"A daily supplement of pharmaceutical grade chondroitin is as good as celecoxib Celebrex at relieving arthritic knee pain and doesnt have dangerous side effects researchers say.  Dr. JeanYves Reginster of Liege State University in Belgium and colleagues recruited  people over age  with knee osteoarthritis from five European countries and randomly assigned them to take  mg of the extrapure chondroitin sulfate Chondrosulf  mg of celecoxib Celebrex or a placebo every day for six months.  Those who took chondroitin sulfate or celecoxib had similar levels of pain relief at the end of the study and in both groups the improvement was greater than for those taking just a placebo according to the report in Annals of the Rheumatic Diseases.  Reginster told Reuters Health the findings are in line with earlier studies showing pharmaceuticalgrade chondroitin sulfate could significantly decrease the progression of knee osteoarthritis over a period of three years.  He stressed that pharmaceuticalgrade chondroitin is not the same as overthecounter supplements which are made differently and cant get into the joint in high enough concentrations to combat the causes of cartilage degradation and pain.  European regulatory bodies recommend pharmaceuticalgrade chondroitin sulfate as well as pharmaceuticalgrade glucosamine sulfate as firstline treatments for osteoarthritis Reginster said by email because of the side effects associated with celecoxib and other nonsteroidal inflammatory drugs NSAIDs including stomach ulcers bleeding liver and kidney problems.  Dr. Michael Shepard of Hoag Orthopedic Institute in Orange California noted that the study had a relatively low number of participants and that most U.S. studies of this type would run two years rather than six months.  In addition U.S.based studies of chondroitin have had mixed results said Shepard who wasnt involved in the study. Some have found the supplements to be as effective as ibuprofen also an NSAID and some have found that chondroitin sulfate is no more effective than placebo he told Reuters Health.   I tell my patients buyer beware Shepard said in an email. I tell them about the mixed results of chondroitin in the literature. I tell them to try chondroitin for one month as a trial and if they like it and feel better with it then keep taking it.  If chondroitin doesnt work for them he suggests taking an NSAID periodically and to be aware of the side effects.  If you are going to stay on an NSAID for a prolonged period then you need regular follow up with your doctor Shepard cautioned.  Dr. Rachel Wolfe of Wake Forest Baptist Medical Center in WinstonSalem North Carolina agreed that chondroitin is reasonable to try for some people especially those with contraindications to NSAIDs.  However it should not replace other therapy such as quad strengthening exercises and weight loss which we know will provide benefit. It should be used in conjunction with these measures said Wolfe who wasnt involved in the study.  Chondroitin is not a miracle pill but if it allows people to feel less pain and be more active thereby losing weight and strengthening muscles then I think there may benefit Wolfe told Reuters Health by email. Studies like this highlight that medicine is still an art  we do not have perfect answers and we have to individualize for each patient.  The study was sponsored by IBSA Institut Biochimique SA a pharmaceutical company based in Lugano Switzerland that makes the chondroitin sulfate supplements used in the test.  SOURCE bit.lyrcPLh httpbit.lyrcPLh Annals of the Rheumatic Diseases online May  ."