Vitamin C and E Supplementation Versus Standard Meloxicam Regimen in the Treatment of Patients With Chronic Degenerative Arthritis of the Knee: A Preliminary Pilot Study

Abstract

Objectives: To investigate the effectiveness of vitamin C and E supplementation in remission of the symptoms of chronic degenerative arthritis (osteoarthritis) of the knee. Design: A pilot controlled trial conducted from December 2009 until April 2011 among 46 patients diagnosed with osteoarthritis (OA) in one or both knees. Intervention: Patients were randomly assigned to two different treatment groups and were either supplemented with ascorbic acid 1 gr × 2 daily per os together with vitamin E 100 mg × 3 daily per os or they were treated with meloxicam tabs 15 mg × 1 daily per os. Main outcome measures: A. Clinical markers: functionality of the knee (WOMAC index), pain (using a pain visual analogue scale) and the deficit in knee flexion and extension B. Laboratory markers: total antioxidant capacity (TAC) and concentration of malonyldialdehyde (MDA) in the synovial fluid. Results: Twenty patients were randomly allocated into each of the two intervention groups. The treatment lasted for 20 days and the patients' status was evaluated every 10 days. The condition of the patients' knees in both treatment groups presented a significant improvement as recorded by the clinical markers; accompanied by an enhancement of TAC but with no effect on MDA levels. Conclusions: Administration of vitamins C and E has a similar effect in the remission of the symptoms of the OA in the knee, comparable to that of the treatment with meloxicam, but without the possible side effects and thus can be proposed as adjuvant therapy.

The Role of Vitamin E in Preventing and Treating Osteoarthritis – A Review of the Current Evidence

“…After 20 days, both treatment groups demonstrated similar improvements in WOMAC and pain visual analog scale ( Oikonomidis et al, 2014 ). They also improved extension and flexion deficits in the patients, but the effect of meloxicam was limited to patients with severe-extreme osteoarthritis ( Oikonomidis et al, 2014 ). The total antioxidant capacity of the synovial fluid was significantly enhanced in the vitamin C + vitamin E supplemented group compared to meloxicam control ( Oikonomidis et al, 2014 ).…”

“…The authors postulated that the reduction in nitrative stress shown by nitrotyrosine staining contributed to the analgesic effects of vitamin E shown in this study. The combination of vitamin C (1 g 2 times daily) and vitamin E (100 mg 3 times daily) had also been compared against meloxicam (15 mg oral daily) treatment in 46 osteoarthritic patients ( Oikonomidis et al, 2014 ). After 20 days, both treatment groups demonstrated similar improvements in WOMAC and pain visual analog scale ( Oikonomidis et al, 2014 ).…”

“…The combination of vitamin C (1 g 2 times daily) and vitamin E (100 mg 3 times daily) had also been compared against meloxicam (15 mg oral daily) treatment in 46 osteoarthritic patients ( Oikonomidis et al, 2014 ). After 20 days, both treatment groups demonstrated similar improvements in WOMAC and pain visual analog scale ( Oikonomidis et al, 2014 ). They also improved extension and flexion deficits in the patients, but the effect of meloxicam was limited to patients with severe-extreme osteoarthritis ( Oikonomidis et al, 2014 ).…”

“…They also improved extension and flexion deficits in the patients, but the effect of meloxicam was limited to patients with severe-extreme osteoarthritis ( Oikonomidis et al, 2014 ). The total antioxidant capacity of the synovial fluid was significantly enhanced in the vitamin C + vitamin E supplemented group compared to meloxicam control ( Oikonomidis et al, 2014 ). The presence of vitamin C could improve redox recycling of vitamin E, thereby potentiate its antioxidant effects.…”

A blinded, placebo‐controlled study on the clinical effects of vitamin E supplementation in dogs with osteoarthritis

“…The results showed improvement in both clinical signs and inflammatory markers. [14][15][16][17][18][19][20][21] The only study investigating the use of VE in dogs was conducted after surgical transection of the cranial cruciate ligament and found that supplementation improved lameness and pain scores. 21 In addition, it decreased the severity of the cartilage damage observed on necropsy examination and resulted in decreased concentrations of nitric oxide and prostaglandins in the synovial fluid.…”