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Chondroitin sulfate, glucosamine and hyaluronic acid (HA) applied for the treatment of arthrosis (osteoarthritis) are designated as chondroprotective agents. There is evidence in favor of their effectiveness. However, some recent reviews questioned it, while it was noticed that later publications tended to be less positive than older industry-sponsored trials. For intraarticular injections predominantly HA is used. Clinical efficacy of intraarcticular injections and significance of the difference from placebo has been questioned as well. Moreover, no plausible explanation has been found for the discrepancy between the short intraarticular half-life of injected HA and reported long duaration of the positive effect (6-9 months) after a course of intraarticular injections. Chondroprotective agents are administered to osteoarthritis patients, including pensioners and citizens with low incomes, who purchase them for a prolonged use. It must be largely equivalent to recommend them, instead of peroral drugs or dietary supplements, a diet modification with consumption of more food containing natural glycosaminoglycans. More comprehensive analysis of literature is required in the process of registration of drugs and dietary supplements.

About the authors

S. V. Jargin

Российский университет дружбы народов

Author for correspondence.
Email: sjargin@mail.ru
к.м.н., доцент кафедры фармакологии Russian Federation


  1. Заводовский Б.В. Связь между уровнем антител к гликозаминогликанам хряща у пациентов с остеоратрозом и эффективность лечения хондропротекторами/Б.В. Заводовский, Е.А. Коваленко [и др.]//Тер. архив. -1999. -№ 5. -С. 47-50.
  2. Ленинджер А.Л. Основы биохимии: пер. с англ.; под ред. В.А. Энгельгарта, Я.М. Варшавского. -М.: Мир, 1985 -798 с.
  3. Серов В.В. Соединительная ткань/В.В. Серов, А.Б. Шехтер. -М.: Медицина, 1981. -312 с.
  4. Шмидт Е.И. Опыт применения структума у больных ревматоидным артритом/Е.И. Шмидт, И.В. Белозерова, Ф.М. Ахмеджанов, Д.Г. Солдатов//Тер. архив. -2004. -№ 11. -С. 93-95.
  5. Adebowale A. The bioavailability and pharmacokinetics of glucosamine hydrochloride and low molecular weight chondroitin sulfate after single and multiple doses to beagle dogs/A. Adebowale [et al.]//Biopharm. Drug Dispos. -2002. -Vol. 23. -P. 217-225. 6.
  6. Altaian R.D. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group // R.D. Altaian, R. Moskowitz // J Rheumatol. 1998. -Vol.25. - P. 2203-2212.
  7. Arrich J. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and metaanalysis/J. Arrich [et al.]//CMAJ. -2005. -Vol. 172. -P. 1039-1043.
  8. Bannuru R.R. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis/R.R. Bannuru [et al.]//Arthritis Rheum. -2009. -Vol.61. -P. 1704-1711.
  9. Black C. The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation/C. Black, C. Clar, R. Henderson [et al.]//Health Technol. Assess. -2009. -Vol. 13. -P. 1 -148.
  10. Block J.A. The effects of oral glucosamine on joint health: is a change in research approach needed?/J.A. Block, T.R. Oegema, J.D. Sandy, A. Plaas//Osteoarthritis Cartilage. -2010. -Vol. 18. -P. 5-11.
  11. Brandt K.D. Intraarticular injection of hyaluronan as treatment for knee osteoarthritis: what is the evidence?/K.D. Brandt, G.N. Smith Jr., L.S. Simon//Arthritis Rheum. -2000. -Vol. 43. -P. 1192-1203.
  12. Distler J. Evidence-based practice: review of clinical evidence on the efficacy of glucosamine and chondroitin in the treatment of osteoarthritis/J. Distler, A. Anguelouch//J. Am. Acad. Nurse Pract. -2006. -Vol. 18. -P. 487-493. 7. 7. ТРАВМАТОЛОГИЯ И ОРТОПЕДИЯ РОССИИ 3 (57) -2010
  13. Dougados M. Symptomatic slow-acting drugs for osteoarthritis: what are the facts ?/M. Dougados//Joint Bone Spine. -2006. -Vol. 73. -P. 606-609.
