title: Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial.
abstract: Until now glucosamine sulfate (GS) has been the most widely used supplement and has been shown to be efficacious in the treatment of osteoarthritis (OA). Methylsulfonylmethane (MSM) and boswellic acids (BA) are new effective supplements for the management of inflammation and joint degeneration, according to previous experimental studies. The aim of our study is to test the effectiveness of association of MSM and BA in comparison with GS in knee arthritis.In this prospective randomized clinical trial, MEBAGA (Methylsulfonylmethane and Boswellic Acids versus Glucosamine sulfate in the treatment of knee Arthritis), 120 participants affected by arthritis of the knee were randomly assigned to an experimental group (MB group) or a control group (GS group) treated for 60 days with 5 g of MSM and 7.2 mg of BA or with 1500 mg of GS daily, respectively. At the 2-month (T1) and 6-months (T2) follow-up , the efficacy of these two nutraceuticals was assessed using the visual analog pain scale (VAS) and the Lequesne Index (LI) for joint function, along with the use of anti-inflammatory drugs (non-steroidal anti-inflammatory drugs and anti-cyclooxygenase-2).The repeated measures ANOVA analysis shows that for VAS, LI, and the use of anti-inflammatory drugs scores there are improvements due to the time in the two groups (respectively, F=26.0; P<0.0001; F=4.15; P=0.02; F=3.38; P=0.04), with a tendency to better values for the MB group at T2.On the basis of these preliminary data, we could support the efficacy of the MSM in association with BA in the treatment of OA. These results are consistent with the anti-inflammatory and chondroprotective effects previously occurred in experimental studies. This new combination of integration (MSM and BS) has presented good results and satisfactory in comparison with GS, until now the cornerstone of the treatment of arthritis in according to guidelines.
authors.affiliation: Course of Motor and Sports Sciences, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, Bari, Italy Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy angelanotarnicola@yahoo.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Notarnicola
authors.affiliation: Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maccagnano
authors.affiliation: Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Moretti
authors.affiliation: Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Pesce
authors.affiliation: Course of Motor and Sports Sciences, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, Bari, Italy Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy Department of Biomedical Sciences and Human Oncology, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Tafuri
authors.affiliation: Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fiore
authors.affiliation: Course of Motor and Sports Sciences, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, Bari, Italy Orthopedics Section, Department of Medical Science of Basis, Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Moretti
mesh_terms: D000328:Adult; D000368:Aged; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D005260:Female; D005944:Glucosamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D011446:Prospective Studies; D013450:Sulfones / Q000627:therapeutic use*; D014315:Triterpenes / Q000627:therapeutic use*; D064232:Visual Analog Scale
chemical_list: D013450:Sulfones; D014315:Triterpenes; C054625:boswellic acid; C025910:dimethyl sulfone; D005944:Glucosamine; D004121:Dimethyl Sulfoxide
keywords: boswellic acid; glucosamine; knee; methylsulfonylmethane; osteoarthritis