Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial
Abstract: Glucosamine,
chondroitinsulfate are frequently used to prevent further joint degeneration in
osteoarthritis (OA). Methylsulfonylmethane (MSM) is a supplement containing
organic sulphur and also reported to slow anatomical joint progressivity in the
knee OA. The MSM is often combined with glucosamine and chondroitin sulfate.
However, there are controversies whether glucosamine-chondroitin sulfate or
their combination with methylsulfonylmethane could effectively reduce pain in
OA. This study is aimed to compare clinical outcome of glucosamine-chondroitin
sulfate (GC), glucosamine-chondroitin sulfate-methylsulfonylmethane (GCM), and
placeboin patients with knee osteoarthritis (OA) Kellgren-Lawrence grade I-II.
Methods: a double blind, randomized controlled clinical trial was conducted on
147 patients with knee OA Kellgren-Lawrence grade I-II. Patients were allocated
by permuted block randomization into three groups: GC (n=49), GCM (n=50), or
placebo (n=48) groups. GC group received 1500 mg of glucosamine + 1200 mg of
chondroitin sulfate + 500 mg of saccharumlactis; GCM group received 1500 mg of
glucosamine + 1200 mg of chondroitin sulfate + 500 mg of MSM; while placebo
group received three matching capsules of saccharumlactis. The drugs were
administered once daily for 3 consecutive months VAS and WOMAC scores were
measured before treatment, then at 4th, 8th and 12th week after treatment.
Results: on statistical analysis it was found that at the 12th week, there are
significant difference between three treatment groups on the WOMAC score
(p=0.03) and on the VAS score (p=0.004). When analyzed between weeks, GCM
treatment group was found statistically significant on WOMAC score (p=0.01) and
VAS score (p<0.001). Comparing the score difference between weeks, WOMAC
score analysis showed significant difference between GC, GCM, and placebo in
week 4 (p=0.049) and week 12 (p=0.01). In addition, VAS score also showed
significant difference between groups in week 8 (p=0.006) and week 12
(p<0.001). Conclusion: combination of
glucosamine-chondroitinsulfate-methylsulfonylmethane showed clinical benefit
for patients with knee OAK ellgren-Lawrence grade I-II compared with GC and
placebo. GC did not make clinical improvement in overall groups of patients
with knee OA Kellgren Lawrence grade I-II.
Keywords: Glucosamine;
chondroitin sulfate; methylsufonylmethane; osteoarthritis
Author: Andri M.T. Lubis,
Carles Siagian, Erick Wonggokusuma, Aldo F Marsetyo, Bambang Setyohadi
Journal Code: jpkedokterangg170322
