The suppleness supplement Pain: Many believe that CosaminDS - glucosamine combined with chondroitin sulfate - can help joints stiffened by osteoarthritis.

July 26, 1998|By Nancy Menefee Jackson | Nancy Menefee Jackson,SPECIAL TO THE SUN

When the Ravens take the field this fall, several of them will fortify their knees - a football player's Achilles heel - with a nutritional supplement that is supposed to help the body renew joint cartilage. The supplement, CosaminDS, is sold only through pharmacies.

The same supplement, under the name Cosequin, has been used for five years by veterinarians on canine patients who suffer from arthritis or knee injuries from chasing one too many Frisbees - and by the animals' owners for osteoarthritis.

Have all these people, and dogs, found a dietary answer to arthritis? Does the supplement actually help regrow cartilage, or is it just anti-inflammatory? So far, study samples have been small, though anecdotal evidence is plentiful.

"We've used it for a little over a year," says Bill Tessendorf, the Ravens' head certified athletic trainer. "It must work because [the players] keep asking for it."

But Dr. Kim Hammond of Falls Road Animal Hospital is "totally not impressed" because no research has proved that it improves cartilage - "It's like eating steak and expecting to grow horns," he says - but he dispenses it because his clients demand it.

The supplement is a combination of two ingredients - glucosamine, from crab shells, and chondroitin sulfate, from cow trachea. A local company, Nutramax Laboratories, produces it.

Nutramax President Robert W. Henderson, a Baltimore pharmacist, patented the combination in 1993. Both ingredients occur naturally in the body and are the building blocks of cartilage. They have been used separately in Europe to treat arthritis for a decade.

"I looked at the mechanics of how they worked, and it just seemed to me that if I put them together it was going to be more effective," says Henderson.

His son, veterinarian Todd Henderson, saw the possibility for animals, and began using it in 1992. Now, of 22,000 small-animal practices in the United States, more than 18,000 use it, he says.

The supplement took off as a human treatment last year after "The Arthritis Cure," which touted CosaminDS, became a best seller and after Jane Brody, health writer for the New York Times, wrote about the improvements in her arthritic knee after she started taking the stuff prescribed for her dog. Nutramax began receiving 5,000 calls a day.

Last year, 34 U.S. Navy Seals and divers with mild to moderate arthritis took part in a pilot study of CosaminDS. For eight weeks, half took a placebo while the other half took CosaminDS. After three weeks, they switched. The subjects kept pain diaries and did functional tests.

"What we found," says Dr. Alan Philippi, a medical officer for the U.S. Navy in Norfolk, Va., "is there was a statistically significant decrease in the pain people experienced from their arthritis" while taking CosaminDS. The study found no liver or gastrointestinal side effects. But Philippi emphasizes that his study was small.

Dr. Amal Das, an orthopedic surgeon in North Carolina, studied 93 patients for six months. Although he could not give statistics, since he is submitting his paper to the New England Journal of Medicine, which will hold the copyright, he said he found CosaminDS to be effective for mild to moderate arthritis. It was not effective when no cartilage was left.

"It's kind of an exciting study, because it had no known side effects and it had statistically significant results," he says.

"I have lots of anecdotal evidence, but it's anecdotal," Das adds. "I have patients I've scheduled for joint replacement surgery, and I say, 'Well, try this, but we'll get you scheduled for the replacement.' And they call me back and say, 'Keep your silly plastic and metal joints.' "

Dr. Bill Howard, director of Union Memorial Hospital Sports Medicine Center and a surgeon, is cautious about a product not yet proved, but he has his own anecdotal evidence: When his 11-year-old Chesapeake Bay retriever could no longer accompany him up the steps, he began giving him the supplement. Now the dog can walk up steps. "I think personally there is something," Howard says.

Getting beyond the anecdotes will fall to Dr. David Hungerford, a professor of orthopedic surgery at the Johns Hopkins Medical Institutions. Later this summer, he will evaluate CosaminDS in a study involving 325 participants.

He is encouraged by animal studies, but he is concerned that people will decide on their own that they've got arthritis and head to the drugstore to pick up a bottle. "Maybe they've got pain because of nerve root compression. Maybe their hip pain is due to a tumor or hernia. If you've got known arthritis you're being treated for, I don't think it's a bad thing to go out and try this. But your physician should know about it."

Pub Date: 7/26/98

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