Patients and doctors are always eager to find the different treatments available on the market that provide clinical efficacy and safety, especially when it comes to chronic diseases such as osteoarthritis (OA).

Chondroitin Sulfate (CS) and Glucosamine (GL) are highly safe drugs whose clinical efficacy has been widely demonstrated in osteoarthritic patients.

Analgesics and anti-inflammatory drugs can provide a fast and powerful response to the painful symptoms of OA, but they are not always free of safety problems that can affect the gastrointestinal, cardiovascular, hepatic and renal systems.

CS and GL are well-known natural substances. For example, the structure of CS is identical to endogenous chondroitin sulfate, a natural substance found in human connective tissue.

They are now known to be highly safe substances, a fact that has been proven in experimental pharmacology, confirmed in numerous clinical trials and corroborated by pharmacovigilance.

Moreover, because they are substances of natural origin, CS and GL are used in nutritional supplements.

In fact, CS and GL are currently prescription drugs in Europe, but not in the United States. Despite the fact that the safety and efficacy of CS and GL have been widely demonstrated in osteoarthritic patients, the American medical community disagrees with the European community.

While the European League Against Rheumatism (EULAR) has assigned CS and GL the highest level of scientific evidence (1A) and recommendation (A), the American College of Rheumatology (ACR) considers the scientific evidence to be insufficient.

EULAR vs ACR CS / GL for OA of the Knee

However, in recent years, the position of American rheumatologists has begun to change. Proof of this is the plenary session “The Great Debate: Perspectives on Glucosamine Sulfate and Chondroitin Sulfate”, scheduled to be held during the Annual Meeting of the ACR in November 2006. This is the second consecutive year the ACR will hold a debate on this topic.

CS and GL are not the only European prescription drugs that are treated differently in the US. Omega-3 fatty acids have been approved in Europe for post-heart-attack treatment, whereas they have not been authorized for this purpose in the US.

The American market - and the British market to some extent - differs from the European market in many regards. American consumers have access to nutritional supplements as OTCs in supermarkets and health-food stores, whereas these products are sold exclusively in pharmacies in Europe.

Regardless of cultural differences, doctors and patients the world over agree on the growing importance of the safety of medicinal products. And in this regard, CS and GL share the best of both worlds: the clinical efficacy of prescription drugs and the safety of products of natural origin.