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Vol. 7. Issue 1.
Pages 3-11 (March 2006)
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Vol. 7. Issue 1.
Pages 3-11 (March 2006)
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Sulfato de glucosamina. de la condromodulación a la reducción sintomática y del progreso de la artrosis
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Antonio Ponce-Vargas
Servicio de Reumatología. Complejo Hospitalario Carlos Haya. Liga Reumatológica Andaluza (LIRA). Málaga. España
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Resumen

La artrosis es una de las causas más frecuentes de dolor y discapacidad en las personas mayores. Dado el aumento de la población anciana, cada vez más se precisan de intervenciones terapéuticas que permitan retrasar sus deletéreos efectos en la salud de las personas. Por consiguiente, una política sanitaria responsable debería tener en cuenta esta demanda social y un enfoque prioritario de recursos para esta enfermedad cada vez más prevalente. El interés clínico e investigador por esta afección se ha renovado. El mayor conocimiento fisiopatológico de los cambios inmunológicos y enzimáticos que operan en la enfermedad ha modificado el concepto mecanicista que se tenía de su patogenia incorporando otro más dinámico y biológico, en que el condrocito desempeña un papel fundamental, y además sería sensible al tratamiento farmacológico, lo que retrasaría el proceso degenerativo. El sulfato de glucosamina (SG) es una molécula con un amplio abanico de acciones biológicas entre las que sobresalen la antiinflamatoria y la reguladora al alza del metabolismo de la matriz del cartílago. Recientes estudios in vitro demuestran este perfil condromodulador que favorece el anabolismo del condrocito. Igualmente, estudios a largo plazo, aleatorizados y controlados con placebo han mostrado una mejora en los síntomas y de la progresión del estrechamiento articular en personas tratadas con SG, junto con un perfil de seguridad similar al de los grupos placebo. El siguiente artículo realiza un acercamiento al control de la enfermedad con los fármacos sintomáticos de acción lenta y modificadores de la estructura en la artrosis y revisa las evidencias disponibles del SG en el tratamiento específico de la artrosis.

Palabras clave:
Artrosis
Sulfato de glucosamina
Fármacos modificadores de la enfermedad para la artrosis
Abstract

Osteoarthritis (OA) is one of the most frequent causes of pain and disability in the elderly. Given the old population's increase, therapeutic interventions are necessary to allow retarding the deleterious effects on the health of people. Consequently, a responsible sanitary policy should keep in mind this social demand and a high-priority focus of resources for this prevalent disease. There is now a renewed clinical and research interest in this complaint. Greather physiopathological understanding of the immunological and enzymatic changes that influence the disease have modified the mechanical concept once held of its pathogenicity to include other more dynamic and biological causes in which plays a basic role. Furthermore, it would also be sensitive to pharmacological treatment, thus delaying the degenerative process. Glucosamine sulphate (GS) is a molecule with a wide range of biological actions with some of the most important being the antiinflammatory effect and an increased metabolism of the cartilage matrix. Recent studies in vitro show a profile of chondro-modulation that favors the anabolism of the chondrocyte. Similarly, long-term, prospective, placebo-controlled studies have shown an improvement in the symptoms and of the progression of the narrowing of the articular space in people treated with GS, with a profile of similar safety to the placebo groups. The following article carries out an approach to the control of the illness with the Delayed-acting symptomatic drugs and disease modyfing drugs in the OA and it reviews the available evidences of GS in the specific treatment of OA.

