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... Nutraceuticals are food products with medical or health benefits, including the prevention and treatment of disease (VANDERWEERD et al., F. Mata and L. Dormer: Meta-analysis of the efficacy of nutraceuticals in dog osteoarthritis 2012). It is believed that some nutraceuticals provide the body with several nutrients, essential for cartilage repair and reduction of inflammation (BIERER and BUI, 2002). So far there has been no evidence to suggest that nutraceuticals are associated with adverse effects (PUCHEU and DUHAUTOIS, 2009). ...
... Studies conducted by ROUSCH et al. (2010) andFRITSCH et al. (2010) also found that fish oil diet supplementation (including omega-3 fatty acids) resulted in the improvement of clinical signs of canine OA. A number of studies conducted by BIERER and BUI (2002) found evidence to suggest GLM powder is effective in reducing clinical signs associated with canine OA. However, there are also several studies that question the efficacy of nutraceuticals in alleviating clinical signs associated with canine osteoarthritis. ...
... Although the methodologies of the studies included in this model were very similar, some of the studies only included subjective assessment of pain (e.g. BIERER and BUI, 2002;BUI and BIERER, 2001;ROUSH et al., 2010) whereas others used this subjective assessment in combination with an objective methodology using GRFs (HIELM-BJÖRKMAN et al., 2009a;HIELM-BJÖRKMAN et al., 2012). The use of GRFs may provide a standardized means of measuring OA, whereas subjective assessment allows for variation therefore decreasing the internal validity. ...
Osteoarthritis is a common condition in dogs. Non-steroidal anti-inflammatory drugs are currently the most widely used treatment option; however, their chronic use is associated with numerous malefic side effects, including death. There has been increased interest in alternative treatments and nutraceuticals have assumed fundamental importance. A number of individual studies and systematic reviews have been done, but no meta-analysis has been produced to date. By conducting a meta-analysis, we aimed to fill this research gap. We combined the results of 13 case placebo controlled trials in a single major study, to determine the efficacy of nutraceuticals in alleviating symptoms of osteoarthritis. A population of 638 dogs was used, from which 327 were treated with nutraceuticals and 321 were used as controls. A successful random effects model was adjusted (P<0.001), with a risk ratio of 0.62 within a 95% CI of [0.47; 0.81], favouring the use of nutraceuticals. The nutraceuticals used in the trials were green-lipped mussel, chondroitin sulphate, an extract of India and Java turmeric (P54FP), a homeopathic combination preparation known as Zeel®, Ω-3 fatty acids, deep sea fish oil, a mix of glucosamine with chondroitin sulphate and hyaluronic acid, and cannabidiol.
... Arten innehåller ett flertal potentiellt antiinflammatoriska komponenter och andra näringsämnen som främjar god ledhälsa, men verkningsmekanismerna är ännu relativt outredda. De många fleromättade fettsyrorna musslan innehåller anses vara de viktigaste komponenterna med samma föreslagna verkningsmekanismer som tidigare nämnts, d v s att de fungerar som alternativa substrat i eicosanoidproduktionen, vilket dämpar inflammationen (Bierer & Bui, 2002). En grupp tidigare oupptäckta omega-3-fettsyror med potent antiinflammatorisk effekt har detekterats hos musselarten av bl a Treschowa et al. (2007). ...
... Fettsyrorna har extraherats, koncentrerats och stabiliserats vid framställningen av den kommersiella beredningen Lyprinol® (Pharmalink International Limited, Burleigh Heads, Gold Coast, Australien). Denna har visats vara effektiv vid behandling av osteoartrit i humana försök (Pharmalink International Limited, 2012;Treschowa et al., 2007) och dess antiinflammatoriska egenskaper har konfirmerats i olika studier där man bland annat sett hämning av eicosanoidproduktionen i inflammatoriskt stimulerade celler in vitro (Bierer & Bui, 2002;Whitehouse et al., 1997). I en studie genomförd av Treschowa et al. (2007) visades antiinflammatoriska effekter hos substansen både profylaktiskt och terapeutiskt. ...
