Efficacy of chondroprotective agents

Chondroprotective agents are substances capable of preventing, delaying, or reversing cartilage lesions due to osteoarthritis. Typically, aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) have been prescribed for pain relief in OA; their use is, however, associated with significant gastrotoxicity, and does not prevent joint deterioration. COX-2 inhibitors, while having fewer side effects, have recently been linked to cardiovascular complications. In the past several years, there have been reports of chondroprotective effects, as well as amelioration of pain, following intraarticular injection of hyaluronic acid derivatives or oral administration of the so-called nutraceuticals, glucosamine and chondroitin sulfate. Because no mechanism of action for these agents has been demonstrated and sample sizes in many clinical trials have been small, their use remains controversial. This review examines the most recent clinical studies of these therapeutic modalities.