Chondroitin Sulphate and Glucosamine Sulphate Synergistically Reduced DRG Proinflammatory Molecules and Improved Axonal Function in Sciatic Nerve Ligated Rats.

Neuropathic pain (NP) is a sickness of the somatosensory nervous system. It is linked to defective quality of life and often poorly managed. Due to the limited number of approved drugs, limited efficacy and side effects associated with them, drugs or drug combinations with great efficacy and very minimal or no side effects will be of great advantage in managing NP. This study aimed at investigating the synergistic antinociceptive effects of the combination of glucosamine sulphate (GS) (240mg/kg) and chondroitin sulphate (CS) (900mg/kg) in chronic constriction injury (CCI)-induced neuropathy in rat. Forty-two Wistar rats were randomly distributed into seven groups (n=6). Sciatic nerve was ligated with four loose ligatures to induce NP. Effects of drugs were examined on stimulus and non-stimulus evoked potentials, expression of dorsal root ganglia (DRG) pain modulators and structural architecture of DRG. Oral administration of GS and CS for 21 days reduced hyperalgesia, allodynia, sciatic nerve functional aberration and DRG pain modulators. Histopathology and immunohistochemistry revealed restoration of structural integrity of DRG. Our result showed that the combination of GS and CS produced antinociceptive effects by attenuating hyperalgesia, allodynia and downregulation of NP mediators. GS and CS additionally produced synergistic analgesic effect than its individual components.

A comparison of oral versus topical combination of glucosamine sulphate and diacerein in patients of grade 2 osteoarthritis

<p class="abstract"><strong>Background:</strong> The study aimed to compare oral versus topical combination of glucosamine sulphate and diacerein in patients of grade 2 Osteoarthritis.</p><p class="abstract"><strong>Methods: </strong>This was a prospective study of 70 patients with grade 2 osteoarthritis knee, randomly divided into 2 groups of 35 each. The first group was given oral 1500mg of glucosamine and 100mg of diacerein per day and second group was given topical preparation of 10% w/w glucosamine sulphate and 1% w/w diacerein to be applied twice. Both the groups were followed up at 1, 3, 6 and 12 weeks. At each follow up, Visual Analog Scale (VAS) and Lequesne et al scores were used as efficacy parameters. C-Reactive Protein (CRP) level was measured in the beginning and at the end of 12 weeks.</p><p class="abstract"><strong>Results:</strong> Both the groups showed improvement in pain and joint function as depicted by VAS score and Lequesne index however the difference was not statistically significant. The decrease in CRP value was significant in oral group (p value&lt;0.001) but not in topical group (p value of 0.047). Paracetamol demand was slightly higher in topical group however the difference was not significant.</p><p class="abstract"><strong>Conclusions:</strong> Glucosamine sulphate and diacerein combination are effective in improving pain, stiffness and function in patients of grade 2 osteoarthritis knee. However, the efficacy of glucosamine sulphate and diacerein combination- oral as well as topical, in improving pain and stiffness is similar- there is no superiority of one over the other.</p>

Effects of Palm Tocotrienol-Rich Fraction Alone or in Combination with Glucosamine Sulphate on Grip Strength, Cartilage Structure and Joint Remodelling Markers in a Rat Model of Osteoarthritis

Background: Osteoarthritis is a degenerative joint disease lacking disease-modifying therapeutic agents. This study aimed to compare the effects of palm tocotrienol-rich fraction (TRF), glucosamine sulphate, and both agents combined in rats with osteoarthritis induced by monosodium iodoacetate (MIA). Methods: Thirty adult male rats were randomized into normal control, and osteoarthritis groups were treated orally daily with vehicle, palm TRF (100 mg/kg), glucosamine sulphate (250 mg/kg), and both agents combined for 4 weeks. Body weight and grip strength were measured weekly. After being sacrificed, the joints and blood were harvested for histology and serum cartilage oligomeric matrix protein (COMP) levels. Results: The body weight of the rats receiving treatment rebounded significantly after an initial reduction (vs osteoarthritic control, p < 0.05). The rats receiving combined treatments showed significantly better grip strength than the osteoarthritic control and individual treatment groups (p < 0.05). The serum COMP level was lower in all the treated groups (vs osteoarthritic control, p < 0.05). Cartilage histology of the treated rats was not significantly improved (vs osteoarthritic control, p > 0.05). Conclusion: The combination of palm TRF and glucosamine sulphate was more effective than individual agents in improving the grip strength of the rats, but the cartilage damage might need more time to heal.

