MESACA 研究：甲基磺酰甲烷和乳香酸治疗膝骨关节炎。

The "MESACA" study: methylsulfonylmethane and boswellic acids in the treatment of gonarthrosis.

机构信息

Department of Clinical Methodology and Medical-Surgical Technologies-Orthopaedics Section, University General Hospital, Bari, Italy.

出版信息

Adv Ther. 2011 Oct;28(10):894-906. doi: 10.1007/s12325-011-0068-3. Epub 2011 Oct 7.

DOI:10.1007/s12325-011-0068-3

PMID:21986780

Abstract

INTRODUCTION

Osteoarthritis is a chronic rheumatoid disease mediated by metalloproteinases and inflammatory cytokines. Methylsulfonylmethane (MSM) and boswellic acids (BA) each show promise in the treatment of inflammatory processes, but the efficacy of combined treatment with these substances in the treatment of arthritis has not yet been studied.

METHODS

In this prospective randomized clinical trial, MESACA (for "methylsulfonylmethane and boswellic acids in the treatment of knee arthritis"), 60 subjects affected by arthritis of the knee were randomly assigned to an experimental group treated for 60 days with 5 g of MSM and 7.2 mg of BA daily, or a control group which was administered a placebo. At 2 and 6 months follow-up (FU), the efficacy of combined treatment with these two dietary supplements was assessed using the visual analog pain scale (VAS) and the Lequesne index (LI) for joint function, as well as monitoring the use of anti-inflammatory drugs (nonsteroidal anti-inflammatory drugs and anti-cyclooxygenase-2).

RESULTS

Pain, assessed with the VAS scale, was worse in the group treated with MSM and BA as compared with the placebo group at 2 months FU (3.8 vs. 2.7; P=0.04), whereas no difference between the two groups was observed at 6 months FU (2.7 vs. 3.6; P=0.2). No statistically significant differences were found in the LI between the two groups at either FU (2 months: 4.8 vs. 4.2; P=0.51; 6 months: 4.4 vs. 4.5; P=0.91). By contrast, a statistically significant difference in patients need for anti-inflammatory drugs was seen in the experimental as compared to the placebo group, even by 2 months FU (0.2 vs. 0.6 tablets/day; P<0.0001), that persisted up to the end of the study (0.1 vs. 0.6 tablets/day; P<0.0001).

CONCLUSIONS

Although the combined administration of MSM and BA in the treatment of gonarthrosis was not shown to be more efficacious than placebo in the management of the clinical and functional picture, it significantly reduced patients need for anti-inflammatory drugs.

摘要

简介

骨关节炎是一种由金属蛋白酶和炎症细胞因子介导的慢性类风湿疾病。甲磺酰甲烷 (MSM) 和乳香酸 (BA) 在治疗炎症过程中都有一定的效果，但尚未研究这两种物质联合治疗关节炎的疗效。

方法

在这项前瞻性随机临床试验中，60 名膝关节关节炎患者被随机分为实验组和对照组，实验组在 60 天内每天接受 5 克 MSM 和 7.2 毫克 BA 的治疗，对照组则接受安慰剂治疗。在 2 个月和 6 个月的随访（FU）中，通过视觉模拟疼痛量表（VAS）和关节功能 Lequesne 指数（LI）评估联合使用这两种膳食补充剂的疗效，同时监测抗炎药物（非甾体抗炎药和环氧化酶-2 抑制剂）的使用情况。

结果

在 2 个月 FU 时，与安慰剂组相比，接受 MSM 和 BA 治疗的组的疼痛（用 VAS 量表评估）更严重（3.8 比 2.7；P=0.04），但在 6 个月 FU 时两组之间无差异（2.7 比 3.6；P=0.2）。在 FU 时两组之间 LI 无统计学差异（2 个月：4.8 比 4.2；P=0.51；6 个月：4.4 比 4.5；P=0.91）。相比之下，实验组患者对抗炎药物的需求与安慰剂组相比存在统计学差异，甚至在 2 个月 FU 时（0.2 比 0.6 片/天；P<0.0001），这种差异一直持续到研究结束（0.1 比 0.6 片/天；P<0.0001）。