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      Glucosamine and chondroitin sulfate in the repair of osteochondral defects in dogs - clinical-radiographic analysis Translated title: Sulfato de condroitina e glucosamina na reparação de defeitos osteocondrais em cães - análise clínico-radiográfica

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          Abstract

          Among the proposed treatments to repair lesions of degenerative joint disease (DJD), chondroprotective nutraceuticals composed by glucosamine and chondroitin sulfate are a non-invasive theraphy with properties that favors the health of the cartilage. Although used in human, it is also available for veterinary use with administration in the form of nutritional supplement independent of prescription, since they have registry only in the Inspection Service, which does not require safety and efficacy testing. The lack of such tests to prove efficacy and safety of veterinary medicines required by the Ministry of Agriculture and the lack of scientific studies proving its benefits raises doubts about the efficiency of the concentrations of such active substances. In this context, the objective of this study was to evaluate the efficacy of a veterinary chondroprotective nutraceutical based on chondroitin sulfate and glucosamine in the repair of osteochondral defects in lateral femoral condyle of 48 dogs, through clinical and radiographic analysis. The animals were divided into treatment group (TG) and control group (CG), so that only the TG received the nutraceutical every 24 hours at the rate recommended by the manufacturer. The results of the four treatment times (15, 30, 60 and 90 days) showed that the chondroprotective nutraceutical, in the rate, formulation and administration at the times used, did not improve clinical signs and radiologically did not influence in the repair process of the defects, since the treated and control groups showed similar radiographic findings at the end of the treatments.

          Translated abstract

          Dentre os tratamentos propostos para a doença articular degenerativa (DAD), os nutracêuticos condroprotetores à base de sulfato de condroitina constituem uma terapia não invasiva que favorece a manuteção da saúde da cartilagem. Além de utilizados em humanos, foram também disponibilizados para uso veterinário administrados na forma de suplemento nutricional independentemente de prescrição, uma vez que possuem somente o registro do Serviço de Inspeção Federal, que não exige testes de eficácia e segurança. A falta desses testes pelo Ministério da Agricultura para comprovação da eficácia e segurança de medicamentos veterinários e a carência de estudos científicos que comprovem seus benefícios geram dúvidas quanto à eficiência de tais substâncias ativas. Nesse contexto, o objetivo deste estudo foi avaliar a eficácia de um nutracêutico condroprotetor veterinário à base de sulfato de condroitina e glucosamina, na reparação de defeitos osteocondrais no côndilo femoral lateral de 48 cães, por meio de análises clínica e radiográfica. Os animais foram distribuídos em grupos tratado (GT) e controle (GC), de forma que somente o GT recebeu o nutracêutico a cada 24 horas na posologia recomendada pelo fabricante. Os resultados dos quatro tempos de tratamento utilizados (15, 30, 60 e 90 dias) mostraram que o produto na dose, formulação e no período de administração utilizados não proporcionou melhora dos sinais clínicos e não influenciou radiograficamente o processo de reparação dos defeitos, visto que os grupos tratado e controle apresentaram aspectos radiográficos idênticos ao término dos tratamentos.

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          Most cited references27

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          Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis.

          Glucosamine and chondroitin sulfate are used to treat osteoarthritis. The multicenter, double-blind, placebo- and celecoxib-controlled Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) evaluated their efficacy and safety as a treatment for knee pain from osteoarthritis. We randomly assigned 1583 patients with symptomatic knee osteoarthritis to receive 1500 mg of glucosamine daily, 1200 mg of chondroitin sulfate daily, both glucosamine and chondroitin sulfate, 200 mg of celecoxib daily, or placebo for 24 weeks. Up to 4000 mg of acetaminophen daily was allowed as rescue analgesia. Assignment was stratified according to the severity of knee pain (mild [N=1229] vs. moderate to severe [N=354]). The primary outcome measure was a 20 percent decrease in knee pain from baseline to week 24. The mean age of the patients was 59 years, and 64 percent were women. Overall, glucosamine and chondroitin sulfate were not significantly better than placebo in reducing knee pain by 20 percent. As compared with the rate of response to placebo (60.1 percent), the rate of response to glucosamine was 3.9 percentage points higher (P=0.30), the rate of response to chondroitin sulfate was 5.3 percentage points higher (P=0.17), and the rate of response to combined treatment was 6.5 percentage points higher (P=0.09). The rate of response in the celecoxib control group was 10.0 percentage points higher than that in the placebo control group (P=0.008). For patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo (79.2 percent vs. 54.3 percent, P=0.002). Adverse events were mild, infrequent, and evenly distributed among the groups. Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. (ClinicalTrials.gov number, NCT00032890.). Copyright 2006 Massachusetts Medical Society.
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            Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.

