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Moskowitz RW.
Case Western Reserve University, Division of Rheumatic Diseases,
University Hospitals of Cleveland, OH, USA.
OBJECTIVES: To review the current status of collagen hydrolysate
in the treatment of osteoarthritis and osteoporosis.
METHODS: Review of past and current literature relative
to collagen hydrolysate metabolism, and assessment of clinical
investigations of therapeutic trials in osteoarthritis and
osteoporosis.
RESULTS: Hydrolyzed gelatin products have long been used
in pharmaceuticals and foods; these products are generally
recognized as safe food products by regulatory agencies. Pharmaceutical-grade
collagen hydrolysate (PCH) is obtained by hydrolysis of pharmaceutical
gelatin. Clinical studies suggest that the ingestion of 10
g PCH daily reduces pain in patients with osteoarthritis of
the knee or hip; blood concentration of hydroxyproline is
increased. Clinical use is associated with minimal adverse
effects, mainly gastrointestinal, characterized by fullness
or unpleasant taste. In a multicenter, randomized, doubleblind,
placebo-controlled trial performed in clinics in the United
States, United Kingdom, and Germany, results showed no statistically
significant differences for the total study group (all sites)
for differences of mean pain score for pain. There was, however,
a significant treatment advantage of PCH over placebo in German
sites.
In addition, increased efficacy for PCH as compared to placebo
was observed in the overall study population amongst patients
with more severe symptomatology at study onset. Preferential
accumulation of 14C-labeled gelatin hydrolysate in cartilage
as compared with administration of 14C-labeled proline has
been reported. This preferential uptake by cartilage suggests
that PCH may have a salutary effect on cartilage metabolism.
Given the important role for collagen in bone structure,
the effect of PCH on bone metabolism in osteoporotic persons
has been evaluated. Studies of the effects of calcitonin with
and without a collagen hydrolysate-rich diet suggested that
calcitonin plus PCH had a greater effect in inhibiting bone
collagen breakdown than calcitonin alone, as characterized
by a fall in levels of urinary pyridinoline cross-links. PCH
appeared to have an additive effect relative to use of calcitonin
alone.
CONCLUSIONS: Collagen hydrolysate is of interest as a therapeutic
agent of potential utility in the treatment of osteoarthritis
and osteoporosis. Its high level of safety makes it attractive
as an agent for long-term use in these chronic disorders.
Publication Types:
- Clinical Trial
- Multicenter Study
- Randomized Controlled Trial
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