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Chondroitin Sulfate

What is Chondrotin Sulfate?

Chondroitin sulfate is a chemical that is normally found in cartilage around joints in the body. Chondroitin sulfate is manufactured from animal sources, such as cow cartilage.
 
Chondroitin sulfate is used for osteoarthritis. It is often used in combination with other products, including manganese ascorbate, glucosamine sulfate, glucosamine hydrochloride, or N-acetyl glucosamine. Research from a couple of decades ago showed that chondroitin sulfate helped arthritis pain when taken with conventional medicines, such as aspirin, for pain and swelling. 
 
Some people use chondroitin sulfate for heart disease, weak bones (osteoporosis), and high cholesterol. Chondroitin sulfate is also used in a complex with iron for treating iron-deficiency anemia.
 
Chondroitin sulfate is available as an eye drop for dry eyes. In addition, it is used during cataract surgery, and as a solution for preserving corneas used for transplants. It is approved by the FDA for these uses.
 
Some people with arthritis use ointments or skin creams for pain that contain chondroitin sulfate, in combination with glucosamine sulfate, shark cartilage, and camphor. But as far as we know, chondroitin sulfate isn’t absorbed through the skin. That would mean that any benefit from these creams and ointments is due to some other ingredient.
 
There is great variability among chondroitin and chondroitin plus glucosamine products. Some products contain no chondroitin despite label claims, while others contain more chondroitin than the label shows. Price isn’t always a guarantee of quality. Low-cost chondroitin products (less than $1 per 1200 mg chondroitin) seem to contain little chondroitin, but some higher-priced products may also contain less chondroitin than claimed.
 
Usage of Chondroitin Sulfate
 
Reducing pain from a type of arthritis called osteoarthritis, when taken by mouth. 
Osteoporosis (weak bones).
 
How does it work?
 
In osteoarthritis, the cartilage in the joints breaks down. Taking chondroitin sulfate, one of the building blocks of cartilage, might slow this breakdown.
 
