These side chains account for the hydration and resistance to compression within and by the cartilage matrix. The basis for oral glucosamine and chondroitin sulfate as chondroprotective therapies for cartilage degeneration is that they might shift the chemical equilibrium in articular cartilage to favor synthesis of complete aggrecan molecules, and thereby provide increased levels of substrates or components of proteoglycans. Glucosamine and chondroitin sulfate have been widely used for many years in veterinary medicine as a means of ameliorating the symptoms of arthritis in animals. Several human trials have been conducted in Europe and Asia which have demonstrated the efficacy of these compounds as judged by improvement in subjective symptoms of osteoarthritis and improved range of motion. Benefits have been moderate with approximately 50 percent to 80 percent of the treatment group of patients showing improvement as opposed to 20 percent to 30 percent in placebo groups.
Beneficial effects appear to persist for several months after cessation of therapy.
However, there are relatively few studies of the use of these compounds in osteoarthritis in the United States, and in particular, none have demonstrated alteration of the natural history of osteoarthritis. Most studies have concluded that these compounds have a place in the armamentarium of the physician as a means of treatment which is essentially as effective as anti-inflammatory medication. This compound includes a patented combination of glucosamine, chondroitin sulfate, and manganese ascorbate. Manganese and ascorbate have been added as cofactors for the biosynthesis of proteoglycans. Whether or not this particular combination is effective is yet to be determined in controlled trials.