Sulfato de glucosamina y condroitín sulfato, fármacos para el tratamiento de la artrosis, acusados de no presentar eficacia clínica. ¿Culpables?

Abstract

Glucosamine sulphate and chondroitin sulphate have been approved by the Spanish Medications and Health Products Agency for the symptomatic treatment of osteoarthritis arthritis. Their efficacy and safety have been demonstrated in multiple clinical studies and via meta-analyses. Recently, based on a meta-analysis published in the British Medical Journal (2010), the therapeutic advantage of glucosamine and chondroitin sulphate versus other older drugs has been seriously questioned. The publication was criticized from key opinion leaders in the field and the journal published a rectification criticizing some aspects of the paper, particularly its conclusions on a possible veto on funding and prescription of these drugs, which were not directly related to the results. The methodology employed was also widely criticized and therefore the entire paper should be interpreted with reserve. Despite subsequent support for the use of these drugs, the impact of that first publication on their funding and use remains considerable.

The present study analyzes, from a pharmacological point of view, the causes that may have contributed to a false and imprudent accusation. The aim is to define the correct place of glucosamine sulphate and chondroitin sulphate in the treatment of osteoarthritis arthritis, a chronic disease whose prevalence is increasing and which, by 2020, could become the fourth most important cause of disability worldwide.