LIEGE, Belgium, December 2, 2015 /PRNewswire/ --
A task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and international KOLs has reached a consensus about implementing the ESCEO algorithm in practice and about developing a consensus paper on glucosamine, clearly differentiating between the clinically-proven pCGS formulation and other clinically ineffective glucosamine formulations.
Multiple guidelines for the management of osteoarthritis (OA) by different Societies, are used in Europe, America and internationally.
(Logo: http://photos.prnewswire.com/prnh/20151124/290592LOGO )
Despite availability of international evidence-based guidelines for osteoarthritis management, agreement on the different treatment modalities is still lacking.
The pharmacological treatment of osteoarthritis has traditionally relied upon analgesics and anti-inflammatories, and there is general agreement for the use of these classes of drugs for pain management. Paracetamol is still largely recommended as a first line treatment for pain in OA; however, there are increasing concerns on its safety, including gastrointestinal side effects and hepato-toxicity. Guidelines do not differentiate clearly between clinically proven (evidence-based criteria and Cochrane Review) and clinically non-proven formulations of glucosamine, with the exception of the ESCEO algorithm, and this creates inconsistency in recommendations given and confusion in practice.
The ESCEO treatment algorithm recommends as an alternative approach the use of symptomatic slow-acting drugs for knee osteoarthritis (SYSADOAs), in which pCGS is included, as background therapy with paracetamol as add-on rescue analgesia, as needed. "The ESCEO algorithm - said Prof Jean-Yves Reginster, ESCEO co-founder and President - recommends the use of SYSADOAs specifically patented crystalline glucosamine sulfate and prescription chondroitin sulfate as a first line treatment for OA; it is clear today that not all the products are similar, and the discrepancies between various guidelines simply reflect the fact that they do not consider the same medications."
"Our first take home message from the meeting on which we are all agreed, is that glucosamine hydrochloride is just a placebo. All guidelines agree that glucosamine hydrochloride does not work. This drug has never been shown to be effective in clinical trials; there is not a single study in the literature that shows glucosamine hydrochloride to be effective."
"Regarding glucosamine sulfate there are differences between the preparations available today - added Prof Reginster. "Most preparations are highly unstable and should not be used; there are many fake, supposedly 'stabilised' preparations that are simply glucosamine hydrochloride and sodium sulfate combined. To have an effective treatment, the molecule needs to be stabilized as in the patented crystalline glucosamine sulfate formulation. Only this stabilised molecule reaches therapeutically effective levels in the plasma and synovial fluid and has demonstrated efficacy in clinical trials. In view of the progressive nature of OA, it would not be ethical for a professional to prescribe an unstable formulation of glucosamine, since it is known that no benefit for the patient will result at the end of the treatment."
CONCLUSIONS
An important step towards harmonization of different treatment modalities has been done in this consensus meeting: the task force agreed on differentiating between the clinically proven, prescription-only formulation of patented crystalline glucosamine sulfate and other preparations of glucosamine.
Based on clinical evidences, patented crystalline glucosamine sulfate:
- is more effective on pain and function,
- may delay the progression of the disease,
and therefore, is superior to other glucosamines on the market. Only pCGS remains stable and reliably delivers pharmacologically effective concentrations of glucosamine both in plasma and in the joints. When prescribing first line OA treatment, physicians should consider pCGS as the best option.
Share this article