Comparative efficacy of a combination of undenatured type II collagen, Boswellic acids, methylsulfonylmethane, vitamins C and D3 and a combination of chondroitin sulfate and glucosamine hydrochloride in the treatment of primary osteoarthritis of the knee joint

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Abstract

Aim. To evaluate the efficacy of Artneo (AN) in comparison with a combination of glucosamine hydrochloride and chondroitin sulfate (GC) in patients with osteoarthritis (OA) of the knee joint (KJ).

Materials and methods. 70 patients with stages I–III of primary knee OA were randomized into 2 groups. Participants in the 1st (n=35) took AN 1 caps/day, in the 2nd (n=35) GC according to the standard regimen. After 7, 30, 90, 180 days, the Lequesne index (severity of OA), pain when moving according to VAS, WOMAC score were assessed, after 1, 3, 6 months – quality of life SF-36 and morning stiffness, after 6 months – MRI with T2 mapping, laboratory safety indicators.

Results. Over the course of 6 months of use, an improvement in the WOMAC index and a decrease in pain were observed without intergroup differences, and a greater decrease in stiffness in the AN group. After 3 months, the severity of OA decreased from moderate to mild in the AN group and was significantly lower compared to the GC group; quality of life (physical component of SF-36) was higher in the AN group. After 6 months, there was an improvement in cartilage ultrastructure (T2 relaxation time) in both groups and a more pronounced reduction of the synovitis area (MRI) in the AN group (2.95 and 1.37 times in the AN and GC group, respectively). There were no clinically significant adverse reactions observed in both groups.

Conclusion. The use of AN in patients with stage I–III primary knee OA was not inferior in efficacy to the combination of GC. Further studies with greater statistical power (sample size) and follow-up period are warranted including in real clinical practice.

About the authors

Vadim I. Mazurov

Mechnikov North-Western State Medical University; Clinical Rheumatology Hospital 25

Email: belib@mail.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482
Scopus Author ID: 16936315400

акад. РАН, д-р мед. наук, проф., гл. науч. консультант, дир. Научно-исследовательского института ревматологии, зав. каф. терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им. Э.Э. Эйхвальда ФГБОУ ВО «СЗГМУ им. И.И. Мечникова», рук. Центра аутоиммунных заболеваний СПб ГБУЗ «КРБ №25»

Russian Federation, Saint Petersburg; Saint Petersburg

Irina B. Belyaeva

Mechnikov North-Western State Medical University

Author for correspondence.
Email: belib@mail.ru
ORCID iD: 0000-0002-7981-6349
SPIN-code: 3136-9062

д-р мед. наук, доц., проф. каф. терапии, ревматологии, экспертизы временной нетрудоспособности и качества медицинской помощи им. Э.Э. Эйхвальда

Russian Federation, Saint Petersburg

Evgeniy A. Trofimov

Mechnikov North-Western State Medical University

Email: belib@mail.ru
ORCID iD: 0000-0003-3236-4485
SPIN-code: 4358-1663
Scopus Author ID: 57082588900

д-р мед. наук, проф. каф. терапии и ревматологии им. Э.Э. Эйхвальда 

Russian Federation, Saint Petersburg

Irina E. Itskovich

Mechnikov North-Western State Medical University

Email: belib@mail.ru
ORCID iD: 0000-0001-8352-3955

д-р мед. наук, зав. каф. лучевой диагностики и лучевой терапии

Russian Federation, Saint Petersburg

Artem L. Burulev

Mechnikov North-Western State Medical University

Email: belib@mail.ru
ORCID iD: 0009-0007-5401-5047

канд. мед. наук, доц. каф. лучевой диагностики и лучевой терапии 

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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2. Fig. 1. Lequesne algofunctional index: a – absolute values; b – changes from the initial value, %.

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3. Fig. 2. VAS pain when walking: a – absolute values; b – changes from the initial value, %.

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4. Fig. 3. WOMAC score: a – absolute values; b – changes from the initial value, %.

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5. Fig. 4. Morning stiffness: a – absolute values; b – changes from the initial value, min.

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6. Fig. 5. SF-36 quality of life with calculation of the effect size (Kendall’s W concordance coefficient).

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7. Fig. 6. Assessment by the doctor (a) and the patient (b) of the effecacy of therapy at the end of 6 months of treatment.

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8. Fig. 7. Area of synovitis after 6 months according to MRI.

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9. Fig. 8. Area of synovitis in patient V. during Artneo therapy after 6 months: a – visit 2, area of synovitis 8.1 cm2; b – visit 9, area of synovitis 1.5 cm2.

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