            Conventional symptomatic treatments for osteoarthritis do not favorably affect disease progression. The aim of this randomized, placebo-controlled trial was to determine whether long-term (3-year) treatment with glucosamine sulfate can modify the progression of joint structure and symptom changes in knee osteoarthritis, as previously suggested. Two hundred two patients with knee osteoarthritis (using American College of Rheumatology criteria) were randomized to receive oral glucosamine sulfate, 1500 mg once a day, or placebo. Changes in radiographic minimum joint space width were measured in the medial compartment of the tibiofemoral joint, and symptoms were assessed using the algo-functional indexes of Lequesne and WOMAC (Western Ontario and McMaster Universities). Osteoarthritis was of mild to moderate severity at enrollment, with average joint space widths of slightly less than 4 mm and a Lequesne index score of less than 9 points. Progressive joint space narrowing with placebo use was -0.19 mm (95% confidence interval, -0.29 to -0.09 mm) after 3 years. Conversely, there was no average change with glucosamine sulfate use (0.04 mm; 95% confidence interval, -0.06 to 0.14 mm), with a significant difference between groups (P =.001). Fewer patients treated with glucosamine sulfate experienced predefined severe narrowings (>0.5 mm): 5% vs 14% (P =.05). Symptoms improved modestly with placebo use but as much as 20% to 25% with glucosamine sulfate use, with significant final differences on the Lequesne index and the WOMAC total index and pain, function, and stiffness subscales. Safety was good and without differences between groups. Long-term treatment with glucosamine sulfate retarded the progression of knee osteoarthritis, possibly determining disease modification.
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              Cartilage in normal and osteoarthritis conditions.

              The preservation of articular cartilage depends on keeping the cartilage architecture intact. Cartilage strength and function depend on both the properties of the tissue and on their structural parameters. The main structural macromolecules are collagen and proteoglycans (aggrecan). During life, cartilage matrix turnover is mediated by a multitude of complex autocrine and paracrine anabolic and catabolic factors. These act on the chondrocytes and can lead to repair, remodeling or catabolic processes like those that occur in osteoarthritis. Osteoarthritis is characterized by degradation and loss of articular cartilage, subchondral bone remodeling, and, at the clinical stage of the disease, inflammation of the synovial membrane. The alterations in osteoarthritic cartilage are numerous and involve morphologic and metabolic changes in chondrocytes, as well as biochemical and structural alterations in the extracellular matrix macromolecules.
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                Author and article information

                Journal
                rceres
                Revista Ceres
                Rev. Ceres
                Universidade Federal de Viçosa (Viçosa, MG, Brazil )
                0034-737X
                2177-3491
                October 2012
                : 59
                : 5
                : 587-596
                Affiliations
                [01] Viçosa Minas Gerais orgnameUniversidade Federal de Viçosa orgdiv1Departamento de Veterinária Brazil
                [02] Viçosa Minas Gerais orgnameUnião de Ensino Superior de Viçosa Brazil
                Article
                S0034-737X2012000500003 S0034-737X(12)05900500003
                4ea9e4a8-e8b2-45c2-a6a1-b31c995a2fed

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 06 August 2012
                : 27 October 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 10
                Product

                SciELO Brazil

                Categories
                Clinical and Surgical Animal Medicine

                artrose,condroprotetor,nutracêutico,degenerative joint disease,osteoarthritis,arthrosis,chondroprotective,nutraceutical,doença articular degenerativa,osteoartrite

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