Comparison of meloxicam and a glucosamine-chondroitin supplement in management of feline osteoarthritis

Summary

Objectives: To compare the efficacy of meloxicam and a glucosamine-chondroitin (Glu-Ch) supplement in the management of feline osteoarthritis (OA).

Methods: Prospective, blinded, randomized clinical trial. Cats over eight years of age with clinical signs of chronic OA were assigned to one of two groups and Glu-Ch or meloxicam was administered orally for 70 days, followed by a placebo until day 98. Cats were assessed by a veterinarian on five occasions and the owner completed an assessment form at the same time.

Results: Data were collected from thirty cats. Pre-treatment disease scores were significantly higher in the meloxicam group for owner mobility (p = 0.01) and veterinary lameness (p = 0.02). Owner mobility scores at day 14 (p = 0.01) and day 42 (p = 0.002) were significantly improved compared to pre-treatment scores for the meloxicam group. When meloxicam and Glu-Ch were discontinued and the placebo commenced, a significant proportion of the meloxicam group showed worsening of all the ownerassessed scores between day 70 and day 98, when compared to the Glu-Ch group (mobility p = 0.01; activity p = 0.02; temperament p = 0.04; lifestyle p = 0.01).

Clinical significance: Treatment with meloxicam resulted in a significant improvement in mobility and activity levels of cats with OA until the placebo was introduced. A greater proportion of cats receiving meloxicam medication showed a significant worsening of owner assessment scores once the placed was introduced, when compared to the Glu-Ch group.

