Comparative Effectiveness of Channa sriatus Extract Versus Glucosamine Sulphate for the Treatment of Primary Knee Osteoarthritis: A Randomised Controlled Trial (original) (raw)
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2019
Knee osteoarthritis (KOA) is one of the commonest types of osteoarthritis (OA). Currently, the treatment is to provide the pain relief to OA patients. The concern for the side effects of current treatment encouraged the studies to search for natural products to reduce the side effects. Channa striatus (CS) is a freshwater fish that proclaimed as natural remedies to various illnesses by local communities without scientific evidence. Therefore, the objective of this study was to evaluate the effect of oral administration of different doses of CS extract (1000 mg/day and 500 mg/day) on the level of cartilage marker, Cartilage Oligomeric Protein (COMP) and inflammatory markers, Cyclooxgenase-2 (COX-2) and Prostaglandin E2 (PGE2) and compared within Glucosamine Sulphate (GS) treatment in KOA patients. One hundred and forty-eight patients were enrolled in this randomized, double-blind, placebo-controlled trial comparing the effect of two doses of oral CS extract (1000 mg/day and 500 mg/da...
Evaluation of Chondroprotective Activity of Channa striatus in Rabbit Osteoarthritis Model
BioMed Research International
Objectives. The objective of the study is to evaluate the chondroprotective activity of Channa striatus (Channa) and glucosamine sulphate (glucosamine) on histomorphometric examinations, serum biomarker, and inflammatory mediators in experimental osteoarthritis (OA) rabbit model. Design. Anterior cruciate ligament transection (ACLT) was performed to induce OA in thirty-three male New Zealand white rabbits and were randomly divided into three groups: Channa, glucosamine, and control group. The control group received drinking water and the Channa and glucosamine groups were orally administered with 51.4 mg/kg of Channa extract and 77.5 mg/kg of glucosamine sulphate in drinking water, respectively, for eight weeks and then sacrificed. The articular cartilage was evaluated macroscopically and histologically using semiquantitative and quantitative methods. Serum cartilage oligomeric matric protein (COMP), cyclooxygenase 2 (COX-2) enzyme, and prostaglandin E2 (PGE2) were also determined. ...
2011
The main aim of this study was to compare the immunoreactivity of some osteoarthritis related neuropeptides following oral administration of two natural remedies that is Channa striatus extract and zerumbone against monosodium iodoacetate induced knee osteoarthritis changes in the rat's synovial membrane. Assay of PGE 2 and PGF2α in the serum were performed to evaluate their role during osteoarthritis events and post oral application of the treatment. Forty rats were divided equally into four groups. Rats in the first and second groups were received channa extract and zerumbone, respectively. Rats in the third group were treated with celecoxib, whereas the fourth group was treated with normal saline. Evaluation of immunoreactivity of the following neuropeptides: Protein gene product 9.5, calcitonin gene related peptide and neuropeptide Y in the synovial membranes was implemented with the aid of both histopathology and immunohistochemistry approaches. Results revealed lower pathology score in both first and second groups accompanied with markedly improved immunoreactivity in zerumbone treated groups compared to channa extract group. Significant different concentrations of PGE 2 but not PGF 2 α were detected within studied groups. Both remedies significantly improved the immunoreactivity which appeared more apparent in the group treated with zerumbone. Prostaglandin E 2 has a role in osteoarthritis development and regulation.
Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose
Annals of the rheumatic diseases, 2015
To determine whether high-dose fish oil is superior to low-dose supplementation for symptomatic and structural outcomes in knee osteoarthritis (OA). A randomised, double-blind, multicentre trial enrolled 202 patients with knee OA and regular knee pain. They were randomised 1:1 to high-dose fish oil (4.5 g omega-3 fatty acids) 15 mL/day or (2) low-dose fish oil (blend of fish oil and sunola oil; ratio of 1:9, 0.45 g omega-3 fatty acids) 15 mL/day. The primary endpoints were Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score at 3, 6, 12 and 24 months, and change in cartilage volume at 24 months. Secondary outcomes included WOMAC function, quality of life, analgesic and non-steroidal anti-inflammatory drug use and bone marrow lesion score. Although there was improvement in both groups, the low-dose fish oil group had greater improvement in WOMAC pain and function scores at 2 years compared with the high-dose group, whereas between-group differences at 1 year d...
