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Chondroitin Beats Celecoxib in Treatment of Knee Osteoarthritis

treatment of knee osteoarthritis

For treatment of knee osteoarthritis, you may want to consider the natural supplement chondroitin rather than the prescription drug celecoxib. According to a new study, chondroitin beats celecoxib in treatment of knee osteoarthritis because it offers benefits beyond pain relief and improved mobility.


Osteoarthritis is the most common form of arthritis in the knee, the strongest and largest joint in the body. Knee osteoarthritis typically develops slowly over time, and with each passing year the pain and mobility challenges worsen.

Among the more common drug treatments for knee osteoarthritis are acetaminophen (an over-the-counter anti-inflammatory), NSAIDS (nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen, available OTC and by prescription), and prescription COX-2 inhibitors (e.g., celecoxib as Celebrex). Among the popular natural treatment options are chondroitin sulfate and glucosamine, which are taken either separately or together.

Chondroitin is made naturally by the body and helps retain water in cartilage. Glucosamine is another natural compound found primarily in the fluid around the joints. Both of these substances have shown anti-inflammatory properties and an ability to regenerate cartilage and/or modify disease progression.

Chondroitin and celecoxib study
In this latest study, investigators compared the effectiveness of celecoxib with a natural supplement, chondroitin sulfate, in 194 individuals with knee osteoarthritis characterized by inflammation and moderate pain. The multicenter, randomized, double-blind, controlled, comparative study took place over a two-year period.

During that time, the participants took either 1,200 mg per day of chondroitin sulfate or 200 mg of celecoxib. Three magnetic resonance imaging (MRI) scans were performed during the study as well.

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At the end of the intervention period, here’s what the researchers found:

  • Progression of knee osteoarthritis was slower among patients who took chondroitin sulfate, based on MRI results
  • Both chondroitin and celecoxib were equally effective (about 50%) in improving pain, function, stiffness, and joint swelling

The authors noted that “This trial demonstrated, for the first time, the superiority of CS [chondroitin sulfate] over CE (celecoxib] at reducing the long term progression of knee OA structural changes.” These findings are noteworthy because they have “important implications regarding the usefulness of CS for long term management of knee OA and its impact on disease outcome.”

Other studies of chondroitin and knee osteoarthritis
Most studies of chondroitin sulfate and knee osteoarthritis also involve taking glucosamine. One recent study (July 2015), for example, reported that use of 100 mg glucosamine plus 180 mg chondroitin sulfate daily versus placebo for 12 weeks or longer resulted in a significant improvement in knee function and physical activity among middle- to older adults.

However, several studies, in addition to the current one, have focused on chondroitin alone. A systematic review appearing in March 2015 in the American Journal of Sports Medicine, for example, noted that treatment with chondroitin sulfate resulted in a significant reduction in cartilage loss in three of four placebo-controlled studies.

If you have osteoarthritis of the knee, an effective alternative to the COX-2 inhibitor celecoxib is chondroitin. An added bonus of using chondroitin for treatment of knee osteoarthritis is that this natural remedy provides some protection against structural changes associated with progression of the disease.

Also Read: Knee osteoarthritis and Chinese medicine
The Complete Guide to Healing Arthritis
Tai chi improves knee osteoarthritis pain in elderly

Gallagher B et al. Chondroprotection and the prevention of osteoarthritis progression of the knee: a systematic review of treatment agents. American Journal of Sports Medicine 2015 Mar; 43(3): 734-44
Pelletier JP et al. In a Two-Year Double-Blind Randomized Controlled Multicenter Study, Chondroitin Sulfate Was Significantly Superior to Celecoxib at Reducing Cartilage Loss with Similar Efficacy at Reducing Disease Symptoms in Knee Osteoarthritis Patients [abstract]. Arthritis and Rheumatology 2015; 67 (suppl 10). Accessed November 11, 2015.
Tsuji T et al. Effects of N-acetyl glucosamine and chondroitin sulfate supplementation on knee pain and self-reported knee function in middle-aged and older Japanese adults: a randomized, double-blind, placebo-controlled trial. Aging, Clinical and Experimental Research 2015 Jul 16