Dispute about chondoprotectors

Disputes about chondroprotectors and https://pillintrip.com/ru/medicine/mucosolvan have been open since 2012, when experts from the American College of Rheumatology (ACR) excluded glucosamine and chondroitin from the recommendations for the treatment of osteoarthritis.

It is noteworthy that 2 weeks after the ACR guidelines, recommendations for the treatment of OA were issued in the United States for primary care physicians (therapists), in which both chondroitin and glucosamine were used. Since then, many studies have been conducted with rather conflicting results.

Different duration and dose of therapy, combination with NSAIDs or monotherapy with chondroitin / glucosamine or a combination thereof; patients with different stages of OA and the severity of pain, different duration of therapy and observation – from such a wide variety, completely different conclusions can be drawn, including or excluding certain criteria …

In many studies, the efficacy was assessed using scales and patient questionnaires, quite subjectively, in some, using X-ray dynamics, it is difficult to reproduce (try to take pictures of the knee 2 times exactly the same).

Taking cartilage for a biopsy and watching how people like it in “before and after” advertising is costly and traumatic (Would you agree?) But recently such a cool method as MRI mapping of cartilage has appeared. Objective, non-invasive and reproducible.
This method was already used by Professor Jean Pierre Peletier, Canada (by the way, the former founder and later president of OARSI 1996-1998).
It assessed the effectiveness of the combination of cholesterol and GA in terms of maintaining the volume and quality of cartilage on MRI. Positive results were obtained after 2 years of use.

In earlier studies, it is important that long-term and systematic use of chondroprotectors not only reduced inflammation and pain, but also the risks of joint replacement.

In 2016, Prof. Hockberg (who excluded CP from the ACR recommendations in 2012) conducted a multicenter study of patients with OA grade 2-3, in which the effectiveness of the analgesic and anti-inflammatory action of 1.2 g of cholesterol + 1.5 g of GA was equal in effectiveness to 200 mg of celecoxib by 6 months reception.

And Prof. Rogester conducted a review in which the combination showed a lower efficiency than monotherariya.

As you can see, there are so many contradictions!

Even international communities cannot come to a consensus: some are in favor, others are against. Although, if you think about it, the same reviews and meta-analyzes are analyzed.

How is it that OARSI does not recommend chondroitin and glucosamine, and ESCEO, through analysis of the same material, comes to the opposite conclusion? Probably different criteria, tolerances and endpoints are used.

In my opinion, the more studies with understandable and objective MRI mapping, the clearer it will become, which of the societies for the study of OA is closer to the truth.