Piramal drug for osteoarthritis

Nicholas Piramal India Ltd is launching a dietary supplement product for , a degenerative joint disease affecting 50 per cent of people older than age 65, of which 75 per cent are women. The product is slated for launch on 23 January 2000.

Nicholas Piramal officials claim that Rejoint, a combination pack containing glucosamine and chondroitin capsules, provides nutrition to the cartilage and help the body to naturally restore the cartilage repair mechanism. Glucosamine is found naturally in the body and is known to give cartilages the required strength and rigidity.

Osteoarthritis is a condition wherein the cartilage of the affected joint is roughened and becomes worn down. As the disease progresses, much of the cartilage is worn out, and the bone ends start to rub against each other. Bone spurs may develop around the joint, causing pain and inflammation.

The cartilage is built up of four basic components – collagen, proteoglycans, water, and chondrocytes. Collagen is a network of fibres (strong rod-like molecules made of interwoven polypeptide chains cross-linked to form helix patterns). Proteoglycans and water, which lubricate the cartilage, are held within the helix. Water is essential for shock absorption and sponginess and also to carry nutrients to the cartilage. Proteoglycans attract and hold water. Collagens in turn hold proteoglycans, while chondrocytes synthesise the cartilage.

If the cartilage is damaged, collagens become loose, proteoglycans float away, and the cartilage loses its ability to retain water and absorb shocks. Hence, a cartilage becomes more susceptible to cracking, fissuring and wearing down.

The cause of osteoarthritis, or what causes the cartilage to degenerate, is unknown. The development may be metabolic, genetic, chemical, or due to mechanical factors, experts say. The risk factors are age, trauma, repetitive joint use, obesity, congenital defects and recent research indicates that abnormal enzyme release by cartilage cells could be a probable cause.

The recommended dosage for Nicholas Piramal''s product is one capsule of glucosamine and chondroitin twice a day. The per day cost of the therapy works out to Rs 40. The recommended duration of therapy is two to four months, "but symptomatic relief can be observed within 10 days to one month", a company official claims.

Glucosamine supplements are gaining a lot of attention as an arthritis treatment as they appear to be safe, and there is some evidence they may improve symptoms in people with osteoarthritis, says the Mayo Foundation for Medical Education and Research. However, the foundation does not recommend it as an arthritis treatment as studies on glucosamine have been small and have lasted for only few weeks. "Larger, longer studies are needed before any positive effects from the supplements can be proven," the foundation says.