Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Chondroitin Sulfate Treatment Is Effective at Reducing Cartilage Loss in the Tibiofemoral Compartment in Knee OA as Assessed by Magnetic Resonance Imaging (MRI).

Pelletier8,  Jean-Pierre, Wildi5,  Lukas M., Raynauld5,  Jean-Pierre, Beaulieu3,  André, Bessette4,  Louis, Morin1,  Frédéric, Abram6,  François

Centre de Recherche Musculo-squelettique, Trois-Rivières
CR-CHUM, Notre-Dame Hospital, Montreal, QC, Canada
Faculty of Medicine, University of Laval, QC
Groupe de Recherche en Rhumatologie et Maladies Osseuses, Sainte-Foy
Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Notre-Dame Hospital
Research and Development, ArthroVision Inc., Montreal
StatSciences Inc., Notre-Dame de l'Ile-Perrot
University of Montreal Hospital Research Centre (CRCHUM), Notre-Dame Hospital, Montreal, QC, Canada

Background:

The osteoarthritis (OA) disease-modifying effect of chondroitin sulfate (CS) has been demonstrated by X-ray in knee OA after two years of treatment [1,2]. We further explored by performing a randomized, double-blind, placebo-controlled study using a more sensitive imaging technique, quantitative MRI, the effect of CS treatment on cartilage volume loss in knee OA. We also investigated, for the first time, the effect of CS on bone marrow lesion (BML) size and the severity of synovitis.

Methods:

Knee OA patients were treated with CS (800 mg once daily) or placebo for 6 months, followed by an open-label period of 6 months in which patients from both groups received CS. Patients with primary knee OA, Kellgren-Lawrence grades 2–3, and clinical as well as MRI signs of synovitis were included. MRI was performed at baseline, 6, and 12 months. Global cartilage volume and sub-regions were quantified using a specially developed computer program. The BML size was assessed using a semi-quantitative scoring system. Synovial membrane thickness (synovitis) was measured in mm, and joint swelling incidence was evaluated. Statistical analyses were assessed by ANCOVA for the cartilage volume, Wilcoxon Mann-Whitney tests for BML, ANOVA for synovitis, and Fisher's exact test for joint swelling.

Results:

Knee OA patients were treated with CS (n=35) or placebo (n=34). Patients on CS treatment (12 months CS) compared to the patients in the placebo group (6 months placebo followed by 6 months CS) experienced a significant reduction in global cartilage volume loss at 6 (p=0.064 for a trend) and 12 (p=0.025) months, in the lateral tibiofemoral compartment (p=0.015; p=0.004), as well as in the tibial plateau (p=0.002; p=0.017). Interestingly, there was also a reduction in BML score in the global knee and lateral tibiofemoral compartment at 12 months (p=0.060; p=0.035, respectively). Although there was no statistically significant difference in synovial thickness between the 2 treatment groups at 6 months, discrimination between patients showed that those who received concomitant NSAID treatment demonstrated a statistically significant reduction in the CS group compared to the placebo group (p=0.029), as well as lower incidence of joint swelling (p=0.092).

Conclusion:

Data showed that CS treatment can rapidly and significantly reduce the cartilage loss in symptomatic knee OA patients. This protective effect was associated with a decrease in BML size, supporting their role in cartilage loss. Moreover, data revealed that CS in combination with NSAIDs exerts an additional clinically relevant anti-inflammatory activity.

References:

1.Michel, BA, et al. Arthritis Rheum. 2005; 52: 779–86.

2.Kahan, A, et al. Arthritis Rheum. 2009; 60: 524–33.

To cite this abstract, please use the following information:
Pelletier, Jean-Pierre, Wildi, Lukas M., Raynauld, Jean-Pierre, Beaulieu, André, Bessette, Louis, Morin, Frédéric, et al; Chondroitin Sulfate Treatment Is Effective at Reducing Cartilage Loss in the Tibiofemoral Compartment in Knee OA as Assessed by Magnetic Resonance Imaging (MRI). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :938
DOI: 10.1002/art.28706

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