Clinical and biochemical study of the comparative efficacy of topical versus oral glucosamine/chondroitin sulfate on osteoarthritis of the knee

The aim of this study was to detect and compare the efficacy of topical and oral glucosamine/chondroitin sulfate on knee OA (OAK), and to prove their efficacy on sparing the articular cartilage among the Egyptian patients. 180 patients with OAK were included and randomly divided into 2 groups, each of 90 patients. One group took 1500 mg oral glucosamine/chondroitin sulfate and the other group used topical glucosamine/chondroitin sulfate for 3 months. The diagnosis was based on the American College of Rheumatology (ACR) criteria for OAK. Age, duration of OA, and body mass index (BMI) of the patients were recorded. Knee radiographs were assessed with the Kellgren–Lawrence scale. The severity of knee pain, stiffness, and disability were measured using the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The serum C-reactive protein (CRP) and Cartilage oligomeric matrix protein changes (COMP) were measured. No statistical difference was found between the 2 groups regarding age, sex, duration of OA, and Kellgren–Lawrence grading scale. Both VAS and WOMAC subscores showed significant equal relief of pain and joint function between the 2 groups regardless of the severity or duration of knee OA. Topical glucosamine was superior to the oral route in improving stiffness and function. Topical and oral glucosamine/chondroitin sulfate are safe and equally effective on improving knee pain, stiffness and function. Glucosamine/chondroitin sulfate is beneficial as a symptomatic treatment and not as a cartilage sparing drug in the treatment of OAK.