title: Mud-bath therapy and oral glucosamine sulfate in patients with knee osteoarthritis: a randomized, controlled, crossover study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of combined treatment of mud-bath therapy and glucosamine crystalline sulfate (GlcN-S) in patients with knee osteoarthritis (OA).
  
  
  METHODS
  This study was a randomised, controlled, crossover investigation. Patients were randomly assigned (1:1) by the investigators to two groups, named group 1 and 2. Group 1 included twenty-three patients receiving oral GlcN-S treatment from the beginning of the study (T0) to the end of the 3rd month of treatment (T3) and a combined treatment of both mud-bath therapy and GlcN-S from T3 to the end of the study at six months (T6). Group 2 included twenty-two patients receiving a combined treatment of both mud-bath therapy and GlcN-S from T0 to T3 and that discontinued mud-bath therapy, receiving GlcN-S treatment alone, from T3 to T6. Primary endpoints of the study consisted of evaluating OA severity and activity at baseline and at follow-up visits.
  
  
  RESULTS
  All 45 patients, eligible for the study, completed the period of the crossover. In group 1, no significant difference was shown in the comparison from T0 to T3, while from T3 to T6 most variables were significantly improved. In group 2, instead, the comparison between T0 and T3 showed a significant difference in different parameters. When comparing T3 and T6, despite an improvement of all the variables, no significant difference was shown.
  
  
  CONCLUSIONS
  The association of GlcN-S and mud-bath therapy has a positive and safe role in improving pain, function and quality of life in knee OA patients.
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Peluso
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Caso
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Costa
authors.affiliation: Orthopedic Unit, Rizzoli Hospital, Ischia, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Sorbo
authors.affiliation: ASL Napoli 2 Nord, Naples, Italy.
authors.forename: Nello
authors.initials: N
authors.lastname: Carraturo
authors.affiliation: IRCCS Centro Cardiologico Monzino, Unit of Cell and Molecular Biology in Cardiovascular Diseases, Milan, Italy.
authors.forename: Matteo Nicola Dario
authors.initials: MN
authors.lastname: Di Minno
authors.affiliation: Julio Jasolino Thermal Study Centre, Ischia, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Carraturo
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Oriente
authors.affiliation: Julio Jasolino Thermal Study Centre, Ischia, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Balestrieri
authors.affiliation: Santobono-Pausilipon Hospital, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Minicucci
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy. rscarpa@unina.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001696:Biomechanical Phenomena; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D005260:Female; D005944:Glucosamine / Q000008:administration & dosage*; D006801:Humans; D007558:Italy; D007719:Knee Joint / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009094:Mud Therapy; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005944:Glucosamine