Effect of Nucart VG (Boswellia serrata in combination with veg glucosamine sulphate) in comparison with glucosamine sulphate to improve quality of life of knee osteoarthritis patients: a randomized controlled trial

<p class="abstract"><strong>Background:</strong> <em>Boswellia serrata</em> has been proved to be an effective and safe herb for the treatment of osteoarthritis (OA). This study aims at assessing the synergistic effect of this herb with vegetarian glucosamine sulphate, a nutritional supplement, on knee osteoarthritis using quality of life indicators.</p><p class="abstract"><strong>Methods:</strong> This<strong> </strong>was an open label, parallel group randomized trial of 12-week duration. Sixty-six subjects were equally randomized to two treatment arms: <em>Boswellia serrata</em> extract (600 mg) and glucosamine (750 mg) [Nucart VG]; and glucosamine sulphate (market comparator) 750 mg. Patients were administered 1 tablet twice-a-day post-meal for three months. Efficacy of treatment was measured on primary end-points like EuroQol-5D (EQ-5D) (health status indicator), visual analogue scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scale (pain indicators), while safety was measured in terms of vital parameters. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed for comparing scores between the two groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The baseline characteristics of patients between two groups were insignificantly different (p&gt;0.05). In ITT analysis, the health status (EQ-5D score) of patients in Nucart VG group improved significantly than the comparator group at follow up 2 (p=0.037) and showed further improvement at follow up 3 (p=0.012). The pain indicators i.e. VAS and WOMAC scores were significantly lower in Nucart VG group right from follow up 1 till follow up 3 (p&lt;0.05). Similar were the observations during PP analysis.</p><p class="abstract"><strong>Conclusions:</strong> Nucart VG is beneficial for the treatment of mild to moderate knee OA, as inferred from the functional and health status assessment.</p>

Formulation and Characterization of Glucosamine Sulphate Loaded Carbopol Based Hydrogels for the Management of Osteoarthritis

Osteoarthritis is emerging as the most ordinary form of arthritis, affecting 22-39% of the Indian population. A wide range of medications and therapies are available for the treatment of osteoarthritis. With a desire to develop a therapeutically effective dosage form, the present study was carried out to formulate glucosamine sulfate loaded carbopol based hydrogel. Hydrogels H1 to H6 were formulated without permeation enhancers while formulations H7 to H12 were developed with a different class of permeation enhancers such as PEG400, oleic acid, Tween 40, DMSO and PG. Based on viscosity, it was detected that formulation H4 containing polymer 1% was ideal for incorporating drug. Considering H4 as a placebo, H6 was used for further evaluation. Drug content was found to be 99.2±0.64, with in vitro drug release of 15±0.86, 22±1.59, 28±0.72, 35±0.68, 40±0.31, 47±0.83, 58±1.59, and 70±0.9 % at a duration of 1, 2, 3, 4, 5, 6, 7, 8 hours respectively. Skin irritation tests carried out on Wistar rats revealed that skin was intact with no inflammation or erythema detected, compared to untreated site. By diffusion disc method, it was evident that the levels of microbial load were relatively low, and no harmful microorganisms were identified. There were no significant changes in physicochemical properties on stability studies. Due to a simple method of preparation and effective drug delivery, glucosamine sulfate loaded hydrogels could be contemplated as a prominent formulation in the beneficiary treatment of osteoarthritis.

Formulation and development of a topical combination cream for arthritis management

Purpose: To design and prepare a non-prescription cream for cost-effective, potent, rapid and longlasting relief from arthritic pain.Method: The cream was prepared by formulating the aqueous phase using glucosamine sulphate, potassium chloride and chondroitin sulphate sodium, and then pouring it into the oil phase under suitable conditions. The physicochemical and antimicrobial properties, in vitro and ex vivo drug release, and overall physical and chemical stability of the formulations were characterized.Results: Sodium metabisulfite (0.5 %) and butylated hydroxyanisole (BHA) (0.01 %) showed a very strong synergistic effect on overall stability of the cream.Conclusion: This study confirms that the formulated cream is potentially suitable for the management of arthritis pain in patients. Keywords: Arthritis, Ex vivo drug release, Sodium metabisulfite, Butylated hydroxyanisole, Product stability