Evidence-Based …, 2010
The multidisciplinary "New Millennium Indian Technology Leadership Initiative" Arthritis Project was undertaken to validate Ayurvedic medicines. Herbal formulations in popular use were selected by expert consensus and standardized using modern tools. Our clinical strategy evolved from simple exploratory evaluations to better powered statistically designed drug trials. The results of the first drug trial are presented here. Five oral formulations (coded A, B, C, D and E), with a common base of Zingiber officinale and Tinospora cordifolia with a maximum of four plant extracts, were evaluated; with placebo and glucosamine as controls. 245 patients suffering from symptomatic OA knees were randomized into seven arms (35 patients per arm) of a double blind, parallel efficacy, multicentric trial of sixteen weeks duration. The groups matched well at baseline. There were no differences for patient withdrawals (17.5%) or adverse events (AE) of mild nature. Intention-to-treat efficacy analysis, demonstrated no significant differences (P < .05) for pain (weight bearing) and WOMAC questionnaire (knee function); placebo response was high. Based on better pain relief, significant (P < .05) least analgesic consumption and improved knee status, "C" formulation was selected for further development. Controlled exploratory drug trials with multiple treatment arms may be used to economically evaluate several candidate standardized formulations.
Evidence-based complementary and alternative medicine : eCAM, 2011
The multidisciplinary "New Millennium Indian Technology Leadership Initiative" Arthritis Project was undertaken to validate Ayurvedic medicines. Herbal formulations in popular use were selected by expert consensus and standardized using modern tools. Our clinical strategy evolved from simple exploratory evaluations to better powered statistically designed drug trials. The results of the first drug trial are presented here. Five oral formulations (coded A, B, C, D and E), with a common base of Zingiber officinale and Tinospora cordifolia with a maximum of four plant extracts, were evaluated; with placebo and glucosamine as controls. 245 patients suffering from symptomatic OA knees were randomized into seven arms (35 patients per arm) of a double blind, parallel efficacy, multicentric trial of sixteen weeks duration. The groups matched well at baseline. There were no differences for patient withdrawals (17.5%) or adverse events (AE) of mild nature. Intention-to-treat efficacy analysis, demonstrated no significant differences (P < .05) for pain (weight bearing) and WOMAC questionnaire (knee function); placebo response was high. Based on better pain relief, significant (P < .05) least analgesic consumption and improved knee status, "C" formulation was selected for further development. Controlled exploratory drug trials with multiple treatment arms may be used to economically evaluate several candidate standardized formulations.
Study on Knee Osteoarthritis with a Unani Poly Herbal Formulation: A Series of Case Studies
International Journal of Research in Ayurveda & Pharmacy, 2016
The most common cause for limiting mobility of the elderly people is joint disease, especially knee osteoarthritis. It is the major cause of disability and socioeconomic burden at present. Qurs-e-mafasil is a Unani poly herbal compound formulation mentioned in a Unani pharmacopeia, Qarabadeen-e-Majeedi. In which it is recommended for waja-ul-mafasil (arthralgia). This formulation contains three ingredients, Chob Zard (Curcuma longa Linn.), Surinjan Talkh (Colchium luteum Baker.) and Samaghe Arabi (Acacia Arabica Willd.). Aim of this study was to comprehend the effectiveness of the drug Qurs-e-mafasil in knee osteoarthritis patients. This study was done in 30 patients. Qurs-e-mafasil was administered orally as 2 pills 3 times a day with water or milk for 4 weeks. The outcome measures such as VAS (Visual Analogue Scale), KOOS (Knee injury and Osteoarthritis Outcome Score) and 15 meters walking test were used to assess the symptoms before and after treatment. These paired data were analyzed statistically according to Wilcoxon Matched paired signed rank test. KOOS mean pain score was 39.73 ± 2.399 before treatment and it was 56.93 ± 2.214 after treatment with an extremely significant improvement. Similarly there was a significant (52.14± 3.449) improvement at 4 th week in KOOS symptoms score. There was a significant change in the mean of KOOS total score (13.6%) and, significant improvement was observed in VAS (56.80 ± 2.571) and walking time (22.85 ± 0.527) at 4 th week. Therefore, it is revealed that when Qurs-e-mafasil administered orally the symptoms of osteoarthritis are relived significantly.
