritis.


Assuntos
Colágeno Tipo III/sangue , Glucosamina/uso terapêutico , MicroRNAs/sangue , Osteoartrite do Joelho/sangue , Osteoartrite do Joelho/tratamento farmacológico , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Resultado do Tratamento
18.
Arthritis Res Ther ; 20(1): 172, 2018 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-30086786

RESUMO

BACKGROUND: The aim of this study was to measure the association between exposure to commonly used oral osteoarthritis (OA) therapies and relevant confounding risk factors on the occurrence of knee replacement (KR), using the Osteoarthritis Initiative (OAI) database. METHODS: In this nested case-control design study, participants who had a KR after cohort entry were defined as "cases" and were matched with up to four controls for age, gender, income, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, Kellgren-Lawrence grade, and duration of follow up. Exposure to oral OA therapies (acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) inhibitors, narcotics, and glucosamine/chondroitin sulfate) was determined within the 3 years prior to the date of the KR. Conditional regression analyses were performed to estimate the association between KR and exposure to oral OA therapies and other potential confounding risk factors. RESULTS: A total of 218 participants who underwent a KR (cases) were matched to 540 controls. The median time to KR was 4.3 years among cases. The majority in both groups were Caucasian with mean age of 69 years and 61% were female. Numerically, cases were more exposed to acetaminophen, NSAIDs, and COX-2 inhibitors. Exposure to narcotics and glucosamine/chondroitin sulfate was relatively similar between cases and controls. No significant association was found between the occurrence of KR and exposure to any of the oral OA therapies within the 3 years prior to KR. A significantly higher occurrence of KR was found in Caucasian subjects (OR 1.84; 95% CI, 1.13-2.99; p = 0.015) and subjects with body mass index (BMI) ≥ 27 kg/m2 (OR 1.65; 95% CI, 1.06-2.58; p = 0.027). CONCLUSION: This study provides evidence that the main risk factors leading to KR are disease severity, symptoms and high BMI. Importantly, exposure to oral OA therapies was not associated with the occurrence of KR.


Assuntos
Artroplastia do Joelho/estatística & dados numéricos , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/cirurgia , Idoso , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Índice de Massa Corporal , Estudos de Casos e Controles , Sulfatos de Condroitina/uso terapêutico , Feminino , Glucosamina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
19.
J Orthop Surg Res ; 13(1): 170, 2018 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-29980200

RESUMO

OBJECTIVE: To assess the symptomatic effectiveness and safety of oral symptomatic slow-acting drugs (SYSADOAs) on the treatment of knee and/or hip osteoarthritis, such as chondroitin, glucosamine, and combination treatment with chondroitin plus glucosamine. METHODS: We searched electronic database including PubMed, Embase, Cochrane Library, and the reference lists of relevant articles published from inception to May 22, 2018. An updated meta-analysis was performed to assess the effectiveness of these slow-acting drugs for osteoarthritis. RESULTS: Twenty-six articles describing 30 trials met our inclusion criteria and were included in the meta-analysis. The estimates between chondroitin and placebo showed that chondroitin could alleviate pain symptoms and improve function. Compared with placebo, glucosamine proved significant effect only on stiffness improvement. However, the combination therapy did not have enough evidence to be superior to placebo. Additionally, there was no significant difference in the incidence of AEs and discontinuations of AEs when compared with placebo. CONCLUSIONS: Given the effectiveness of these symptomatic slow-acting drugs, oral chondroitin is more effective than placebo on relieving pain and improving physical function. Glucosamine showed effect on stiffness outcome. Regarding on the limited number of combination therapy, further studies need to investigate the accurate effectiveness. This information accompanied with the tolerability and economic costs of included treatments would be conducive to making decisions for clinicians.


Assuntos
Condroitina/uso terapêutico , Glucosamina/uso terapêutico , Osteoartrite do Quadril/tratamento farmacológico , Osteoartrite do Joelho/tratamento farmacológico , Quimioterapia Combinada , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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