Oral Glucosamine Found No More Effective Than Placebo For Osteoarthritis Pain

MedicalResearch.com Interview with:

Jos Runhaar, PhD Erasmus MC Department of General Practice Rotterdam The Netherlands

Dr. Runhaar

Jos Runhaar, PhD
Erasmus MC
Department of General Practice
Rotterdam
The Netherlands 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Most international guidelines report an overall lack of efficacy of glucosamine for osteoarthrits. We however know that it is a very heterogeneous disease. Therefore, it is possible that there are certain subgroups of osteoarthritis patients that actually might have effect from glucosamine; for instance subgroups based on different pathologies underlying the clinical presentation, different co-morbidities, or different disease stages.

For investigating efficacy in subgroups large sample sizes are needed, and certain methodological techniques are necessary, to get a valid and robust answer. Several years ago, a group of renowned international osteoarthritis researchers started the OA Trial Bank especially for investigating these subgroup effects of osteoarthritis treatments and collect individual patient data of worldwide-performed intervention studies in osteoarthritis patients. When using the individual patient data of multiple studies, it brings us the large sample size and allows us to use the right methods. We do these subgroup analyses in the OA Trial Bank for many different interventions, not just for glucosamine. The subgroup analyses for glucosamine and for corticosteroid injections are published, the others are ongoing (for instance exercise, orthoses and topicals) or planned and still waiting for funding.

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Pharmaceutical Grade Chondroitin Sulfate As First-Line Treatment of Osteoarthritis

MedicalResearch.com Interview with:

Jean-Yves Reginster M.D.,PH.D. Professor of Epidemiology, Public Health and Health Economics Head of the Bone and Cartilage Metabolism Unit University of Liège

Dr. Reginster

Jean-Yves Reginster M.D.,PH.D.
Professor of Epidemiology, Public Health and Health Economics
Head of the Bone and Cartilage Metabolism Unit
University of Liège

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Whereas several recommendations, issued by scientific societies, recommend to use Symptom-Modifying Slow Acting Drugs (SYSADOAs) for the symptomatic and structural management of osteoarthritis, no medication is currently registered, in this particular indication, by the European Medicines Agency (EMA) or by the Food and Drug Administration (FDA).

This study is the first study, conducted, with a SYSADOA which fully complies with the requirements of the EMA for the assessment of drugs to be used in the treatment of osteoarthritis, i.e. a six-month duration, two co-primary endpoints (pain and function) and a three-arm design, with a placebo and an active comparator. The main findings are that pharmaceutical grade chondroitin sulfate provides an improvement in pain and function, which is greater than placebo and not distinguishable from celecoxib, a non-steroidal anti-inflammatory drug currently licensed for the symptomatic management of osteoarthritis.

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Lifetime Risk of Symptomatic Hand Osteoarthritis Higher in Whites

MedicalResearch.com Interview with:

Jin Qin, ScD, MS Epidemiologist Centers for Disease Control and Prevention Chamblee, GA 30341

Dr. Jin Qin

Jin Qin, ScD, MS
Epidemiologist
Centers for Disease Control and Prevention
Chamblee, GA 30341 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The hand is one of the sites most commonly affected by osteoarthritis (OA) but is often understudied compared with knee and hip OA. Many people with hand OA have significant symptoms, impaired hand strength and function, and disability in activities of daily living, like using a smart phone or a computer keyboard, and opening a jar. Lifetime risk is the probability of developing a condition over the course of a lifetime.

In this study, we estimated that 40% of adults will develop symptomatic hand OA in their lifetimes. Nearly one in two women (47%) and one in four men (25%) will develop the condition. Whites have a 41% lifetime risk, compared with 29% for blacks. The lifetime risk among individuals with obesity is 47%, which is 11 percentage points higher than those without obesity.

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Noisy Knees May Indicate Risk of Osteoarthritis

MedicalResearch.com Interview with:

Grace H. Lo MD MSc Department of Medicine, Baylor College of Medicine Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey Medical Center, Houston, TX

Dr. Grace H. Lo

Grace H. Lo MD MSc
Department of Medicine, Baylor College of Medicine
Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety
Michael E. DeBakey Medical Center, Houston, TX

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Osteoarthritis is the most common form of arthritis. Many people who have signs of osteoarthritis on x-rays do not necessarily complain of pain. Presently, there are no known strategies for preventing the development of pain in this group of people.

This study suggests that if these people have noisy knees (otherwise known as “crepitus”), they are at higher risk for developing pain within the next year compared to the people who do not have noisy knees. Future studies that target people who have x-ray signs of osteoarthritis, who do not complain of pain, but do report noisy knees, hold the promise of identifying interventions that can prevent knee pain.

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Earlier Onset of Arthritis in More Recent Generations Linked to Obesity

MedicalResearch.com Interview with:

Elizabeth Badley PhD Professor Emeritus Dalla Lana School of Public Health, University of Toronto Director: The Arthritis Community Research and Evaluation Unit and Head, Division of Health Care and Outcomes Research Krembil Research Institute Toronto Western Hospital Toronto, Ontario

Dr. Elizabeth Badley

Elizabeth Badley PhD Professor Emeritus
Dalla Lana School of Public Health, University of Toronto
Director: The Arthritis Community Research and Evaluation Unit and
Head, Division of Health Care and Outcomes Research
Krembil Research Institute
Toronto Western Hospital
Toronto, Ontario 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The aging of the baby boomer population is focusing attention on the health experience of this sector of the population.  Arthritis is one of the most frequent chronic health problems in the population.  Our research question was to investigate whether the prevalence of arthritis differs between generations (also called birth cohorts) and what might be associated with any differences. Using data collected in a longitudinal Canadian population health survey between 1994 and 2011, we looked at 4 generations: the World War II generation born 1935-1944, older baby boomers born 1945-1954, younger baby boomers born 1955-64, and Generation X born 1965-1974.
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Musculoskeletal Symptoms May Mark Onset of Arthritis in Psoriasis Patients