  14. Evanich J.D. Efficacy of intraarticular hyaluronic acid injections in knee osteoarthritis/J.D. Evanich, C.J. Evanich, M.B. Wright, J.A. Rydlewicz//Clin Orthop. -2001. -N390. -P. 173-181.
  15. Fox B.A. Glucosamine hydrochloride for the treatment of osteoarthritis symptoms/B.A. Fox, M.M. Stephens//Clin. Interv. Aging. -2007. -Vol. 2. -P. 599-604.
  16. Gouze J.N. Exogenous glucosamine globally protects chondrocytes from the arthritogenic effects of IL-l beta/J.N. Gouze [et al.]//Arthritis Res. Ther. -2006. -Vol. 8. -P. R173.
  17. Juni P. Efficacy and safety of intraarticular hylan or hyaluronic acids for osteoarthritis of the knee: a randomized controlled trial // P. Juni [et al.] // Arthritis Rheum. - 2007. - Vol. 56. - P. 3610-3619.
  18. Kirkham S.G. Review article: Glucosamine/S.G. Kirkham, R.K. Samarasinghe//J. Orthop. Surg. (Hong Kong). -2009. -Vol. 17. -P. 72-76.
  19. Kubo M. Chondroitin sulfate for the treatment of hip and knee osteoarthritis: current status and future trends/M. Kubo [et al.]//Life Sci. -2009. -Vol. 85. -P. 477 -483.
  20. Lo G.H. Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis/G.H. Lo, M. LaValley, T. McAlindon, D.T. Felson.//JAMA. -2003. -Vol.290. -P. 3115-3121.
  21. Lohmander L.S. Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee: a randomised, double blind, placebo controlled multicentre trial. Hyaluronan Multicentre Trial Group/L.S. Lohmander [et al.]//Ann Rheum Dis. -1996; Vol. 55. -P. 424-431.
  22. Lozada C.J. Glucosamine in osteoarthritis: guestions remain/C.J. Lozada//Cleve Clin. J. Med. -2007. -Vol.74. -P. 65-71.
  23. Matheu V. Immediate-hypersensitivity reaction to glucosamine sulfate/V. Matheu [et al.]//Allergy. -1999. -Vol. 54. -P. R643.
  24. McAlindon T. Why are clinical trials of glucosamine no longer uniformly positive? T. McAlindon // Rheum. Dis. Clin. North Am. - 2003. - Vol. 29. - P. 789-801.
  25. Morris J.D. Chondroitin sulfate in osteoarthritis therapy / J.D. Morris, K.M. Smith // Orthopedics. - 2009. -Vol. 32. // Режим доступа: http://orthosupersite.com/view.asp?rID=38352 .
  26. Reginster J.Y. Current role of glucosamine in the treatment of osteoarthritis/J.Y. Reginster, О Bruyere, A. Neuprez//Rheumatology (Oxford). -2007. -Vol. 46. -P. 731-735.
  27. Samson D.J. Treatment of prirnary and secondary osteoarthritis of the knee/D.J. Samson [et al.]//Evid. Rep. Technol. Assess (Full Rep). -2007. -N 157. -P. 1-157. (http://www.ahrq.gov/clinic/tp/oakneetp.htm)
  28. Snibbe J.C. Use of injections for osteoarthritis in joints and sports activity/J.C. Snibbe, R.A. Gambardella//Clin. Sports Med. -2005. -Vol. 24. -P. 83-91.
  29. Skwara A. Gait patterns after intraarticular treatment of patients with osteoarthritis of the knee -hyaluronan versus triamcinolone: a prospective, randomized, doubleblind, monocentric study/A. Skwara [et al.]//Eur. J. Med. Res. 2009. -Vol. 14. -P. 157-164.
  30. Tallia A.F. Asthma exacerbation associated with glucosamine-chondroitin supplement/A.F. Tallia, D.A. Cardone//J. Am. Board Fam. Pract. -2002. -Vol. 15. -p. 481-484.
  31. Uebelhart D. Clinical review of chondroitin sulfate in osteoarthritis/D. Uebelhart//Osteoarthritis Cartilage. -2008. -Vol. 16. -Suppl. 3. -P. S19-21.
  32. Vangsness Jr., C.T. A review of evidence-based medicine for glucosamine and chondroitin sulfate use in knee osteoarthritis/C.T. Vangsness Jr., W. Spiker, J. Erickson//Arthroscopy -2009. -Vol. 25. -P. 86-94.
  33. Vlad S.C. Glucosamine for pain in osteoarthritis: why do trial results differ?/S.C. Vlad, M.P. LaValley, Т.Е. McAlindon, D.T. Felson//Arthritis Rheum. -2007. -Vol. 56. -P. 2267-2277.
  34. Volpi N. Quality of different chondroitin sulfate preparations in relation to their therapeutic activity/N. Volpi//J. Pharm. Pharmacol. -2009. -Vol. 61. -P. 1271 -1280.

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