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Osteoarthritis (OA) is one of the most disabling arthritic conditions in knee joint. Its pathogenesis is complex and doubtful and its management is a real challenge for medical community.
The goals of the treatment in osteoarthritis are:
1- Controlling the pain
2- Preserving the joint structures
3- Improving the quality of life
Achieving these goals relies on a combination of non-pharmacological and pharmacological approaches.
Glucosamine (GlcN) and Chondroitin sulfate (CS) are two natural compounds considered as “Symptomatic Slow-Acting Drugs for OA (SYSADOA).
The proposed beneficial effects for these two drugs are:
1- Increasing the synthesis of type II collagen and proteoglycans in chondrocytes.
2- Reducing the production of some proinflammatory cytokines and proteases.
3- Reducing the cellular death process.
4- Improving the anabolic-catabolic balance of extracellular cartilage matrix.
There are many controversies on the indications of these two products. Several Guidelines recommend them as a treatment strategy for OA, however many other guidelines abstain from this recommendation. Some consider them as a drug while others behave them like a supplement. In most European countries, they are prescribed as a drug whereas in US, they are delivered over-the-counter and are not considered as a drug.
Some authors use GlcN and CS as a combination therapy for synergistic potency with a dosage of 500 mg TDS for GlcN and 400 mg TDS for CS.