Biologics: targets & …, 2010
Background:Isolated fucoidans from brown marine algae have been shown to have a range of anti-inflammatory effects.Purpose:This present study tested a Maritech® extract formulation, containing a blend of extracts from three different species of brown algae, plus nutrients in an open label combined phase I and II pilot scale study to determine both acute safety and efficacy in osteoarthritis of the knee.Patients and methods:Participants (n = 12, five females [mean age, 62 ± 11.06 years] and seven males [mean age, 57.14 ± 9.20 years]) with a confirmed diagnosis of osteoarthritis of the knee were randomized to either 100 mg (n = 5) or 1000 mg (n = 7) of a Maritech® extract formulation per day. The formulation contained Maritech® seaweed extract containing Fucus vesiculosis (85% w/w), Macrocystis pyrifera (10% w/w) and Laminaria japonica (5% w/w) plus vitamin B6, zinc and manganese. Primary outcome was the average comprehensive arthritis test (COAT) score which is comprised of four sub-scales: pain, stiffness, difficulty with physical activity and overall symptom severity measured weekly. Safety measures included full blood count, serum lipids, liver function tests, urea, creatinine and electrolytes determined at baseline and week 12. All adverse events were recorded.Results:Eleven participants completed 12 weeks and one completed 10 weeks of the study. Using a multilevel linear model, the average COAT score was reduced by 18% for the 100 mg treatment and 52% for the 1000 mg dose at the end of the study. There was a clear dose response effect seen between the two treatments (P ≤ 0.0005) on the average COAT score and each of the four COAT subscales (pain, stiffness, difficulty with physical activity and overall symptom severity) (P ≤ 0.05). The preparation was well tolerated and the few adverse events were unlikely to be related to the study medication. There were no changes in blood parameters measured over the course of the study with the exception of an increase in serum albumin which was not clinically significant.Conclusion:The seaweed extract nutrient complex when taken orally over twelve weeks decreased the symptoms of osteoarthritis in a dose-dependent manner. It was demonstrated to be safe to use over the study period at the doses tested. The efficacy of the preparation now needs to be demonstrated in a phase III randomized controlled trial (RCT).Australian and New Zealand Clinical Trials Register:ACTRN12607000229471.
Journal of Ayurveda and Integrative Medicine, 2017
Background: In present era, pharmacological, biochemical and surgical interventions are not success remedy for Osteoarthritis (OA). Ayurveda and other complementary medicine have medication for OA. Objectives: The main aim of the study was to assess the efficacy and safety of therapeutic combination of Vatari guggulu along with Maharasnadi kwatha and Narayan taila with gentle massage for 15 min daily up to 12 weeks on affected knee joint pain assessed on Visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Materials and methods: It was an open label, multicentre, prospective, clinical study conducted on 142 patients of OA Knee. Vatari guggulu 500 mg thrice in a day along with Maharasnadi kwatha 20 ml with equal amount of water twice daily and Narayan taila 20 ml twice in a day for external application with gentle massage for 15 min up to 12 weeks were used to all the study participants. Results: VAS, WOMAC score and clinical symptoms were reduced significantly from baseline to end of the treatment (P < 0.001). Conclusions: The study provides good evidence in support of the efficacy and safety of the Vatari guggulu along with Maharasnadi kwatha and Narayan taila in the management of Osteoarthritis knee.
BMC complementary …, 2007
Background: The efficacy and safety of a dietary supplement derived from South American botanicals was compared to glucosamine sulfate in osteoarthritis subjects in a Mumbai-based multi-center, randomized, double-blind study. Methods: Subjects (n = 95) were screened and randomized to receive glucosamine sulfate (n = 47, 1500 mg/day) or reparagen (n = 48, 1800 mg/day), a polyherbal consisting of 300 mg of vincaria (Uncaria guianensis) and 1500 mg of RNI 249 (Lepidium meyenii) administered orally, twice daily. Primary efficacy variable was response rate based on a 20% improvement in WOMAC pain scores. Additional outcomes were WOMAC scores for pain, stiffness and function, visual analog score (VAS) for pain, with assessments at 1, 2, 4, 6 and 8 weeks. Tolerability, investigator and subject global assessments and rescue medication consumption (paracetamol) were measured together with safety assessments including vital signs and laboratory based assays. Results: Subject randomization was effective: age, gender and disease status distribution was similar in both groups. The response rates (20% reduction in WOMAC pain) were substantial for both glucosamine (89%) and reparagen (94%) and supported by investigator and subject assessments. Using related criteria response rates to reparagen were favorable when compared to glucosamine. Compared to baseline both treatments showed significant benefits in WOMAC and VAS outcomes within one week (P < 0.05), with a similar, progressive improvement over the course of the 8 week treatment protocol (45-62% reduction in WOMAC or VAS scores). Tolerability was excellent, no serious adverse events were noted and safety parameters were unchanged. Rescue medication use was significantly lower in the reparagen group (p < 0.01) at each assessment period. Serum IGF-1 levels were unaltered by treatments. Conclusion: Both reparagen and glucosamine sulfate produced substantial improvements in pain, stiffness and function in subjects with osteoarthritis. Response rates were high and the safety profile was excellent, with significantly less rescue medication use with reparagen. Reparagen represents a new natural productive alternative in the management of joint health.