Keywords

Feline - osteoarthritis - glucosamine - chondroitin - meloxicam

• References

• 1 Bennett D, Morton C. A study of owner observed behavioural and lifestyle changes in cats with musculoskeletal disease before and after analgesic therapy. J Feline Med Surg 2009; 11: 997-1004.
• 2 Clarke SP, Bennett D. Feline osteoarthritis: a prospective study of 28 cases. J Small Anim Pract 2006; 47: 439-445.
• 3 Clarke SP, Mellor D, Clements DN. et al. Prevalence of radiographic signs of degenerative joint disease in a hospital population of cats. Vet Rec 2005; 157: 793-799.
• 4 Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994-1997). J Am Vet Med Assoc 2002; 220: 628-632.
• 5 Lascelles BDX, Hansen BD, Roe S. et al. Evaluation of client-specific outcome measures and activity monitoring to measure pain relief in cats with osteoarthritis. J Vet Intern Med 2007; 21: 410-416.
• 6 Peterson ME, Taylor RS, Greco DS. et al. Acromegaly in 14 cats. J Vet Intern Med 1990; 4: 192-201.
• 7 Bennett D, Zainal Ariffin SM, Johnston P. Osteoarthritis in the cat: 1. How common is it and how easy to recognise?. J Feline Med Surg 2012; 14: 65-75.
• 8 Bennett D, Zainal Ariffin SM, Johnston P. Osteoarthritis in the cat: 2. How should it be managed and treated?. J Feline Med Surg 2012; 14: 76-84.
• 9 Morton CM, Grant D, Johnston L. et al. Clinical evaluation of meloxicam versus ketoprofen in cats suffering from painful acute locomotor disorders. J Feline Med Surg 2011; 13: 237-234.
• 10 Lascelles BDX, Henderson AJ, Hackett IJ. Evaluation of the clinical efficacy of meloxicam in cats with painful locomotor disorders. J Small Anim Pract 2001; 42: 587-593.
• 11 Mullins KB, Thomason JM, Lunsford KV. et al. Effects of carprofen, meloxicam and deracoxib on platelet function in dogs. Vet Anaesth Analg 2012; 39: 206-217.
• 12 Carroll GL, Howe LB, Peterson KD. Analgesic efficacy of preoperative administration of meloxicam or butorphanol in onychectomized cats. J Am Vet Med Assoc 2005; 226: 913-919.
• 13 Sparkes AH, Heiene R, Lascelles BDX. et al. ISFM and AAFP consensus guidelinesLong-term use of NSAIDs in cats. J Feline Med Surg 2010; 12: 521-538.
• 14 Maddison JE. Cats and NSAIDs-what are the issues?. Irish Vet J. 2007 60. 174.
• 15 Winkelmayer WC, Waikar SS, Mogun H. et al. Nonselective and cyclooxygenase-2-selective NSAIDs and acute kidney injury. Am J Med 2008; 121: 1092-1098.
• 16 Warner TD, Mitchell JA. Cyclooxygenases: new forms, new inhibitors, and lessons from the clinic. FASEB J 2004; 18: 790-804.
• 17 Tiraloche G, Girard C, Chouinard L. et al. Effect of oral glucosamine on cartilage degradation in a rabbit model of osteoarthritis. Arthritis Rheum 2005; 52: 1118-1128.
• 18 Naito K, Watari T, Furuhata A. et al. Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model. Life Sci 2010; 86: 538-543.
• 19 Tat SK, Pelletier JP, Vergés J. et al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study. Arthritis Res Ther. 2007 9. R117.
• 20 Bruyere O, Reginster J-Y. Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis. Drugs Aging 2007; 24: 573-580.
• 21 Richy F, Bruyere O, Ethgen O. et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003; 163: 1514-1522.
• 22 Towheed TE, Anastassiades T. Glucosamine therapy for osteoarthritis: an update. J Rheumatol 2007; 34: 1787-1790.
• 23 Wandel S, Jüni P, Tendal B. et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010 341. c4675.
• 24 Bruyere O, Pavelka K, Rovati LC. et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthr Cartil 2008; 16: 254-260.
• 25 Sawitzke AD, Shi H, Finco MF. et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis Rheum 2008; 58: 3183-3191.
• 26 Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee. Rheumatology (Oxford) 2002; 41: 279-284.
• 27 Cibere J, Thorne A, Kopec JA. et al. Glucosamine sulfate and cartilage type II collagen degradation in patients with knee osteoarthritis: randomized discontinuation trial results employing biomarkers. J Rheumatol 2005; 32: 896-902.
• 28 Vlad SC, LaValley MP, McAlindon TE. et al. Glucosamine for pain in osteoarthritis: Why do trial results differ?. Arthritis Rheum 2007; 56: 2267-2277.
• 29 Cibere J, Kopec JA, Thorne A. et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 2004; 51: 738-745.
• 30 McAlindon T, Formica M, LaValley M. et al. Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial. Am J Med 2004; 117: 643-649.
• 31 Pavelká K, Gatterová J, Olejarová M. et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002; 162: 2113-2123.
• 32 Bruyere O, Pavelka K, Rovati LC. et al. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Menopause 2004; 11: 138-143.
• 33 Aghazadeh-Habashi A, Jamali F. The glucosamine controversy; a pharmacokinetic issue. J Pharm Pharm Sci 2011; 14: 264-273.
• 34 McCarthy G, O’Donovan J, Jones B. et al. Randomised double-blind, positive-controlled trial to assess the efficacy of glucosamine/chondroitin sulfate for the treatment of dogs with osteoarthritis. Vet J 2007; 174: 54-61.
• 35 Laine L, White WB, Rostom A. et al. COX-2 selective inhibitors in the treatment of osteoarthritis. Sem Arthritis Rheum 2008; 38: 165-187.
• 36 Gunew MN, Menrath VH, Marshall RD. Long-term safety, efficacy and palatability of oral meloxicam at 0.01-0.03 mg/kg for treatment of osteoarthritic pain in cats. J Feline Med Surg 2008; 10: 235-241.
• 37 Panchaphanpong J, Asawakarn T, Pusoonthornthum R. Effects of oral administration of N-acetyl-d-glucosamine on plasma and urine concentrations of glycosaminoglycans in cats with idiopathic cystitis. Am J Vet Res 2011; 72: 843-850.
• 38 Zamprogno H, Hansen BD, Bondell HD. et al. Item generation and design testing of a questionnaire to assess degenerative joint disease-associated pain in cats. Am J Vet Res 2010; 71: 1417-1424.
• 39 Lascelles BDX. Feline degenerative joint disease. Vet Surg 2010; 39: 2-13.
• 40 Godfrey DR. Osteoarthritis in cats: a retrospective radiological study. J Small Anim Pract 2005; 46: 425-429.
• 41 Lascelles BDX, Henry 3rd JB, Brown J. et al. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg 2010; 39: 535-544.
• 42 Whiting PG, Pool RR. Intrameniscal calcification and ossification in the stifle joints of three domestic cats. J Am Anim Hosp Assoc 1985; 21: 579-584.
• 43 Walker M, Phalan D, Jensen J. et al. Meniscal ossicles in large non-domestic cats. Vet Radiol Ultrasound 2002; 43: 249-254.
• 44 Kranenburg HC, Meij BP, van Hofwegen EML. et al. Prevalence of spondylosis deformans in the feline spine and correlation with owner-perceived behavioural changes. Vet Comp Orthop Traumatol 2012; 25: 217-223.
• 45 Semanik P, Song J, Chang RW. et al. Assessing physical activity in persons with rheumatoid arthritis using accelerometry. Med Sci Sports Exerc 2010; 42: 1493-1501.
• 46 Lascelles BDX, Hansen BD, Thomson A. et al. Evaluation of a digitally integrated accelerometer-based activity monitor for the measurement of activity in cats. Vet Anaesth Analg 2008; 35: 173-183.