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Keywords = SYSADOA

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17 pages, 2811 KiB  
Systematic Review
Effectiveness and Safety of SYSADOAs Used in Eastern and Western Regions for the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials—SYSADOAs Are Effective and Safe for Knee OA
by Yong-Beom Park and Jun-Ho Kim
Medicina 2025, 61(2), 331; https://doi.org/10.3390/medicina61020331 - 13 Feb 2025
Viewed by 2477
Abstract
Background and Objective: According to international guidelines, glucosamine and chondroitin, regarded as slow-acting drugs for osteoarthritis (SYSADOAs), have been first-line treatments for knee osteoarthritis (OA); however, their efficacies remain controversial. Additionally, the efficacies of plant extract cocktails, SKI306X, and its newer formulation, [...] Read more.
Background and Objective: According to international guidelines, glucosamine and chondroitin, regarded as slow-acting drugs for osteoarthritis (SYSADOAs), have been first-line treatments for knee osteoarthritis (OA); however, their efficacies remain controversial. Additionally, the efficacies of plant extract cocktails, SKI306X, and its newer formulation, SKCPT, have not been well investigated. To evaluate the effectiveness and safety of symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) in patients with knee OA. Materials and Methods: Electronic databases were systematically searched to identify randomized controlled trials (RCTs) assessing the effectiveness and safety of SYSADOAs, including chondroitin sulfate, glucosamine sulfate, and SKCPT/SKI306X. The outcomes included pain relief, functional improvements, and safety profiles. The outcome measurements were compared between the treatment and control groups, including placebo and non-placebo groups, within and after 3 months of follow-up. Results: Analysis of 21 RCTs showed significantly greater improvement in pain relief in the treatment group compared with the placebo group both within (standard mean difference [SMD], 0.38; 95% confidence interval [CI], 0.18–0.57; p < 0.001) and after 3 months of follow-up (SMD, 0.22; 95%CI, 0.03–0.42 p = 0.023). The treatment group also showed significantly greater functional improvements regardless of follow-up. Pain and functional improvement did not differ significantly between the treatment and non-placebo groups. Regarding the safety profile, the risk ratios did not differ significantly between the treatment and control groups, including the placebo and non-placebo subgroups. Conclusions: Glucosamine, chondroitin, and SKCPT/SKI306X improved the pain and function and were non-inferior to pharmacologic drugs for up to 12 months. These findings support the clinical use of these SYSADOAs to treat knee OA. Level of Evidence: Therapeutic Level II. Full article
(This article belongs to the Special Issue Updates on Risk Factors, Prevention and Treatment of Knee Disease)
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14 pages, 4116 KiB  
Systematic Review
Efficacy and Safety of Celecoxib and a Korean SYSADOA (JOINS) for the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis
by Yong-Beom Park and Jun-Ho Kim
J. Clin. Med. 2025, 14(4), 1036; https://doi.org/10.3390/jcm14041036 - 7 Feb 2025
Viewed by 1855
Abstract
Background: The efficacy of cyclooxygenase-2 (COX-2) inhibitors, including celecoxib, in managing knee osteoarthritis (KO) is well-established. Recently, the plant extract cocktail JOINS (SKI306X and its newer formulation, SKCPT) has been shown to be an effective slow-acting drug for KO. Aims: To compare the [...] Read more.