... Man har sett positiv inverkan av musselarten på symptombilden hos hundar med osteoartrit och hoppas därför att tillskott av denna skulle kunna begränsa användandet av konventionella preparat och därmed minska påverkan på magslemhinnan (Bierer & Bui, 2002). Musselarten har inte påvisats ha negativ effekt på magens slemhinna vilket kan tyda på att den hämmar inflammationsassocierade enzymer snarare än enzymer med underhållande funktion ( Whitehouse et al., 1997;Bierer & Bui, 2002). ...
... rations have been well tolerated, and shown to improve symptoms in arthritic dogs (Bierer & Bui, 2002; Bui & Bierer, 2003; Pollard, Guilford, Ankenbauer-Perkins, & Hedderley, 2006). ...
... In veterinary studies, green-lipped mussel preparations have been well tolerated, and shown to improve symptoms in arthritic dogs (Bierer & Bui, 2002; Bui & Bierer, 2003; Pollard et al., 2006). ...
Unlabelled:
This paper is an evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
Search strategy:
To prepare each Natural Standard review, electronic searches are conducted in nine databases, including AMED, CANCERLIT, CINAHL, CISCOM, the Cochrane Library, EMBASE, HerbMed, International Pharmaceutical Abstracts, Medline, and NAPRALERT. Search terms include the common name(s), scientific name(s), and all listed synonyms for each topic. Hand searches are conducted of 20 additional journals (not indexed in common databases), and of bibliographies from 50 selected secondary references. No restrictions are placed on language or quality of publications. Researchers in the field of complementary and alternative medicine (CAM) are consulted for access to additional references or ongoing research.
Selection criteria:
All literature is collected pertaining to efficacy in humans (regardless of study design, quality, or language), dosing, precautions, adverse effects, use in pregnancy/lactation, interactions, alteration of laboratory assays, and mechanism of action (in vitro, animal research, human data). Standardized inclusion/exclusion criteria are utilized for selection.
Data analysis:
Data extraction and analysis are performed by healthcare professionals conducting clinical work and/or research at academic centers, using standardized instruments that pertain to each review section (defining inclusion/exclusion criteria and analytic techniques, including validated measures of study quality). Data are verified by a second reviewer.
Review process:
A blinded review is conducted by multidisciplinary research-clinical faculty at major academic centers with expertise in epidemiology and biostatistics, pharmacology, toxicology, CAM research, and clinical practice. In cases of editorial disagreement, a three-member panel of the Editorial Board addresses conflicts, and consults experts when applicable. Authors of studies are contacted when clarification is required.
... Moreover, other researchers showed that greater EPA and DHA concentrations could improve the clinical signs (lameness and weight bearing) of OA dogs (Fritsch et al., 2010a; Fritsch et al., 2010b). Another study on the use of GLM in OA dogs found that the clinical signs improved significantly after six weeks (Bierer and Bui, 2002). PCSO-524 has a huge difference in efficacy between other mussel extracts and powders due to the patented CO 2 extracted oil (Whitehouse et al., 1997). ...
This study was designed to compare the therapeutic benefits of a compound of omega-3 fatty acids from the New Zealand green-lipped mussel (Perna canaliculus) (PCSO-524) and omega-3 fatty acids in fish oil on clinical outcomes and osteoarthritis biomarkers (chondroitin sulfate WF6 epitope) in 66 dogs that had osteoarthritis (OA); 39 dogs with OA hip joints, 15 dogs with OA shoulder joints and 12 dogs with OA shoulder and hip joints. The animals were presented at the Small Animal Hospital, Faculty of Veterinary Science, Chulalongkorn University. The dogs were allocated into two groups randomly. One group received PCSO-524 (n = 33) and the other group received fish oil (n = 33), administered orally for 24 weeks. Serum OA biomarkers (WF6), lameness scores, weight-bearing scores, range of motion (ROM) and peak vertical force gait analysis were evaluated before treatment and two, four, eight, 12, 16, 20 and 24 weeks after the treatment began. The mean of serum WF6 of the PCSO-524 group (262.46±118.06 ng/ml) was significantly (p < 0.05) less than that of the fish oil group (324.76±133.65 ng/ml) after 24 weeks of administration. The lameness scores, weight-bearing scores, peak vertical force gait analysis results and ROM improved significantly within two weeks after the administration of PCSO-524 began, while there was no statistically significant improvement in any of the parameters of the fish oil group after 12 weeks. After week four, the lameness and weight-bearing scores and gait analysis results of the PCSO-524 group improved significantly by comparison with the fish oil group. In conclusion, the PCSO-524 administration led to good clinical outcomes and laboratory results of osteoarthritis of the shoulder and hip joints in dogs.
