Change in knee osteoarthritis cartilage detected by delayed gadolinium enhanced magnetic resonance imaging following treatment with collagen hydrolysate: a pilot randomized controlled trial.
OBJECTIVE
To determine whether either of two magnetic resonance imaging approaches - delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC), or T2 mapping - can detect short-term changes in knee hyaline cartilage among individuals taking a formulation of collagen hydrolysate.


METHODS
Single center, prospective, randomized, placebo-controlled, double-blind, pilot trial of collagen hydrolysate for mild knee osteoarthritis (OA). Participants were allowed to continue the prior analgesic use. The primary outcome was change in dGEMRIC T1 relaxation time in the cartilage regions of interest at the 24-week timepoint. Secondary endpoints included the change in dGEMRIC T1 relaxation time between baseline and 48 weeks, the change in T2 relaxation time at 0, 24 and 48 weeks, the symptom and functional measures obtained at each of the visits, and overall analgesic use.


RESULTS
Among a sample of 30 randomized subjects the dGEMRIC score increased in the medial and lateral tibial regions of interest (median increase of 29 and 41 ms respectively) in participants assigned to collagen hydrolysate but decreased (median decline 37 and 36 ms respectively) in the placebo arm with the changes between the two groups at 24 weeks reaching significance. No other significant changes between the two groups were seen in the other four regions, or in any of the T2 values or in the clinical outcomes.


CONCLUSIONS
These preliminary results suggest that the dGEMRIC technique may be able to detect change in proteoglycan content in knee cartilage among individuals taking collagen hydrolysate after 24 weeks.
Division of Rheumatology, Tufts Medical Center, Box 406, 800 Washington Street, Boston, MA 02111, USA. tmcalindon@tuftsmedicalcenter.org
T E
TE
McAlindon
M
M
Nuite
N
N
Krishnan
R
R
Ruthazer
L L
LL
Price
D
D
Burstein
J
J
Griffith
K
K
Flechsenhar
D000368:Aged; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology*; D003094:Collagen / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010865:Pilot Projects; D011446:Prospective Studies; D011492:Protein Hydrolysates / Q000627:therapeutic use*; D011859:Radiography
D011492:Protein Hydrolysates; D003094:Collagen; D019786:Gadolinium DTPA