Open Access Open Access  Restricted Access Subscription Access

Oxaceprol Monotherapy versus Oxaceprol and Glucosamine Combination Therapy for Knee Osteoarthritis


Affiliations
1 Department of Pharmacology, Government Medical College,Patiala – 147001, Punjab, India
2 Department of Orthopaedics, Government Medical College, Patiala – 147001, Punjab, India
3 Department of Pharmacology, Government Medical College, Patiala – 147001, Punjab, India
 

Introduction: Osteoarthritis (OA) is the commonest form of arthritis which presents with joint pain and functional limitations. Oxaceprol, a derivative of hydroxyproline, inhibits leukocyte migration into the joints thus inhibiting inflammatory process. Oxaceprol also increases availability of Glucosamine and improving uptake of Glucosamine and Proline in chondrocytes. Aims and Objective: To demonstrate efficacy of Oxaceprol Monotherapy versus Oxaceprol and Glucosamine combination therapy in patients diagnosed with Knee Osteoarthritis (KOA). Materials and Methods: This was an open labelled, parallel group, Randomized Controlled Trial where 40 adults age ≥50 years diagnosed with KOA randomly received either Oxaceprol 600mg OD for 4 weeks, or combination of Oxaceprol 600mg OD and Glucosamine Sulphate 1500mg OD for 4 weeks. The patients were analysed as per the differences between WOMAC scale scores, and visual analogue scale (VAS) recording from baseline to 4 weeks of treatment. Results: Our study showed that both Oxaceprol monotherapy (group A, n=20), and Glucosamine plus Oxaceprol combination therapy (group B, n=20) improved joint pain, stiffness, and functionality as shown by analysing WOMAC scores before, and after 4 weeks of treatment. Interestingly, VAS scores, though improved in both the groups individually, were not significantly different from each other. Conclusion: Regardless of limitations, we conclude that the efficacy of Oxaceprol and Glucosamine combination therapy is better than Oxaceprol monotherapy. Further studies are required to examine mechanism of this effect at cellular level.

Keywords

Glucosamine, Knee, Nutraceuticals, Osteoarthritis, Oxaceprol, Pain, Supplement, WOMAC, VAS, Visual Analogue Scale.
User
Notifications
Font Size


