Efficacy evaluation of nonpharmacological treatment (regular exercise), pharmacotherapy (glucosamine sulphate, GS Condro Forte^®) and the combination of both methods in symptomatic osteoarthritis of the knee. Results of open, randomized, controlled study

Česká verzia

Authors: M. Olejárová; R. Svobodová; H. Jarošová; M. Votavová; E. Ištvánková; M. Lösterová; K. Pavelka
Authors place of work: Revmatologický ústav, Praha
Published in the journal: Čes. Revmatol., 16, 2008, No. 4, p. 153-160.
Category: Original Papers

Summary

Background.
Regular excercises, treatment of pain with analgesics/ nonsteroidal anti-inflammatory drugs (NSAIDs) and the administration of symptomatic slow acting drugs of osteoarthritis (SYSADOA) including glucosamine sulphate (GS) belong to recommended guidelines of treatment of knee osteoarthritis.

Objectives.
The objective of the study was to compare the efficacy of GS, regular exercises and the combination of both methods with a control group with no intervention.

Patients and methods.
A total of 157 patients with symptomatic knee osteoarthritis, with a mean age of 62 years, were included in this study. The patients were divided into one of four treatment groups by random: 1. GS Condro Forte 2x800 mg, 1x weekly group exercise and 1x weekly individual exercise, 2. GS Condro Forte 2x800 mg, 3. 1x weekly group exercise and 1x weekly individual exercise, 4. Control group (with no intervention). All patients were allowed to take the same analgesics/ NSAIDs that they have been taking before entering the study “on demand”. Patients had been treated for 6 months, and in group 1 and 2, the patients were observed for another 6 months. Rest pain, pain on motion, algofunctional index WOMAC (A, B, C, total), consumption of analgesics/ NSAIDs and occurrence of adverse effects were observed.

Results.
The combined therapy was the most efficient one. It resulted in an improvement of all parameters in both 3 and 6 months, whereas the improvement lasted for another 3–6 months. The monotherapy of GS contributed to the improvement of all parameters, as well. Exercise, alone, turned out to be the least effective out of all three interventions. Adverse effects occurred rarely (n=13). Dyspeptic difficulties that could occur due to simultaneous administration of NSAIDs were the most frequent ones. The most distinct decrease in the usage of analgesics/ NSAIDs was in the combined therapy (the number of consumers decreased by more than a half).

Conclusion.
Complex therapy in accordance with the EULAR recommendation, including regular exercise and administration of GS, leads to an improvement of both pain and function and reduction of analgesics/ NSAIDs usage. Complex therapy is more efficient than the separate administration of GS or separate exercise.

Key words:
osteoarthritis, osteoarthritis of the knee, physiotherapy, glucosamine sulphate

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