Background: The efficacy of cyclooxygenase-2 (COX-2) inhibitors, including celecoxib, in managing knee osteoarthritis (KO) is well-established. Recently, the plant extract cocktail JOINS (SKI306X and its newer formulation, SKCPT) has been shown to be an effective slow-acting drug for KO. Aims: To compare the efficacy and safety of celecoxib and JOINS in patients with KO. Methods: A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified randomized controlled trials (RCTs) assessing the effectiveness and safety of celecoxib and JOINS. The outcomes included pain relief, functional improvement, and safety profiles. Outcome measurements were compared between the celecoxib and JOINS cohorts at the short-term (closest to 3 months) and mid-term (closest to 12 months). Results: Overall, 23 RCTs involving 3367 patients were included in this systematic review. The efficacy of JOINS in reducing pain, as indicated by the visual analog scale (VAS) score, was comparable to that of celecoxib. Regarding functional improvement assessed using the Western Ontario and McMaster University Arthritis Index (WOMAC), JOINS showed improvement comparable to that of celecoxib regardless of follow-up. In addition, no significant difference was observed in the incidence of adverse events between the celecoxib and JOINS cohorts. Conclusions: The results of this study suggest that JOINS could be considered as a pharmacological agent with significant efficacy for pain relief and functional improvement in patients with KO in clinical practice. Full article
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11 pages, 4601 KiB  
Article
Can Artificial Intelligence Help Orthopaedic Surgeons in the Conservative Management of Knee Osteoarthritis? A Consensus Analysis
by Christian Carulli, Stefano Marco Paolo Rossi, Luca Magistrelli, Alessandro Annibaldi and Enzo Troncone
J. Clin. Med. 2025, 14(3), 690; https://doi.org/10.3390/jcm14030690 - 22 Jan 2025
Viewed by 1155
Abstract
Background: Knee osteoarthritis is a prevalent condition that significantly impacts patients’ quality of life. Effective management typically involves a combination of pharmacological and non-pharmacological treatments. However, establishing a consensus on the optimal treatment strategy is crucial for standardizing care. The present study is [...] Read more.
Background: Knee osteoarthritis is a prevalent condition that significantly impacts patients’ quality of life. Effective management typically involves a combination of pharmacological and non-pharmacological treatments. However, establishing a consensus on the optimal treatment strategy is crucial for standardizing care. The present study is the result of a rigorous process that combines artificial intelligence with human expertise to improve the reliability of medical recommendations. Methods: A new software platform (Butterfly Decisions, 2021, Italy) was employed to leverage AI-assisted decision-making, facilitating the digitalization of the entire consensus process. The process started with data collection through an online survey including simulated clinical cases of knee osteoarthritis collected by 30 orthopedic surgeons; artificial intelligence (AI) analyzed the collected clinical data and identified the key concepts and relevant patterns. Subsequently, AI generated detailed statements summarizing key concepts extracted from the data and proposed a reformulation of the statements to be discussed during the discussion session of the advisory board. The advisory board, composed of four qualified, experienced specialists of knee osteoarthritis, evaluated statements, providing their agreement levels, confidence, and supporting evidence. The AI tools calculated the degree of certainty and contradiction for each statement based on these evaluations. The literature was critically evaluated to ensure that there was an evidence-based evaluation of the proposed treatment statements. Finally, revised versions were proposed to address the feedback, evidence was collected to refine the scientific report, and the board members evaluated the AI performance too. Results: The consensus analysis revealed a high level of agreement in the need for a multimodal approach to treating knee osteoarthritis. The feedback highlighted the importance of integrating physical therapy and weight management, non-pharmacological methods, with Symptomatic Slow-Acting Drug for Osteoarthritis (SYSADOAs) and pharmacological treatments, such as anti-inflammatory drugs and intra-articular knee injections. The board members found that AI was easy to use and understand and each statement was structured clearly and concisely. Conclusions: The expert consensus about knee osteoarthritis conservative management being facilitated with AI met with unanimous agreement. AI-assisted decision-making was shown to have excellent analytical capabilities, but algorithms needs to be trained by orthopaedic experts with the correct inputs. Future additional efforts are still required to evaluate the incorporation of AI in clinical workflows. Full article
(This article belongs to the Section Orthopedics)
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16 pages, 4102 KiB  
Article
Improved Joint Health Following Oral Administration of Glycosaminoglycans with Native Type II Collagen in a Rabbit Model of Osteoarthritis
by Vicente Sifre, Carme Soler, Sergi Segarra, José Ignacio Redondo, Luis Doménech, Amadeo Ten-Esteve, Laura Vilalta, Luis Pardo-Marín and Claudio Iván Serra
Animals 2022, 12(11), 1401; https://doi.org/10.3390/ani12111401 - 30 May 2022
Cited by 4 | Viewed by 3812
Abstract
A prospective, experimental, randomized, double blinded study was designed to evaluate the effects of glycosaminoglycans, with or without native type II collagen (NC), in an osteoarthritis model induced by cranial cruciate ligament transection. The following compounds were tested: chondroitin sulfate (CS), glucosamine hydrochloride [...] Read more.