  • 6.12 Osteoarthritis, Priority Medicines for Europe and the World 2013 Update [Internet]. [cited 5 Nov 2019]. Available from: https://www.who.int/medicines/areas/ priority_medicines/Ch6_12Osteo.pdf
  • Vina ER, Kwoh CK. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol [Internet]. 2018; 30(2): 160–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29227353. https://doi.org/10.1097/BOR.0000 000000000479
  • Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL, et al. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res [Internet]. 17 Dec 2017; 5(1): 16044. Available from: http://www.nature.com/articles/boneres201644. https://doi.org/10.1038/boneres.2016.44.
  • Hunter DJ, McDougall JJ, Keefe FJ. The Symptoms of Osteoarthritis and the Genesis of Pain. Rheum Dis Clin North Am [Internet]. Aug 2008; 34(3): 623–43. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0889857X08000367. https://doi.org/10.1016/j.rdc.2008.05.004.
  • Pal C, Singh P, Chaturvedi S, Pruthi K, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop [Internet]. 2016; 50(5): 518. Available from: http://www.ijoonline.com/text.asp?2016/50/5/518/189608. https://doi.org/10.4103/0019-5413.189608.
  • Mandl LA. Osteoarthritis year in review 2018: clinical. Osteoarthr Cartil [Internet]. Mar 2019; 27(3): 359–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1 063458418315231. https://doi.org/10.1016/j.joca.2018.11.001.
  • Martel-Pelletier J. Pathophysiology of osteoarthritis. Osteoarthr Cartil [Internet]. 2004;12: 31–3. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1063458 40300267X. https://doi.org/10.1016/j.joca.2003.10.002.
  • Crofford LJ. Use of NSAIDs in treating patients with arthritis. Arthritis Res Ther [Internet]. 2013; 15 Suppl 3:S2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24267197. https ://doi.org/10.1186/ar4174.
  • Wu Y, Goh EL, Wang D, Ma S. Novel treatments for osteoarthritis: a recent update. Open Access Rheumatol Res Rev [Internet]. Oct 2018; Volume 10: 135–40. Available from: https://www.dovepress.com/novel-treatments-forosteoarthritis-a-recent-updatepeer- reviewed-article-OARRR. https://doi.org/10.2147/OARRR.S176666.
  • Brown JP, Boulay LJ. Clinical experience with duloxetine in the management of chronic musculoskeletal pain. A focus on osteoarthritis of the knee. Ther Adv Musculoskelet Dis [Internet]. 25 Dec 2013; 5(6): 291–304. Available from: http://journals.sagepub.com/doi/10.1177/1759720X13508508. https://doi.org/10.1177/1759720X13508508.
  • Messina OD, Vidal Wilman M, Vidal Neira LF. Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res [Internet]. 13 Jun 2019;31(6): 807–13. Available from: http://link.springer.com/10.1007/s40520-019-01191-w. https://doi.org/10.1007/s40520-019-01191-w.
  • Chiusaroli R, Piepoli T, Zanelli T, Ballanti P, Lanza M, Rovati LC, et al. Experimental Pharmacology of Glucosamine Sulfate. Int J Rheumatol [Internet]. 2011; 2011: 1–8. Available from: http://www.hindawi.com/journals/ijr/2011/939265/. https://doi.org/10.1155/2011/939265.
  • Simental-Mendía M, Sánchez-García A, Vilchez-Cavazos F, Acosta-Olivo CA, Peña-Martínez VM, Simental-Mendía LE. Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials. Rheumatol Int [Internet]. 11Aug 2018;38(8):1413–28. Available from: http://link.springer.com/10.1007/s00296018-4077-2. https://doi.org/10.1007/s00296-018-4077-2
  • McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and Chondroitin for Treatment of Osteoarthritis. JAMA [Internet]. 15 Mar 2000;283(11): 1469. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.283.11.1469. https://doi. org/10.1001/jama.283.11.1469.
  • Richy F, Bruyere O, Ethgen O, Cucherat M, Henrotin Y, Reginster J-Y. Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee Osteoarthritis. Arch Intern Med [Internet]. 14 Jul 2003;163(13): 1514. Available from: http://archinte.jamanetwork.com/article. aspx?doi=10.1001/archinte.163.13.1514. https://doi. org/10.1001/archinte.163.13.1514.
  • Sawitzke AD, Shi H, Finco MF, Dunlop DD, Harris CL, Singer NG, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis [Internet]. 1 Aug 2010; 69(8): 1459–64. Available from: http://ard.bmj.com/cgi/doi/10.1136/ard.2009.120469. https://doi.org/10.1136/ard.2009.120469.
  • DiNubile N. Glucosamine and Chondroitin Sulfate: What Has Been Learned Since the Glucosamine/chondroitin Arthritis Intervention Trial. Orthopedics [Internet]. 1 Jul 2018; 41(4): 200–7. Available from: https://www.healio.com/doiresolver?doi=10.3928/01477447-20180511-06. https://doi.org/10.3928/01477447-20180511-06.
  • Lyon C, Mullen R, Ashby D. PURL: Time to stop glucosamine and chondroitin for knee OA? J Fam Pract [Internet]. 2018 ;67(9): 566–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30216397
  • Block JA, Oegema TR, Sandy JD, Plaas A. The effects of oral glucosamine on joint health: is a change in research approach needed? Osteoarthr Cartil [Internet]. Jan 2010; 18(1): 5–11. Available from: https://linkinghub.elsevier.com/retrieve/pii/S106345840900212X. https://doi.org/10.1016/j.joca.2009.07.005.
  • Bauer HW, Klasser M, von Hanstein KL, Rolinger H, Schladitz G, Henke H-D, et al. Oxaceprol is as Effective as Diclofenac in the Therapy of Osteoarthritis of the Knee and Hip. Clin Rheumatol [Internet]. 1 Jan 1999; 18(1): 4–9. Available from: http://link.springer.com/10.1007/s100670050043.
  • Pawar HS, Francis NK, Hota T, Peter N, Mitra A. Comparative evaluation of therapeutic efficacy of intraarticular oxaceprol with conventional modalities in osteoarthritis animal model. Clin Rheumatol [Internet].10 Aug 2018;37(8): 2195–201. Available from: http://link. springer.com/10.1007/s10067-018-4087-1.
  • Veihelmann A, Hofbauer A, Refior HJ, Messmer K. Oxaceprol, an atypical inhibitor of inflammation, reduces leukocyte adherence in mouse antigen-induced arthritis. Acta Orthop Scand [Internet]. 8 Jan 2001;72(3): 293–8. Available from: http://www.tandfonline.com/doi/full/10.1 080/00016470152846655.
  • Ionac m. Oxaceprol, an atypical inhibitor of inflammation and joint damage. Pharmacol Res [Internet]. Jun 1996; 33(6): 367–73. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1043661896900511.
  • Harris A, Schropp A, Messmer K. Effects of oxaceprol on the microcirculation in ischemia/reperfusion injury. Eur J Med Res [Internet]. 8 Apr 1998; 3(4): 182–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9533926
  • Kalbhen DA, Kalkert B. Autoradiography studies of the effect of oxaceprol on the metabolism of joint cartilage in vitro and in vivo. Z Rheumatol [Internet]. 46(3):136– 42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3630417
  • Kohn MD, Sassoon AA, Fernando ND. Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clin Orthop Relat Res [Internet]. 12 Aug 2016; 474(8): 1886–93. Available from: http://link.springer.com/10.1007/s11999-016-4732-4.
  • Jensen M. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain [Internet]. Sep 2003; 4(7):407–14. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1526590003007168.
  • Harrison-Munoz S, Rojas-Briones V, Irarrazaval S. Is glucosamine effective for osteoarthritis? Medwave. Mar 2017; 17(Suppl1):e6867. https://doi.org/10.5867/medwave.2017.6867.
  • Herrmann G, Steeger D, Klasser M, Wirbitzky J, Fürst M, Venbrocks R, et al. Oxaceprol is a Well-Tolerated Therapy for Osteoarthritis with Efficacy Equivalent to Diclofenac. Clin Rheumatol [Internet]. 1 Feb 2000; 19(2): 99–104. Available from: http://link.springer.com/10.1007/s100670050025.
  • Mukhopadhyay K, Ghosh P, Ghorai P, Hazra A, Das AK. Oxaceprol versus tramadol for knee osteoarthritis: A randomized controlled trial. Indian J Pharmacol. 2018;50(5): 266–72. https://doi.org/10.4103/ijp.IJP_633_16.

