LIEGE, Belgium, December 2, 2015 /PRNewswire/ --
A task force of the European Society for Clinical and
Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and
international KOLs has reached a consensus about implementing the
ESCEO algorithm in practice and about developing a consensus paper
on glucosamine, clearly differentiating between the
clinically-proven pCGS formulation and other clinically ineffective
glucosamine formulations.
Multiple guidelines for the management of osteoarthritis (OA) by
different Societies, are used in Europe, America and internationally.
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Despite availability of international evidence-based guidelines
for osteoarthritis management, agreement on the different treatment
modalities is still lacking.
The pharmacological treatment of osteoarthritis has
traditionally relied upon analgesics and anti-inflammatories, and
there is general agreement for the use of these classes of drugs
for pain management. Paracetamol is still largely recommended as a
first line treatment for pain in OA; however, there are increasing
concerns on its safety, including gastrointestinal side effects and
hepato-toxicity. Guidelines do not differentiate clearly between
clinically proven (evidence-based criteria and Cochrane Review)
and clinically non-proven formulations of glucosamine, with the
exception of the ESCEO algorithm, and this creates
inconsistency in recommendations given and confusion in
practice.
The ESCEO treatment algorithm recommends as an
alternative approach the use of symptomatic slow-acting drugs
for knee osteoarthritis (SYSADOAs), in which pCGS is included,
as background therapy with paracetamol as add-on rescue analgesia,
as needed. "The ESCEO algorithm - said Prof Jean-Yves Reginster, ESCEO co-founder and
President - recommends the use of SYSADOAs specifically patented
crystalline glucosamine sulfate and prescription chondroitin
sulfate as a first line treatment for OA; it is clear today that
not all the products are similar, and the discrepancies between
various guidelines simply reflect the fact that they do not
consider the same medications."
"Our first take home message from the meeting on which we are
all agreed, is that glucosamine hydrochloride is just a placebo.
All guidelines agree that glucosamine hydrochloride does not work.
This drug has never been shown to be effective in clinical trials;
there is not a single study in the literature that shows
glucosamine hydrochloride to be effective."
"Regarding glucosamine sulfate there are differences between the
preparations available today - added Prof Reginster. "Most
preparations are highly unstable and should not be used; there are
many fake, supposedly 'stabilised' preparations that are simply
glucosamine hydrochloride and sodium sulfate combined. To have an
effective treatment, the molecule needs to be stabilized as in the
patented crystalline glucosamine sulfate formulation. Only this
stabilised molecule reaches therapeutically effective levels in the
plasma and synovial fluid and has demonstrated efficacy in clinical
trials. In view of the progressive nature of OA, it would not be
ethical for a professional to prescribe an unstable formulation of
glucosamine, since it is known that no benefit for the patient will
result at the end of the treatment."
CONCLUSIONS
An important step towards harmonization of different treatment
modalities has been done in this consensus meeting: the task force
agreed on differentiating between the clinically proven,
prescription-only formulation of patented crystalline glucosamine
sulfate and other preparations of glucosamine.
Based on clinical evidences, patented crystalline
glucosamine sulfate:
- is more effective on pain and function,
- may delay the progression of the disease,
and therefore, is superior to other glucosamines on the
market. Only pCGS remains stable and reliably delivers
pharmacologically effective concentrations of glucosamine both in
plasma and in the joints. When prescribing first line OA treatment,
physicians should consider pCGS as the best option.