WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Quartier Hôpital, Avenue Hippocrate 13, CHU B23, 4000, Liège, Belgium.
Chair for Biomarkers of Chronic Disorders, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
Aging Clin Exp Res. 2019 Aug;31(8):1163-1167. doi: 10.1007/s40520-019-01253-z. Epub 2019 Jun 26.
Osteoarthritis (OA) is the most prevalent musculoskeletal disease and a major cause of negative relevant outcomes, associated with an ever-increasing societal burden. Pharmaceutical-grade chondroitin sulfate (CS) was repeatedly reported to reduce pain and improve function in patients with knee OA. This treatment was also shown to be cost-effective, compared to placebo, up to 24 months. However, controversies still persist regarding the usefulness of CS for patients with knee OA, mainly due to inconsistent reports from various clinical trials. In this literature review, we aimed to summarize the main most recent findings on the efficacy and safety of CS in OA. Based on the results of studies presenting a low risk of bias, the most recent meta-analysis shows that only the pharmaceutical-grade CS may be considered as an appropriate background treatment for the management of knee OA. Evidence from another recent meta-analysis, using data from full safety reports, confirms the good safety profile of CS in OA. This new evidence on efficacy and safety suggests that recommendations for the use of CS in patients with knee OA cannot be extrapolated to other low-grade preparations as generics, nutraceutical-grade or over-the-counter preparations.
骨关节炎（OA）是最常见的肌肉骨骼疾病，也是导致负面相关结果的主要原因，与不断增加的社会负担有关。已多次报道，药用级硫酸软骨素（CS）可减轻膝骨关节炎患者的疼痛并改善其功能。与安慰剂相比，这种治疗方法在长达 24 个月的时间内具有成本效益。然而，由于来自不同临床试验的报告不一致，CS 对膝骨关节炎患者的有用性仍然存在争议。在这篇文献综述中，我们旨在总结 CS 在 OA 中的疗效和安全性的主要最新发现。基于呈现低偏倚风险的研究结果，最近的荟萃分析表明，只有药用级 CS 可被视为膝骨关节炎管理的适当背景治疗。另一个最近的荟萃分析使用来自完整安全报告的数据证实了 CS 在 OA 中的良好安全性特征。关于疗效和安全性的这一新证据表明，不能将 CS 在膝骨关节炎患者中的使用建议推广到其他低等级制剂，如仿制药级、营养保健品级或非处方制剂。
