NSAIDs

Found on the shelves of drugstores and supermarkets, NSAIDs are the most common drugs used in treatment of arthritis. Low doses of some NSAIDs help relieve a wide range of pain from headaches to muscle aches. Higher doses help reduce joint inflammation. There are several types of NSAIDS:

Traditional NSAIDs include 20-some prescription medications and a shelf-full of lower-dose, over the counter medications like Advil®, Motrin® and Aleve®. Stomach upset and gastrointestinal bleeding are a known side-effect.

COX-s Inhibitors are designed to be safer for the stomach, however, the risks of long-term use have not been fully evaluated. Vioxx was a COX-2 inhibitor withdrawn from the market after a study showed the drug increased risk of cardiovascular problems.

Salicylates, which include aspirin, are preferred by some patients and doctors. The large doses required to relieve arthritis pain, however, also carry the risk of side-effects including kidney problems and gastrointestinal bleeding.

If the known side-effects of these NSAIDs isn't enough to leave you questioning their long-term use for arthritis pain relief, according to a review article published in the New England Journal of Medicine,1 ?Anti-inflammatory drugs (prescription and over-the-counter, which include Advil®, Motrin®, Aleve®, Ordus®, aspirin, and over 20 others) alone cause over 16,500 deaths and over 103,000 hospitalizations per year in the US.?

Are Glucosamine and Chondroitin Better?

Glucosamine and chondroitin sulfate are substances found naturally in the body. Glucosamine is a form of amino sugar that is believed to play a role in cartilage formation and repair. Chondroitin sulfate is part of a large protein molecule that gives cartilage elasticity. Both glucosamine and chondroitin sulfate, extracted from animal tissue, are sold as dietary or nutritional supplements.

According to the Arthritis Foundation, "studies show that some people with mild to moderate osteoarthritis (OA) taking either glucosamine or chondroitin sulfate reported pain relief at a level similar to that of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Some research indicates that the supplements might also slow cartilage damage in people with OA [osteoarthritis]."

Two new studies have additional encouraging news about use of glucosamine and chondroitin for arthritis pain relief.

*The "GAIT" study, (Glucosamine/Chondroitin Arthritis Intervention Trial - Glucosamine Effectiveness), conducted by the NIH at academic medical centers, was designed to assess the effectiveness and safety of glucosamine and chondroitin sulfate, alone and in combination, compared to placebo and to celecoxib (Celebrix®).

While the study did not show significant help for those with mild knee pain using the glucosamine/chondroitin combination, ?the people with moderate-to-severe pain who took glucosamine and chondroitin sulfate together showed significant improvement in their knee pain,? says lead author Daniel O. Clegg, MD, professor of medicine and chief of the division of rheumatology at the University of Utah School of Medicine in Salt Lake City, one of 16 rheumatology centers involved in the NIH-sponsored GAIT.

Results of a second smaller trial, called the GUIDE trial, were also announced recently. Conducted in Spain and Portugal, the six-month-long study measured the effects of a 1,500-mg daily dose of glucosamine against a 3,000-mg daily dose of acetaminophen (Tylenol), or placebo, in 318 people with knee OA. The researchers concluded that glucosamine relieved pain significantly better than the acetaminophen or placebo.

An Arthritis Today Special Report entitled Good News For Knees advises that arthritis sufferers "look for supplements containing a combination of 500-mg glucosamine and 400-mg chondroitin ? and take three times a day. Be aware you may not notice an effect until several days or weeks after starting glucosamine."

Click here for information about our Glucosamine and Chondroitin supplement

References:

1. Wolfe MM, et. al. New England Journal of Medicine 1999;340(24):1888-99