title: Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial at a single center.
abstract: OBJECTIVE
  To evaluate the symptomatic effects of highly purified chondroitin 4 and chondroitin 6 sulfate (CS) therapy in patients with osteoarthritis (OA) of the hand.
  
  
  METHODS
  This investigator-initiated, single-center, randomized, double-blind, placebo-controlled clinical trial included 162 symptomatic patients with radiographic evidence of hand OA (American College of Rheumatology criteria). Inclusion criteria included patient's assessment of global spontaneous hand pain of at least 40 mm on a 0-100-mm visual analog scale (VAS) and functional impairment of at least 6 (0-30 scale) on the Functional Index for Hand OA (FIHOA) in the most symptomatic hand. Patients received either 800 mg of CS (n = 80 patients) or placebo (n = 82 patients) once daily for 6 months and were analyzed in an intent-to-treat approach. The two primary outcomes were the change in the patient's assessment of global spontaneous hand pain and in hand function (by FIHOA score) from baseline to month 6. Secondary outcomes were improvement in grip strength, duration of morning stiffness, acetaminophen consumption, and the investigator's global impression of treatment efficacy.
  
  
  RESULTS
  There was a significantly more pronounced decrease in the patient's global assessment of hand pain in the CS group than in the placebo group (difference VAS scores -8.7 mm; P = 0.016). Hand function improved significantly more in the CS group than in the placebo group (difference in FIHOA scores -2.14; P = 0.008). There was a statistically significant between-group difference in favor of CS for the duration of morning stiffness and for the investigator's global impression of treatment efficacy. Changes in grip strength, acetaminophen consumption, and safety end points were not significantly different between the two groups.
  
  
  CONCLUSIONS
  This study demonstrates that CS improves hand pain and function in patients with symptomatic OA of the hand and shows a good safety profile.
authors: University Hospitals of Geneva and University of Geneva School of Medicine, Geneva, Switzerland. cem.gabay@hcuge.ch
authors: Cem
authors: C
authors: Gabay
authors: Carole
authors: C
authors: Medinger-Sadowski
authors: Danielle
authors: D
authors: Gascon
authors: Frank
authors: F
authors: Kolo
authors: Axel
authors: A
authors: Finckh
mesh_terms: D000368:Aged; D002809:Chondroitin Sulfates / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D010147:Pain Measurement; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D002809:Chondroitin Sulfates