A prospective, experimental, randomized, double blinded study was designed to evaluate the effects of glycosaminoglycans, with or without native type II collagen (NC), in an osteoarthritis model induced by cranial cruciate ligament transection. The following compounds were tested: chondroitin sulfate (CS), glucosamine hydrochloride (GlHCl), hyaluronic acid (HA) and NC. Fifty-four female 12-week-old New Zealand rabbits were classified into three groups: CTR (control–no treatment), CGH (CS + GlHCl + HA) and CGH-NC (CS + GlHCl + HA + NC). Each group was subdivided into three subgroups according to survival times of 24, 56 and 84 days. Over time, all rabbits developed degenerative changes associated with osteoarthritis. CGH-NC showed significantly improved values on macroscopic evaluation, compared to CTR and CGH. Microscopically, significantly better results were seen with CGH and CGH-NC, compared to CTR, and synovial membrane values were significantly better with CGH-NC compared to CGH. A significant improvement in magnetic resonance imaging biomarkers was also observed with CGH-NC in cartilage transversal relaxation time (T2) and subchondral bone D2D fractal dimension in the lateral condyle. In conclusion, our results show beneficial effects on joint health of CGH and CGH-NC and also supports that adding NC to CGH results in even greater efficacy. Full article
(This article belongs to the Section Veterinary Clinical Studies)
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22 pages, 3190 KiB  
Article
Differential Secretome Profiling of Human Osteoarthritic Synoviocytes Treated with Biotechnological Unsulfated and Marine Sulfated Chondroitins
by Rosita Russo, Valentina Vassallo, Antonietta Stellavato, Mariangela Valletta, Donatella Cimini, Paolo Vincenzo Pedone, Chiara Schiraldi and Angela Chambery
Int. J. Mol. Sci. 2020, 21(11), 3746; https://doi.org/10.3390/ijms21113746 - 26 May 2020
Cited by 19 | Viewed by 4004
Abstract
Symptomatic slow-acting drugs (SYSADOA) are increasingly used as effective therapies for osteoarthritis, representing an attractive alternative to analgesics or non-steroidal anti-inflammatory drugs to relieve disease symptoms. Pharmaceutical preparations of chondroitin sulfate, derived from animal sources, alone or in combination with glucosamine sulfate, are [...] Read more.
Symptomatic slow-acting drugs (SYSADOA) are increasingly used as effective therapies for osteoarthritis, representing an attractive alternative to analgesics or non-steroidal anti-inflammatory drugs to relieve disease symptoms. Pharmaceutical preparations of chondroitin sulfate, derived from animal sources, alone or in combination with glucosamine sulfate, are widely recognized for their beneficial effect on osteoarthritis treatment. A growing interest has also been devoted to understanding the molecular mechanisms modulated by SYSADOA using -omic strategies, most of which rely on chondrocytes as a model system. In this work, by using an integrated strategy based on unbiased proteomics and targeted cytokine profiling by a multiplexed protein array, we identified differences in the secretomes of human osteoarthritic synoviocytes in response to biotechnological unsulfated, and marine sulfated chondroitins treatments. The combined strategy allowed the identification of candidate proteins showing both common and distinct regulation responses to the two treatments of chondroitins. These molecules, mainly belonging to ECM proteins, enzymes, enzymatic inhibitors and cytokines, are potentially correlated to treatment outcomes. Overall, the present results provide an integrated overview of protein changes in human osteoarthritic synoviocytes secretome associated to different chondroitin treatments, thus improving current knowledge of the biochemical effects driven by these drugs potentially involved in pathways associated to osteoarthritis pathogenesis. Full article
(This article belongs to the Special Issue Cellular Secretomes)
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7 pages, 692 KiB  
Article
The Effect of Glucosamine, Chondroitin and Harpagophytum Procumbens on Femoral Hyaline Cartilage Thickness in Patients with Knee Osteoarthritis—An MRI Versus Ultrasonography Study
by Florentin A. Vreju, Paulina L. Ciurea, Anca Rosu, Beatrice A. Chisalau, Cristina D. Parvanescu, Sineta C. Firulescu, Adina Turcu-Stiolica, Andreea L. Barbulescu, Stefan C. Dinescu, Cristiana I. Dumitrescu, Roxana Mihaela Dumitrascu, Criveanu Cristina, Lucretiu Radu, Mihai Tusaliu and Daniela Dumitrescu
J. Mind Med. Sci. 2019, 6(1), 162-168; https://doi.org/10.22543/7674.61.P162168 - 27 Apr 2019
Cited by 7 | Viewed by 454
Abstract
Background: the evaluation of cartilage thickness has become possible with new techniques such as musculoskeletal ultrasonography (US) and magnetic resonance imagining (MRI), making the evaluation of the treatment response and the progression of the disease more accurate. Objective: to evaluate the [...] Read more.