Key words:
Osteoarthritis
Glucosamine sulphate
Disease modyfing drugs for osteoarthritis
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Bibliografía
[1.]
Sociedad Española de Reumatología. Estudio EPISER. Prevalencia de las enfermedades reumáticas en la población española. Madrid: Ed: Merck, Sharp & Dohme; 2001.
[2.]
P. Bourgeois, G. Charles, J. Dehais, B. Delcambre, J.L. Kuntz, S. Rozenberg.
Efficacy and tolerability of chondroitin sulfate 1,200 mg/day versus chondroitin sulfate 3 × 400 mg/day versus placebo.
Osteoarthritis Cartilage, 6 (1998), pp. 25-30
[3.]
I.B. Houpt, R. McMillan, C. Wein, S.D. Paget-Dellio.
Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee.
J Rheumatol, 26 (1999), pp. 2423-2430
[4.]
W. Noack, M. Fischer, K.K. Forster, L.C. Rovati, I. Setnikar.
Glucosamine sulfate in osteoarthritis of the knee.
Osteoarthritis Cartilage, 2 (1994), pp. 51-59
[5.]
A. Reichelt, R.R. Forster, M. Fischer, L.C. Rovati, I. Setnikar.
Efficacy and safety of intramuscular glucosamina sulfate in osteoarthritis of the knee. A randomised, placebo-controlled, double-blind study.
Drug Res, 44 (1994), pp. 75-80
[6.]
M. Lequesne, E. Maheu, C. Cadet, R.L. Dreiser.
Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip.
Arthritis Rheum, 47 (2002), pp. 50-58
[7.]
EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis.
Report of a Task Force of the Standing Comitte for International Clinical Studies Including Therapeutics Trials (ESCISIT).
Ann Rheum Dis, 62 (2003), pp. 1145-1155
[8.]
C. Furnsinn, A.L. Sanderson, G.K. Radda, B. Leighton.
Effects of glucosamine on insulin-stimulated glucose metabolism in rat soleus muscle.
Int J Biochem Cell Biol, 27 (1995), pp. 805-814
[9.]
B. Balkan, B.E. Dunning.
Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats.
Diabetes, 43 (1994), pp. 1173-1179
[10.]
T. Monauni, M.G. Zenti, A. Cretti, M.C. Daniels, G. Targher, B. Caruso, et al.
Effects of glucosamine infusion on insulin secretion and insulin action in humans.
Diabetes, 49 (2000), pp. 926-935
[11.]
A.J. Tannis, J. Barban, J.A. Conquer.
Effect of glucosamine supplementation on fasting and non-fasting plasma glucose and serum insulin concentrations in healthy individuals.
Osteoarthritis Cartilage, 12 (2004), pp. 506-511
[12.]
J.W. Anderson, R.J. Nicolosi, J.F. Borzelleca.
Glucosamine effects in humans: a review of effects on glucose metabolism, side effects, safety considerations and efficacy.
Food Chem Toxicol, 43 (2005), pp. 187-201
[13.]
M.F. MacCarty.
Enhanced synovial production of hyaluronic acid may explain rapid clinical response to hig-dose glucosamine in osteoarthritis.
Med Hypotheses, 50 (1998), pp. 507-510
[14.]
I. Setnikar, C. Giachetti, G. Zanolo, et al.
Pharmokinetics of glucosamine in the dog and in man.
Drug Res, 36 (1986), pp. 729
[15.]
P.M. Van der Krann, E.L. Vitters, B.J. De Vries, W.B. Van den Berg.
High susceptibility of human articular cartilage glycosaminoglycan synthesis to changes in inorganic sulphate availability.
J Orthop Res, 8 (1990), pp. 565-571
[16.]
C.C. De Camara, G.V. Dowless.
Glucosamine sulfate for osteoarthritis.
Am Pharmacother, 32 (1998), pp. 580-587
[17.]
C.A. Heyneman, R.S. Rhodes.
Glucosamine for osteoarthritis cure or comundrum?.
Ann Pharmacother, 32 (1998), pp. 602-603
[18.]
E.H. Adams, T.S. Hunter, T. Williams.
New options in the treatment of arthritis.
J Manage Care Pharm, 5 (1999), pp. 443-448
[19.]
S.A. Jiménez, G.R. Dodge.
The effects of glucosamine sulfate on human chondrocyte gene expression.
Abstract submitted to the ILAR Congress,
[20.]
I. Setnikar.
Antireactive properties of “chondroprotective” drug.
Int J Tissue React, 14 (1992), pp. 253-261
[21.]
Rotta Pharmaceuticals.
Osteoartritis a new therapeutic focus.
Rotta Pharmaceuticals (Data on file), (1999),
[22.]
R. Largo, M.A. Alvarez-Soria, I. Diez-Ortego, E. Calvo, O. Sánchez Pernaute, J. Egido, et al.
Glucosamine inhibits IL-1 beta-induced NFkappaB activation in human osteoarthritic chondrocytes.
Osteoarthritis Cartilage, 11 (2003), pp. 290-298
[23.]
I. Setnikar, R. Cereda, M.A. Pacini, L. Revel.
Antireactive properties of glucosamina sulphate.
Arzneimittelforschung, 41 (1991), pp. 157-161
[24.]
I. Setnikar, M.A. Pacini, L. Revel.
Antiarthritic effects of glucosamina sulfate studied in animal models.
Arzneimittelforschung, 41 (1991), pp. 542-545
[25.]
J.M. Pujalte, E.P. Llavore, F.R. Ylescupidez.
Double-bind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis.
Curr Med Res Opin, 7 (1980), pp. 110-114
[26.]
W. Noack, M. Fischer, K.K. Foster, L.C. Rovati, I. Setnikar.
Glucosamine sulphate in osteoarthritis of the knee.
Osteoarthritis Cartilage, 2 (1994), pp. 51-59
[27.]
H. Muller-Fassbender, G.L. Bach, W. Haase, L.C. Rovati, I. Setnikar.
Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee.
Osteoarthritis Cartilage, 2 (1994), pp. 61-69
[28.]
Lopes-Vaz.
Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamina sulphate in the management of osteoarthritis of the knee in out-patiens.
Curr Med Res Opin, 8 (1982), pp. 145-149
[29.]
I.C. Rovati.
The clinical profile of glucosamine sulfate as a selective symptom modifying drug in osteoarthritis: current data and perspectives [abstract].
Osteoarthritis Cartilage, 5 (1997), pp. 72
[30.]
J.Y. Reginster, R. Deroisy, L.C. Rovati, R.L. Lee, E. Lejeune, O. Bruyere, et al.
Long-term effects of glucosamine sulphate on osteoartritis progresión: a randomised, placebo-controlled clinical trial.
[31.]
K. Pavelka, J. Gatterova, M. Olejarova, S. Machacek, G. Giacovelli, L.C. Rovati.
Glucosamine sulphate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.
Arch Intern Med, 162 (2002), pp. 2113-2123
[32.]
T.E. McAlindon, M.P. La Vallery, J.P. Gulin, D.T. Felson.
Glucosamine and chondroitin treatment for osteoarthritis: a systematic quality assessment and meta-analysis.
JAMA, 283 (2000), pp. 1469-1475
[33.]
T.E. Towheed.
Glucosamine sulfate in osteoarthritis: A systematic review.
Arthritis Rheum, 41 (1998), pp. S198
[34.]
T.E. Towheed.
Published meta-analyses of pharmacological therapies for osteoarthritis.
Ostearthritis Cartilage, 10 (2002), pp. 836-837
[35.]
Rotta Pharmaceuticals.
Glucosamine sulfate: summary of product characteristics.
Rotta Pharmaceuticals, (1999),
[36.]
Pavelka K, Gatterova J, Giacovelli G, et al. Glucosamine sulfate prevents total joint replacement in the long-term follow-up of knee osteaoarthritis patients. American College of Rheumatology 2004 meeting; October 16-21; 2004; San Antonio, TX; presentation 251, poster board 252.
Copyright © 2006. Sociedad Española de Reumatología
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