References
 
Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine may potential the effect of warfarin. The Uppsala Monitoring Centre. Available at: www.who-umc.org/graphics/9722.pdf (Accessed 28 April 2008).
Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8.
Reichenbach S, Sterchi R, Scherer M, et al. Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Ann Intern Med 2007;146:580-90.
Messier SP, Mihalko S, Loeser RF, et al. Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study. Osteoarthritis Cartilage 2007;15:1256-66.
Kahan A. STOPP (STudy on Osteoarthritis Progression Prevention): a new two-year trial with chondroitin 4&6 sulfate (CS). Available at: www.ibsa-ch.com/eular_2006_amsterdam_vignon-2.pdf (Accessed 25 April 2007).
Huang J, Olivenstein R, Taha R, et al. Enhanced proteoglycan deposition in the airway wall of atopic asthmatics. Am J Respir Crit Care Med 1999;160:725-9.
Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808.
Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: A one-year, randomize, double-blind, multicenter study versus placebo. Osteoarthritis Cartilage 2004;12:269-76.
Sakko AJ, Ricciardelli C, Mayne K, et al. Modulation of prostate cancer cell attachment to matrix by versican. Cancer Res 2003;63:4786-91.
Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307.
Di Caro A, Perola E, Bartolini B, et al. Fractions of chemically oversulphated galactosaminoglycan sulphates inhibit three enveloped viruses: human immunodeficiency virus type 1, herpes simplex virus type 1 and human cytomegalovirus. Antivir Chem Chemother 1999;10:33-8.
Cohen M, Wolfe R, Mai T, Lewis D. A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. J Rheumatol 2003;30:523-8.
Baici A, Horler D, Moser B, et al. Analysis of glycosaminoglycans in human serum after oral administration of chondroitin sulfate. Rheumatol Int 1992;12:81-8.
Richy F, Bruyere O, Ethgen O, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003;163:1514-22.
Henry-Launois B. Evaluation of the use of financial impact of Chondrosulf 400 in current medical practice. Part of the Proceedings of a Scientific Symposium held at the XIth EULAR Symposium: New approaches in OA: Chondroitin sulfate (CS 4&6) not just a symptomatic treatment. Geneva, 1998.
Verbruggen G, Goemaere S, Veys EM. Systems to assess the progression of finger joint osteoarthritis and the effects of disease modifying osteoarthritis drugs. Clin Rheumatol 2002;21:231-43.
Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4.
Ricciardelli C, Quinn DI, Raymond WA, et al. Elevated levels of peritumoral chondroitin sulfate are predictive of poor prognosis in patients treated by radical prostatectomy for early-stage prostate cancer. Cancer Res 1999;59:2324-8.
Ylisastigui L, Bakri Y, Amzazi S, et al. Soluble glycosaminoglycans Do not potentiate RANTES antiviral activity on the infection of primary macrophages by human immunodeficiency virus type 1. Virology 2000;278:412-22.
Adebowale AO, Cox DS, Liang Z, et al. Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials. JANA 2000;3:37-44.
Cao LC, Boeve ER, de Bruijn WC, et al. Glycosaminoglycans and semisynthetic sulfated polysaccharides: an overview of their potential application in treatment of patients with urolithiasis. Urology 1997;50:173-83.
Morrison LM. Treatment of coronary arteriosclerotic heart disease with chondroitin sulfate-A: preliminary report. J Am Geriatr Soc 1968;16:779-85.
Morrison LM, Bajwa GS, Alfin-Slater RB, Ershoff BH. Prevention of vascular lesions by chondroitin sulfate A in the coronary artery and aorta of rats induced by a hypervitaminosis D, cholesterol-containing diet. Atherosclerosis 1972;16:105-18.
Mazieres B, Combe B, Phan Van A, et al. Chondroitin sulfate in osteoarthritis of the knee: a prospective, double blind, placebo controlled multicenter clinical study. J Rheumatol 2001;28:173-81.
Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage 2000;8:343-50.
Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Available at: www.nap.edu/books/0309072794/html/.
Pipitone VR. Chondroprotection with chondroitin sulfate. Drugs Exp Clin Res 1991;17:3-7 .
Leffler CT, Philippi AF, Leffler SG, et al. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med 1999;164:85-91.
Silvestro L, Lanzarotti E, Marchi E, et al. Human pharmacokinetics of glycosaminoglycans using deuterium-labeled and unlabeled substances: evidence for oral absorption. Semin Thromb Hemost 1994;20:281-92.
Ronca F, Palmieri L, Panicucci P, et al. Anti-inflammatory activity of chondroitin sulfate. Osteoarthritis Cartilage 1998;6 Suppl A:14-21.
Andermann G, Dietz M. The influence of the route of administration on the bioavailability of an endogenous macromolecule: chondroitin sulphate (CSA). Eur J Drug Metab Pharmacokinet 1982;7:11-6.
Conte A, de Bernardi M, Palmieri L, et al. Metabolic fate of exogenous chondroitin sulfate in man. Arzneimittelforschung 1991; 41:768-72.
McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 2000;283:1469-75.
Limberg MB, McCaa C, Kissling GE, Kaufman HE. Topical application of hyaluronic acid and chondroitin sulfate in the treatment of dry eyes. Am J Ophthalmol 1987;103:194-7.
Kelly GS. The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev 1998;3:27-39.
Bucsi L, Poor G. Efficacy and tolerability of oral chondroitin sulfate as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) in the treatment of knee osteoarthritis. Osteoarthritis Cartilage 1998;6 Suppl A:31-6.
Bourgeois P, Chales G, Dehais J, et al. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3 x 400 mg/day vs placebo. Osteoarthritis Cartilage 1998;6:25-30.
Uebelhart D, Thonar EJ, Delmas PD, et al. Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthritis Cartilage 1998;6:39-46.
Morrison LM, Enrick N. Coronary heart disease: reduction of death rate by chondroitin sulfate A. Angiology 1973;24:269-87.
Lewis CJ. Letter to reiterate certain public health and safety concerns to firms manufacturing or importing dietary supplements that contain specific bovine tissues. FDA. Available at: www.cfsan.fda.gov/~dms/dspltr05.html.
Leeb BF, Schweitzer H, Montag K, Smolen JS. A meta-analysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol 2000;27:205-11.
Bagasra O, Whittle P, Heins B, Pomerantz RJ. Anti-human immunodeficiency virus type 1 activity of sulfated monosaccharides: comparison with sulfated polysaccharides and other polyions. J Infect Dis 1991;164:1082-90.
Jurkiewicz E, Panse P, Jentsch KD, et al. In vitro anti-HIV-1 activity of chondroitin polysulphate. AIDS 1989;3:423-7.
Chavez ML. Glucosamine sulfate and chondroitin sulfates. Hosp Pharm 1997;32:1275-85.
Mazieres B, Loyau G, Menkes CJ, et al. [Chondroitin sulfate in the treatment of gonarthrosis and coxarthrosis. 5-months result of a multicenter double-blind controlled prospective study using placebo]. Rev Rhum Mal Osteoartic 1992;59:466-72.
Conrozier T. [Anti-arthrosis treatments: efficacy and tolerance of chondroitin sulfates]. Presse Med 1998;27:1862-5.
Morreale P, Manopulo R, Galati M, et al. Comparison of the anti-inflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis. J Rheumatol 1996;23:1385-91.
 

