High strength chondroitin sulfate has demonstrated superiority over celecoxib in reducing the progression of knee OA structural changes in an imaging study presented at ACR15.

The two- year double blind trial randomised 194 people with symptomatic OA to 1200mg of chondroitin sulfate daily or 200mg of celecoxib daily. 

The researchers performed MRIs to detect loss of cartilage, changes in bone marrow legions, and thickening of the synovial membrane in the knee.

Patients were also evaluated for swelling and fluid in the knee and their overall symptoms — collected through the visual analogue scale and Western Ontario and McMaster Universities Osteoarthritis Index; VAS and WOMAC, respectively.

At both one and two years, they found a better reduction of cartilage loss in the whole knee, and more particularly in the inner half, of the participants on chondroitin when compared to those on celecoxib.

Additionally, there was a decrease in synovial membrane thickness in some of the participants on chondroitin.

“These findings are most important as they demonstrate that chondroitin, in contrast to celecoxib, can reduce the loss of cartilage, at least in part, by reducing synovial inflammation (thickness),” said lead author Dr. Jean-Pierre Pelletiera a rheumatologist at Institut de recherche en rhumatologie de Montréal.

High dose chondroitin sulfate reduced the progression of knee OA to an extent that was “clinically meaningful” Dr Pelletier said in an interview with the US based news outlet Rheumatology News.

The difference between chondroiton and the comparator group [celecoxib] was meaningful enough to “likely have an impact on the long term outcome of the disease” he said.

Dr. Pelletier noted that the study only used pharmaceutical-grade chondroitin, and results may not be similar for all chondroitin products such as food supplements.

Bioibérica sponsored the study and makes the chondroitin sulfate that participants received.