Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations can optimize osteoarthritis management

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Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations can optimize osteoarthritis management
Key Take-Away: 

Symptomatic slow-acting drugs like glucosamine sulfate is proved to be a robust management strategy in osteoarthritis. It has been elucidated in the presented evidence based study that patented crystalline glucosamine sulfate can be a better treatment regimen as compared to its derivatives, and this distinction will help to improve patient selection and adherence. Patented crystalline glucosamine sulfate (pCGS) formulation is the logical choice, with demonstrated medium-term control of pain and lasting impact on disease progression for long-term management of knee osteoarthritis.

Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium- to long-term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay the joint damage.

ABSTRACT: 
Background: 

Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium- to long-term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay the joint damage. Among SYSADOAs, the evidence is greatest for the patented crystalline glucosamine sulfate (pCGS) formulation (Mylan).

Glucosamine is widely available as glucosamine sulfate (GS) and glucosamine hydrochloride (GH) preparations that vary substantially in molecular form, pharmaceutical formulation, and dose regimen. Only pCGS is given as a highly bioavailable once-daily dose (1500 mg), which consistently delivers the plasma levels of around 10 μ mol/L required to inhibit interleukin-1-induced expression of genes involved in the pathophysiology of joint inflammation and tissue destruction.

Methods: 

Careful consideration of the evidence base reveals that only pCGS can reliably provide a moderate effect size on pain that is higher than paracetamol and equivalent to non-steroidal anti-inflammatory drugs (NSAIDs), while non-crystalline GS and GH fail to reach statistical significance in reducing the pain.

Chronic administration of pCGS has disease-modifying effects, with a reduction in the need for total joint replacement lasting for 5 years after the treatment cessation. 

Results: 

Pharmacoeconomic studies of pCGS demonstrate a long-term reduction in additional pain analgesia and NSAIDs, with a 50% reduction in costs of other OA medication and healthcare consultations.

Conclusion: 

To summarize, pCGS is the logical choice, with demonstrated medium-term control of pain and lasting impact on disease progression.

Physician and patient education on the differentiation of pCGS from other glucosamine formulations will help to improve treatment selection, increase treatment adherence, and optimize clinical benefit in OA.

Source:

International Journal of Rheumatic Diseases

Link to the source:

http://onlinelibrary.wiley.com/doi/10.1111/1756-185X.13068/abstract

The original title of the article:

Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations will optimize osteoarthritis treatment

Authors:

Sukit Saengnipanthkul et al.

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