... Here, we report a consistent significant reduction in arthritic inflammation when rats or mice were treated prophylactically or therapeutically with Perna. Our results are supported by several other groups detailing reduced inflammation in Perna treated arthritic dogs [25,26], arthritic humans272829 , and carrageenaninduced rat paw edema [12,30]. This anti-inflammatory effect has been attributed to several factors, one of which is a reduction in the biosynthesis of the proinflammatory prostaglandins. ...
Rheumatoid arthritis (RA) and its accepted animal model, murine collagen-induced arthritis (CIA), are classic autoimmune inflammatory diseases which require proinflammatory cytokine production for pathogenesis. We and others have previously used N, N-dimethylglycine (DMG) and extracts from the New Zealand green-lipped mussel Perna canaliculus (Perna) as potent immunomodulators to modify ongoing immune and/or inflammatory responses.
In our initial studies, we treated lipopolysaccahride (LPS) stimulated THP-1 monocytes in vitro with increasing concentrations of Perna extract or DMG. Additionally, we treated rat peripheral blood neutrophils with increasing concentrations of Perna extract and measured superoxide burst. In subsequent in vivo experiments, CIA was induced by administration of type II collagen; rats were prophylactically treated with either Perna or DMG, and then followed for disease severity. Finally, to test whether Perna and/or DMG could block or inhibit an ongoing pathologic disease process, we induced CIA in mice and treated them therapeutically with either of the two immunomodulators.
Following LPS stimulation of THP-1 monocytes, we observed dose-dependent reductions in TNF-alpha and IL-12p40 production in Perna treated cultures. DMG treatment, however, showed significant increases in both of these cytokines in the range of 0.001-1 microM. We also demonstrate that in vitro neutrophil superoxide burst activity is dose-dependently reduced in the presence of Perna. Significant reductions in disease incidence, onset, and severity of CIA in rats were noted following prophylactic treatment with either of the two immunomodulators. More importantly, amelioration of mouse CIA was observed following therapeutic administration of Perna. In contrast, DMG appeared to have little effect in mice and may act in a species-specific manner.
These data suggest that Perna, and perhaps DMG, may be useful supplements to the treatment of RA in humans.
The typical canine rehabilitation patient with orthopedic disease may differ in its nutritional needs, with the assumption that most patients will be on a complete and balanced commercial dog food that is not enriched with agents for ameliorating their condition. For a significant number of rehabilitation patients, obesity is a major issue where hypocaloric diet plans are often implemented and are covered extensively elsewhere (VCNA Small Animal Practice May 2021). The focus of this article will be implementation of physical activity or structured physical exercise protocols and how they might be used in combination with a typical hypocaloric diet plan, a diet low in calories. Considering the limited information regarding physical activity or structured exercise programs in dogs, a human comparative assessment of efficacy is fundamental as a baseline of information regarding typical interventions. In addition, many of these long-term rehabilitation cases typically exhibit osteoarthritis (OA) and as part of case management, there is a need to implement nutrient or nutraceutical intervention to either diminish the progression of OA or help with pain control measures, particularly for the nonsteroidal anti-inflammatory intolerant patient. Nutraceutical intervention comes in many forms from botanicals to nutritional enhancement; botanicals will be covered elsewhere in this issue. This overview of nutraceuticals will cover nonbotanical interventions including fish oil, glucosamine/chondroitin, avocado/soybean unsaponifiables, undenatured collagen, green lipped mussel, and egg shell membrane supplementation.
