title: First-line analysis of the effects of treatment on progression of structural changes in knee osteoarthritis over 24 months: data from the osteoarthritis initiative progression cohort.
abstract: OBJECTIVE
  To determine, using data from participants enrolled in the progression cohort of the OAI, the effects of conventional osteoarthritis (OA) pharmacological treatment and those of the combination of glucosamine and chondroitin sulfate (Glu/CS) on knee structural changes.
  
  
  METHODS
  Six hundred patients with knee OA were stratified based on whether or not they received for 24 consecutive months the OA conventional pharmacological treatment and/or Glu/CS. The main outcomes were knee structural changes, including the loss of joint space width (JSW) and of cartilage volume measured by quantitative MRI.
  
  
  RESULTS
  Participants reported taking (+) (n=300) or not taking (-) (n=300) OA treatment (analgesic/NSAIDs). The +analgesic/NSAIDs participants had higher Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (p<0.001) and smaller JSW (p=0.01), reflecting more severe disease at baseline. In the -analgesic/NSAIDs group, participants taking Glu/CS had significantly reduced loss of cartilage volume at 24 months in the medial central plateau (p=0.007). Further subdivision revealed that this effect of Glu/CS occurred in participants with a higher severity of the disease (JSW≤median). In the +analgesic/NSAIDs group, those taking Glu/CS had significantly reduced loss of cartilage volume in the global plateau at 12 months (p=0.05), and in the central plateau at 24 months (p=0.05). These effects occurred in participants with less disease severity (JSW>median). By contrast, no significant reduction in JSW was found between all groups.
  
  
  CONCLUSIONS
  In +analgesic/NSAIDs groups and -analgesic/NSAIDs groups, participants who took Glu/CS had reduced loss of cartilage volume over 24 months in subregions when assessed with qMRI, arguing for a disease-modifying effect of Glu/CS which could not be identified by X-rays.
authors: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors: Johanne
authors: J
authors: Martel-Pelletier
authors: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors: Camille
authors: C
authors: Roubille
authors: Imaging Research & Development, ArthroLab Inc., Montreal, Quebec, Canada.
authors: François
authors: F
authors: Abram
authors: Departments of Medicine and Epidemiology and Public Health, University of Maryland Medical Center, Baltimore, Maryland, USA.
authors: Marc C
authors: MC
authors: Hochberg
authors: StatSciences Inc., Notre-Dame de l'Île-Perrot, Quebec, Canada.
authors: Marc
authors: M
authors: Dorais
authors: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors: Philippe
authors: P
authors: Delorme
authors: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors: Jean-Pierre
authors: JP
authors: Raynauld
authors: Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
authors: Jean-Pierre
authors: JP
authors: Pelletier
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002358:Cartilage, Articular / Q000473:pathology*; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005944:Glucosamine / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010147:Pain Measurement; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002809:Chondroitin Sulfates; D005944:Glucosamine
keywords: Knee Osteoarthritis; Magnetic Resonance Imaging; Treatment