Chondroitin Sulfate

http://www.drwalt.com/blog/2011/10/16/study-finds-chondroitin-improves-pain-and-function-in-patients-with-arthritis/

Study finds chondroitin improves pain and function in patients with arthritis

Sunday, 16 October 2011

A prescription-grade formulation of chondroitin sulfate (Condrosulf) helped improve pain and function in patients with osteoarthritis (OA) of the hand, according to a single-center randomized study of 162 patients who had been suffering from OA for more than six years.

MedPage Today reports, ”The study was sponsored by Institut Biochimique SA, the manufacturer of the proprietary product used in the trial.”

The study found that “hand pain decreased significantly in patients receiving chondroitin sulfate” (CS) while “the effects of chondroitin seemed to be greater on function than pain.”

Researchers also noted that the results were similar to “earlier short-term trials evaluating drugs such as ibuprofen for hand OA.”

However, since chondroitin sulfate (CS) is significantly more expensive that glucosamine sulfate (GS), I usually recommend the latter first.

 

http://www.sciencedaily.com/releases/2011/09/110906085340.htm

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Chondroitin Sulfate Improves Hand Function, Relieves Morning Stiffness Caused by Osteoarthritis, Study Finds

Sep. 7, 2011 — New research shows that chondroitin sulfate significantly decreased pain and improved hand function in patients with osteoarthritis (OA) of the hand compared with those in the placebo group. Results of the clinical trial available in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR), also show that chondroitin sulfate improves grip strength and relieves morning stiffness.


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The ACR estimates that OA -- the most common form of arthritis -- affects more than 27 million adults in the U.S., causing joint pain and stiffness. Approximately 10% of the world population, 60 years and older, have symptomatic osteoarthritis according to the Global Burden of Disease 2000 report from the World Health Organization (WHO). Prior studies have found that 20% to 30% of adults have OA of the hand, with the prevalence rising to more than 50% after 60 years of age.

 

"Although hand OA is highly prevalent among adults and can significantly impact the quality of life for suffers, therapeutic options are still limited," said Cem Gabay, M.D., with University Hospitals of Geneva in Switzerland and lead investigation of the Finger osteoArthritis Chondroitin Treatment Study (FACTS).

 "There are few trials examining therapeutic approaches specific to hand OA and much of the available evidence has been extrapolated from studies investigating other forms of OA."

 

The single-center, placebo-controlled FACTS trial included 162 patients with radiographic hand OA who met inclusion criteria -- spontaneous hand pain on the visual analogue scale (VAS) of 40 mm (scale 0-100) or more and Functional Index for Hand OA (FIHOA) level of 6 (scale 0-30). Participants received either 800 mg of chondroitin sulfate (80 patients) or placebo (82 patients) once daily for 6 months.

 

Results showed that patients in the chondroitin sulfate group had significant decrease in global hand pain compared with the placebo group, reflecting an 8.7 decrease on the VAS. Hand function also improved significantly for those taking chondroitin sulfate, decreasing more than 2 points on the FIHOA. Researchers also reported significantly improved hand function and reduction in morning stiffness for participants taking chondroitin sulfate versus placebo.

 

"Our findings show chondroitin sulfate is a safe and effective treatment for patients with hand OA," concluded Dr. Gabay. "Alternative therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), provide similar pain reducing effects, but with considerably more long-term toxicities." Chondroitin sulfate is a naturally occurring molecule and a main component of joint cartilage. The chondroitin sulfate agent used in this study (Chondrosulf®) is licensed as a drug in Europe and not as a nutripharmaceutical; in the U.S. chondroitin sulfate is sold as a supplement and often paired with glucosamine.

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