Abstract Views: 375

PDF Views: 102




  • Oxaceprol Monotherapy versus Oxaceprol and Glucosamine Combination Therapy for Knee Osteoarthritis

Abstract Views: 375  |  PDF Views: 102

Authors

Vijay Kumar
Department of Pharmacology, Government Medical College,Patiala – 147001, Punjab, India
Sanjeev Sareen
Department of Orthopaedics, Government Medical College, Patiala – 147001, Punjab, India
Shrey Bhatia
Department of Pharmacology, Government Medical College, Patiala – 147001, Punjab, India

Abstract


Introduction: Osteoarthritis (OA) is the commonest form of arthritis which presents with joint pain and functional limitations. Oxaceprol, a derivative of hydroxyproline, inhibits leukocyte migration into the joints thus inhibiting inflammatory process. Oxaceprol also increases availability of Glucosamine and improving uptake of Glucosamine and Proline in chondrocytes. Aims and Objective: To demonstrate efficacy of Oxaceprol Monotherapy versus Oxaceprol and Glucosamine combination therapy in patients diagnosed with Knee Osteoarthritis (KOA). Materials and Methods: This was an open labelled, parallel group, Randomized Controlled Trial where 40 adults age ≥50 years diagnosed with KOA randomly received either Oxaceprol 600mg OD for 4 weeks, or combination of Oxaceprol 600mg OD and Glucosamine Sulphate 1500mg OD for 4 weeks. The patients were analysed as per the differences between WOMAC scale scores, and visual analogue scale (VAS) recording from baseline to 4 weeks of treatment. Results: Our study showed that both Oxaceprol monotherapy (group A, n=20), and Glucosamine plus Oxaceprol combination therapy (group B, n=20) improved joint pain, stiffness, and functionality as shown by analysing WOMAC scores before, and after 4 weeks of treatment. Interestingly, VAS scores, though improved in both the groups individually, were not significantly different from each other. Conclusion: Regardless of limitations, we conclude that the efficacy of Oxaceprol and Glucosamine combination therapy is better than Oxaceprol monotherapy. Further studies are required to examine mechanism of this effect at cellular level.

Keywords


Glucosamine, Knee, Nutraceuticals, Osteoarthritis, Oxaceprol, Pain, Supplement, WOMAC, VAS, Visual Analogue Scale.

References





DOI: https://doi.org/10.18311/ijmds%2F2020%2F24871