MedicalResearch.com Interview with:

Lihi Eder MD PhD Rheumatologist, Women’s College Hospital Scientist, Women’s College Research Institute Assistant Professor of Medicine, University of Toronto Toronto, ON, Canada

Dr. Lihi Eder

Lihi Eder MD PhD
Rheumatologist, Women’s College Hospital
Scientist, Women’s College Research Institute
Assistant Professor of Medicine, University of Toronto
Toronto, ON, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There significant delays in the diagnosis of psoriatic arthritis (PsA) among patients with psoriasis. Many patients with psoriasis experience musculoskeletal symptoms. The majority of them do not have PsA, but other non-inflammatory conditions such as fibromyalgia or osteoarthritis.

In this study, we aimed to assess whether the presence and the degree of musculoskeletal symptoms in psoriasis patients predict the development of psoriatic arthritis. We analyzed a cohort of 410 psoriasis patients who were followed over a period of 9 years. These patients did not have arthritis at baseline. The patients were assessed annually by a rheumatologist for signs of PsA. A total of 57 patients developed psoriatic arthritis during the follow-up period.
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Weak Thigh Muscles Contribute to Knee Arthritis in Women

MedicalResearch.com Interview with:

Adam Culvenor, PT, PhD

Dr. Adam Culvenor

Adam Culvenor, PT, PhD
Research Fellow,Institute of Anatomy
Paracelsus Medizinische Privatuniversität
Strubergasse Salzburg, Austria

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Thigh muscle weakness, particularly of the knee extensors (quadriceps), is a common feature of people with knee osteoarthritis. Thigh muscle weakness could be a consequence of knee osteoarthritis, or precede knee osteoarthritis development. There is conflicting evidence regarding the role of thigh muscle weakness as a risk factor for incident knee osteoarthritis in both men and women. Thigh muscle specific strength is a measure of muscle quality incorporating both the capacity of the muscle to produce force as well as muscle structure (ie. size, cross-sectional area), and preliminary data suggests this may be a more relevant measure of strength in relation to knee osteoarthritis development.

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Intestinal E. coli Linked to Arthritis in Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Randy Longman, M.D. / Ph.D. Assistant Professor of Medicine Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease Weill Cornell Medicine Division of Gastroenterology and Hepatology Joan and Sanford I. Weill Department of Medicine Department of Microbiology and Immunology New York, NY 10021

Dr. Randy Longman

Randy Longman, M.D. / Ph.D.
Assistant Professor of Medicine
Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease
Weill Cornell Medicine
Division of Gastroenterology and Hepatology
Joan and Sanford I. Weill Department of Medicine
Department of Microbiology and Immunology
New York, NY 10021 

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Inflammatory bowel disease is not limited to intestinal inflammation.  Up to 1/3 of patients with active disease suffer from extra-intestinal manifestations.

The most common extra-intestinal manifestations in IBD is joint inflammation or spondyloarthritis.  Peripheral joint spondyloarthritis  carries a prevalence of 20% in Crohn’s Disease and 10% in Ulcerative Colitis, predominantly affecting joints of the lower limbs.  It has long been suggested that gut bacteria can drive this systemic joint inflammation, but microbial targets have not been characterized.

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45 Minutes of Exercise Per Week Maintains Function in Adults With Arthritis

MedicalResearch.com Interview with:

Dorothy D. Dunlop Ph.D. Professor of Medicine and Preventive Medicine Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine Center for Healthcare Studies Chicago, IL 60611

Dr. Dorothy Dunlop

Dorothy D. Dunlop Ph.D.
Professor of Medicine and Preventive Medicine
Northwestern University Feinberg School of Medicine
Institute for Public Health and Medicine
Center for Healthcare Studies
Chicago, IL 60611 

MedicalResearch.com: What is the background for this study?

 

  • We know is being active is good for health.
  • Good evidence supports the current federal guidelines of doing 150 minutes of moderate physical activity each week to prevent serious conditions such as heart disease
  • But only 1 in 10 older US adults with arthritis in their lower limb joints (e.g., knees) meet federal physical activity guidelines
  • Inadequate physical activity is a major public health concern because It can lead to poor function, which threatens a person’s ability to live independently.

These issues motivated our study to investigate the minimum time commitment needed to improve function (or sustain high function) for adults with lower joint osteoarthritis.

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Juvenile Arthritis: TNF Inhibitor Use Doesn’t Appear To Increase Malignancy Risk

MedicalResearch.com Interview with:

Timothy Beukelman, MD, MSCE Associate Professor of Pediatrics Division of Rheumatology and Division of Clinical Immunology & Rheumatology University of Alabama at Birmingham

Dr. Timothy Beukelman

Timothy Beukelman, MD, MSCE
Associate Professor of Pediatrics
Division of Rheumatology and
Division of Clinical Immunology & Rheumatology
University of Alabama at Birmingham

MedicalResearch.com: What is the background for this study?

Response: In 2009 the US FDA issued a boxed warning about malignancies reported in children treated with TNF inhibitors but their analysis did not account for a possible malignancy risk from other medications of from the Juvenile idiopathic arthritis (JIA) disease process itself.

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