A huge percentage of sufferers do not know they are already suffering from it — very few Filipinos see an expert so their condition is often misdiagnosed as something else.
“With osteoarthritis, the cartilage starts to go away and then the bones start to rub against each other, “explains Dr. Bernadette Heizel Reyes, immediate past president of the Philippine Rheumatology Association (PRA). "Not only can osteoarthritis cause painful symptoms, it can also impact a person’s quality of life as it can limit one’s function and mobility and even the ability to exercise, which is of special concern to older patients as exercise is usually the recommended intervention for their other chronic medical conditions. If you can’t exercise, you start to gain weight, which leads to all sorts of serious health problems.” she adds.
Osteoarthritis is recognized as the 11th highest contributor of global disability and today affects almost four-percent of the population worldwide.
"While there may be as many as 10 million to 15 million adult Filipinos aged over 60 who may have some degree of osteoarthritis, with prevalence higher among women than men, we may never be able to know their exact number because a huge percentage of sufferers do not know they are already suffering from it — very few Filipinos see an expert so their condition is often misdiagnosed as something else. Also, many believe osteoarthritis is a natural consequence of aging and thus they can’t do anything about it,” laments PRA vice president Dr. Emmanuel Perez.
While there are medications that can help relieve osteoarthritis symptoms — primarily pain — like acetaminophen (paracetamol), and non-steroidal antiinflammatory drugs or NSAIDs, these are not long-lasting, provide little benefit, and could even cause stomach upset, cardiovascular problems, bleeding problems and liver and kidney damage.
This situation convinced the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) to revisit the 2014 algorithm recommendations for osteoarthritis affecting the knee joints.
“This led to the revision of the recommendations that suggest that a more safe and preferred treatment approach would be the administration of chronic symptomatic slow-acting drugs for osteoarthritis or SYSADOA, such as prescription glucosamine sulfate and/or chondroitin sulfate,” informs ESCEO president Jean Yves Reginster, who is also professor of Epidemiology, Public Health and Health Economics at the University of Liege in Belgium.
The term “symptomatic slow-acting drugs for osteoarthritis” was coined more than a decade ago to designate medications used to alleviate the manifestations of osteoarthritis in the long-term.
Their efficacy has always been a focus of considerable skepticism. This will soon change after this critical reappraisal of the available data and their therapeutic effects, which include results of carefully designed clinical trials conducted in accordance with Good Clinical Practice guidelines.
Prof. Reginster explained that the updated algorithm — comprising a stepwise approach and incorporating consensus on 15 treatment recommendations — was derived from the review of recent publications concerned with the safety of paracetamol, NSAIDs and SYSADOAs. The algorithm is a combination of pharmacological treatment modalities with a focus on drug safety, and parallel utilization of non-pharmacological treatments, and a core set that includes patient education, weight management and exercise program.
“The revision further confirmed that SYSADOAs may be considered as a firstline treatment for osteoarthritis occurring in the knee, with a particular emphasis placed on the outstanding benefit: risk ratio of prescription glucosamine sulfate (and not glucosamine hydrochloride) and chondroitin sulfate formulations,” says Prof. Reginster, who is also a director at the World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging in Belgium.
The revised recommendation now find that SYSADOAs, specifically the prescription glucosamine sulfate, to delay, stabilize or prevent the pathological changes in osteoarthritic joints, limiting the progression of this debilitating disease.
With the current scientific evidence and the updated ESCEO algorithm, the use of prescription glucosamine sulfate as a background treatment for osteoarthritis is now supported, since it was the only pharmacological treatment consistently associated with long-term improvement in pain, physical function and joint space narrowing and as well with a cost-effective profile.