Efficacy and Safety of Undenatured Type II Collagen in The Treatment of Osteoarthritis of The Knee: A Randomized, Double-blind, Placebo-controlled Trial

Oentarini Tjandra, Shirly Gunawan, Johan Johan, Fia Fia Lie, Marcella Erwina Rumawas, Agus Limarta

Abstract


BACKGROUND: Available medication for pain and joint stiffness release in osteoarthritis (OA) often gives considerable side effects. Undenatured type II collagen (UC-II) has been considered as a treatment for OA for its ability to prevent the progress of articular cartilage damage. Hence, this study aimed to evaluate the efficacy and safety of UC-II in modulating knee joint function.

METHODS: This was a randomized, double-blind, placebo-controlled study involving 102 OA subjects. Subjects were randomized into two groups: receiving an oral daily dose of 40 mg/day UC-II or placebo containing microcrystalline cellulose for 90 days. Efficacy was evaluated by using the Western Ontario McMaster Osteoarthritis Index (WOMAC), Lequesne’s Functional Index (LFI), and Visual Analogue Scale (VAS) score on day-1, -7, -30, -60, and -90. Safety was evaluated by assessing the adverse events (AEs) and abnormal laboratory findings.

RESULTS: The WOMAC total score showed a significant difference between the UC-II group vs. the placebo group from day-7 (p<0.05) to day-90 (p<0.01). UC-II was more effective in reducing the WOMAC total scores by 81.6% compared to 19.2% in the placebo group after 90 days. The total LFI and VAS score was significantly reduced in subjects supplemented with UC-II compared to the placebo group (75.8% vs. 7.8%; 67.9% vs. 12.2%, respectively). No significant changes were observed in vital signs and clinical laboratory tests compared to the placebo. The UC-II had a good safety profile with no serious adverse events among participants.

CONCLUSION: UC-II significantly improved the knee pain, stiffness, and functional mobility of OA patients and was well-tolerated.

KEYWORDS: osteoarthritis, undenatured type II collagen, WOMAC, VAS, LFI


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References


Buckwalter JA, Saltzman C, Brown T. The impact of osteoarthritis: implications for research. Clin Orthopedics Related Res. 2004; 427 (Suppl): S6-15, CrossRef.

Marlina, Rahmadian R, Armenia, Widowati W, Rizal, Kusuma HSW, et al. Isolation, characterization, proliferation and differentiation of synovial membrane-derived mesenchymal stem cells (SM-MSCs) from osteoarthritis patients. Mol Cell Biomed Sci. 2020 4(2): 76-82, CrossRef.

El-Tawil S, Arendt E, Parker D. Position statement: the epidemiology, pathogenesis and risk factors of osteoarthritis of the knee. J ISAKOS. 2016; 1(4): 219-28, CrossRef.

Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehetan Kementerian Kesehatan Republik Indonesia; 2013, article.

Chen T, Weng W, Liu Y, Aspera-Werz RH, Nussler AK, Xu J. Update on novel non-operative treatment for osteoarthritis: current status and future trends. Front Pharmacol. 2021; 12: 755230, CrossRef.

Yusuf E. Pharmacologic and non-pharmacologic treatment of osteoarthritis. Curr Treat Options Rheumatol. 2016; 2: 111–25, CrossRef.

Sadigursky D, Sanches MM, Garcia NM, Cantao MO, Matos MA. Effectiveness of the use of non-hydrolysed type II collagen in the treatment of osteoarthritis: a systematic review and meta-analysis. Braz J Health Rev. 2023; 6(1): 1649-60, CrossRef.

Sostres C, Gargallo CJ, Arroyo MT, Lanas A. Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal rract. Best Pract Res Clin Gastroenterol. 2010; 24(2): 121-32, CrossRef.

Xiaoyue Z, Lingli S, Dandong W, Jiesheng R, Liying J. Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. J Orthop Surg Res. 2018; 13(1): 170, CrossRef.