Background: the evaluation of cartilage thickness has become possible with new techniques such as musculoskeletal ultrasonography (US) and magnetic resonance imagining (MRI), making the evaluation of the treatment response and the progression of the disease more accurate. Objective: to evaluate the efficacy of a Symptomatic Slow Acting Drug for Osteoarthritis using both US and MRI for measuring cartilage thickness at baseline and after 1 year. Methods: The study included the clinical evaluation of 20 patients at baseline, at 6 and 12 months as well as imaging exams (US and MRI) at baseline and after 1 year. Measurements were performed in both knees, in lateral and medial condyles, and in the intercondylar area. After the baseline visit, patients underwent a SYSADOA treatment which included Harpagophytum procumbens (HPc) administered on a daily basis, in a specific regimen. Results and discussions: The US examination permitted the detailed evaluation of the femoral hyaline cartilage thickness, with statistically significant differences before and after treatment at the level of the medial compartment, both in the dominant (1.59 ± 0.49 vs. 1.68 ± 0.49, p = 0.0013) and non-dominant knee (1.73 ± 0.53 vs. 1.79 ± 0.52, p = 0.0106). The US and the MRI correlated well (r = 0.63) and showed no radiographic progression in knee osteoarthritis after one year of treatment with specific SYSADOA. Moreover, the US showed improvement in the cartilage thickness of the medial compartment. Conclusions: The combination with HPc could increase the delay in the radiographic progression of the knee osteoarthritis, with improvement of femoral hyaline cartilage thickness in the medial and lateral compartment. The US might be an important tool in OA evaluation and monitoring. Full article
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13 pages, 685 KiB  
Review
Discrepancies in Composition and Biological Effects of Different Formulations of Chondroitin Sulfate
by Johanne Martel-Pelletier, Aina Farran, Eulàlia Montell, Josep Vergés and Jean-Pierre Pelletier
Molecules 2015, 20(3), 4277-4289; https://doi.org/10.3390/molecules20034277 - 6 Mar 2015
Cited by 97 | Viewed by 15920
Abstract
Osteoarthritis is a common, progressive joint disease, and treatments generally aim for symptomatic improvement. However, SYmptomatic Slow-Acting Drugs in Osteoarthritis (SYSADOAs) not only reduce joint pain, but slow structural disease progression. One such agent is chondroitin sulfate—a complex, heterogeneous polysaccharide. It is extracted [...] Read more.
Osteoarthritis is a common, progressive joint disease, and treatments generally aim for symptomatic improvement. However, SYmptomatic Slow-Acting Drugs in Osteoarthritis (SYSADOAs) not only reduce joint pain, but slow structural disease progression. One such agent is chondroitin sulfate—a complex, heterogeneous polysaccharide. It is extracted from various animal cartilages, thus has a wide range of molecular weights and different amounts and patterns of sulfation. Chondroitin sulfate has an excellent safety profile, and although various meta-analyses have concluded that it has a beneficial effect on symptoms and structure, others have concluded little or no benefit. This may be due, at least partly, to variations in the quality of the chondroitin sulfate used for a particular study. Chondroitin sulfate is available as pharmaceutical- and nutraceutical-grade products, and the latter have great variations in preparation, composition, purity and effects. Moreover, some products contain a negligible amount of chondroitin sulfate and among samples with reasonable amounts, in vitro testing showed widely varying effects. Of importance, although some showed anti-inflammatory effects, others demonstrated weak effects, and some instances were even pro-inflammatory. This could be related to contaminants, which depend on the origin, production and purification process. It is therefore vitally important that only pharmaceutical-grade chondroitin sulfate be used for treating osteoarthritis patients. Full article
(This article belongs to the Special Issue Glycosaminoglycans and Their Mimetics)
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