[Combination therapy for exacerbations of pain in osteoarthritis with non-fixed combinations]

To evaluate the efficacy of a combination therapy containing chondroitin sulfate (CS), glucosamine (GL), methylsulfonylmethane (MSM), hyaluronic acid (HA), and native/hydrolyzed collagen compared to collagen-free therapy in the initial management of knee osteoarthritis (OA) exacerbations.

A single-center, prospective, comparative phase IV study included 60 patients with knee OA (Kellgren-Lawrence stages 2-3). Participants were randomized into two groups: Group A (n=30) received CS/GL/MSM/HA, while Group B (n=30) received the same regimen supplemented with collagen. Pain dynamics (VAS, WOMAC), NSAID requirements, and functional outcomes (Timed Up-and-Go test, walking speed, muscle strength) were assessed at weeks 1, 2, 4, and 8.

Group B demonstrated significant superiority: a 76% reduction in WOMAC pain scores (vs. 47% in Group A; p=0.04) and a 74% reduction in VAS scores (vs. 56%; p<0.05). NSAID use at week 8 was 2.6±0.5 days in Group B (vs. 4.3±1.8 in Group A; p=0.04). Functional improvements (12% increase in walking speed, 42% reduction in Timed Up-and-Go test duration) were also more pronounced in Group B (p<0.05).

The combination of CS/GL/MSM/HA with collagen significantly outperforms collagen-free therapy in reducing pain, improving joint function, and decreasing symptomatic treatment needs in patients with knee OA exacerbations. These findings support the inclusion of collagen in OA combination therapy.