Vasiliadis HS, Tsikopoulos K. Glucosamine and chondroitin for the treatment of Osteoarthritis. World J Orthop. 2017; 8(1): 1-11, CrossRef.

Honvo G, Langele L, Charles A, Reginster JY, Bruyere O. Role of collagen derivatives in osteoarthritis and cartilage repair: a systematic scoping review with evidence mapping. Rheumatol Ther. 2020; 7(4): 703-40, CrossRef.

Gencoglu H, Orhan C, Sahin E, Sahin K. Undenatured type II collagen (UC-II) in joint health and disease: a review on the current knowledge of companion animals. Animals. 2020; 10(4): 697, CrossRef.

Crowley DC, Lau FC, Sharma P, Evans M, Guthrie N, Bagchi M, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009; 6(6): 312-21, CrossRef.

Lugo, JP, Saiyed, ZM, Lane, NE. Efficacy and tolerability of undenaturated type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J. 2016; 15: 14, CrossRef.

Luo C, Su W, Song Y, Srivastava S. Efficacy and safety of native type II collagen in modulating knee osteoarthritis symptoms: a randomised, double-blind, placebo-controlled trial. J Exp Orthop. 2022; 9(1): 123, CrossRef.

Azeem MA, Patil R. The study of undenaturated type II collagen in the knee osteoarthritis. Int J Orthop. 2019; 5(1): 172-5, CrossRef.

Mehra A, Anand P, Borate M, Paul P, Kamble S, Mehta KD, et al. A non-interventional, prospective, multicentric real life Indian study to assess safety and effectiveness of undenaturated type 2 collagen in management of osteoarthritis. Int J Res Orthop. 2019; 5(2): 315-20, CrossRef.

Penn Medicine Princeton Health [Internet]. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [cited 2022 Jan 5]. Available from: https://www.princetonhcs.org/.

Hariyanto H, Butarbutar J, Lawrence G, Suhadi FXB, Tanra AH. Association between plasma b-endorphin and WOMAC score in female patients with knee osteoarthritis. Indones Biomed J. 2012; 4(2): 107-11, CrossRef.

Lequesne MG. The algofunctional indices for hip and knee osteoarthritis. J Rheumatol. 1997; 24(4): 779-81, PMID.

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with traditional paper-based visual analog scale in adults. J Am Acad Ortho Surg Glob Res Rev. 2018; 2(3): e088, CrossRef.

Shiojima Y, Takahashi M, Takahashi R, Moriyama H, Maruyama K, Bagchi D, et al. Safety of dietary undenatured type II collagen: a pilot open-label overdose clinical investigation. J Func Food Health Dis. 2022; 12(3): 103-15, CrossRef.

Wu M, Cronin K, Crane JS. Biochemistry, Collagen Synthesis. In: Treasure Island (FL): StatPearls Publishing; 2023, NLMID.

Ruggiero LA, Hernandez VM, Granados MM, Dominguez JM. Main and minor types of collagens in the articular cartilage: The role of collagens in repair tissue evaluation in chondral defects. Int J Mol Sci. 2021; 22(24): 2213329, CrossRef.

Bagi CM, Berryman ER, Teo S, Lane NE. Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA). Osteoarthr. Cartil. 2017; 25(12): 2080-90, CrossRef.

Nagler-Anderson C, Bober LA, Robinson, ME, Siskind, GW. Thorbecke GJ. Suppression of type II collagen-induced arthritis by intragastric administration of soluble type II collagen. Proc Natl Acad Sci USA. 1986; 83(19): 7443-46, CrossRef.

Tong T, Zhao W, Wu YQ, Chang Y, Wang QT, Zhang LL, et al. Chicken type II collagen induced immune balance of the main subtype of helper T cells in mesenteric lymph node lymphocytes in rats with collagen-induced arthritis. Inflamm Res Off J Eur Histamine Res Soc. 2010; 59(5): 369-77, CrossRef.




DOI: https://doi.org/10.18585/inabj.v15i3.2348

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