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Title: Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations will optimize osteoarthritis treatment
Authors: Sukit Saengnipanthkul
Saranatra Waikakul
Sattaya Rojanasthien
Kitti Totemchokchyakarn
Attarit Srinkapaibulaya
Tai Cheh Chin
Nguyen Mai Hong
Olivier Bruyère
Cyrus Cooper
Jean Yves Reginster
Myat Lwin
Bach Mai Hospital
Faculty of Medicine, Chiang Mai University
Chulalongkorn University
University of Oxford
Faculty of Medicine, Khon Kaen University
MRC Lifecourse Epidemiology Unit
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Universite de Liege
Ara Damansara Medical Center Sdn Bhd
Yangon Orthopedic Hospital
Keywords: Medicine
Issue Date: 1-Mar-2019
Citation: International Journal of Rheumatic Diseases. Vol.22, No.3 (2019), 376-385
Abstract: © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd 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 joint structural changes. Among SYSADOAs, 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 μmol/L required to inhibit interleukin-1-induced expression of genes involved in the pathophysiology of joint inflammation and tissue destruction. Careful consideration of the evidence base reveals that only pCGS reliably provides 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 for pain reduction. Chronic administration of pCGS has disease-modifying effects, with a reduction in need for total joint replacement lasting for 5 years after treatment cessation. Pharmacoeconomic studies of pCGS demonstrate long-term reduction in additional pain analgesia and NSAIDs, with a 50% reduction in costs of other OA medication and healthcare consultations. Consequently, 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.
ISSN: 1756185X
Appears in Collections:Scopus 2019

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