The extremely vast biodiversity represented by marine mollusks alongside their widespread utility as a source of food and their high nutritional value has aroused great interest from the scientific community. Furthermore, they can be caught with ease, and their commercial breeding and farming is rampant. This article comprehends the global availability of these organisms, their pretreatment and handling procedures, and their health‐promoting potential with a focus on their antiviral, anti‐inflammatory, and antimicrobial properties. The emphasis herein is on their potential use in the food and nutraceutical industry. In addition, mollusks consumption as part of everyday diet can also be helpful in avoiding many ailments as they are rich in vital nutrients and active secondary metabolites, as well as have the ability to enhance immune response. Moreover, the available literature suggests that normal cooking practices have no notable adverse effects on their nutritional value and they retain certain bioactivities even after the action of digestive enzymes. Though mollusks have been widely studied in relation to the health‐promoting effects reviewed here, there is still more scope for further research in this direction in order to fully utilize this enormous source of food and nutraceuticals.
Osteoarthritis (OA) is the most common joint disorder leading to significant disability and dysfunction seen by small animal clinicians. While OA and degenerative joint disease (DJD) are often considered as being almost synonymous in dogs, this may not be the case in cats. Current therapy focuses on palliative care, aiming to reduce pain and inflammation and maintain or improve joint function without altering the pathologic process in the tissues. This chapter lists three of the most common false assumptions made by clinicians and owners in the initiation of a management plan for chronic OA pain to emphasize the need for a realistic and scientifically sound approach to pain management. Weight control is essential when dealing with OA. The introduction of diets formulated with high omega-3 polyunsaturated fatty acids (PUFA) is adding a whole new dimension to the management of OA. Analgesic and anti-inflammatory agents are the most common final component in the management of OA.
Green-lipped mussel and curcumin in mobility foods for dogs Mobility impairment is a common canine disease. Dogs are reluctant to walk, run and jump, and may show lameness. The cause often is breakdown of cartilage in joints. This implies loss of shock absorber that allows the joint to move smoothly. The ends of the bones begin to rub together, evoking pain. Damaged tissue elicits the release of inflammatory substances, contributing to pain and swelling of the joint. The condition is called osteoarthritis. There are dog foods, snacks and nutritional supplements making joint-health claims, whereas therapeutic mobility foods purport to reduce clinical signs of osteoarthritis. These products are marketed on the basis of a wide variety of joint-protective constituents. Among these agents are powders derived from the New-Zealand green-lipped mussel and preparations of curcumin, which is a component of the yellow spice made from turmeric stem. For demonstration of the efficacy of a potential joint-improving agent, a double-blinded, placebo-controlled trial in dogs with osteoarthritis is required. The placebo has no real effect and treatment identity is kept from both owner and investigator. In this way, the trial design takes into account the impact, if any, of biased evaluation and spontaneous course of disease. In placebo-treated dogs with osteoarthritis there often is perceived improvement over time. Studies on the efficacy of green-lipped mussel either had inadequate design or unconvincing results for its application in the management of canine osteoarthritis. There is no comfortable evidence that mobility foods containing either green-lipped mussel or curcumin reduce clinical signs of osteoarthritis in dogs. Green-lipped mussel and curcumin Powdered preparations and oily extracts of the New Zealand green-lipped mussel (Perna canaliculus) have anti-inflammatory properties in model systems. In-vitro studies indicate that curcuminoid derivatives reduce inflammation and inhibit collagen degradation in cartilage. Thus, there are clues to a beneficial effect of green-lipped mussel and curcumin in the treatment of canine osteoarthritis, but solid evidence can only come from well-designed clinical trials. Trials on green-lipped mussel Oral administration of a green-lipped mussel preparation reportedly improved clinical signs in arthritic dogs (1), but the study was open and non-controlled. Putting green-lipped mussel powder on top of food or incorporating it into a treat significantly improved dogs' arthritis scores over 6 weeks (2). The dose was equivalent to 139 mg/MJ of metabolizable energy as calculated for a 35-kg dog. The two experiments were designated as double-blind and controlled, but no control topping was used and it is uncertain whether the control and test treats were indistinguishable. Moreover, the magnitude of the effects can be considered meaningless.
Aging is a normal process characterized by a variety of physiologic changes. Geriatric dogs are also more likely to be afflicted with certain disease conditions. Both normal and abnormal physiologic changes associated with aging in the dog may be amenable to nutritional intervention. Specific alterations in nutrients or in dietary characteristics can be beneficial; however, these are best done in the context of an individualized nutritional assessment and monitoring paradigm.
This study aimed to establish the effect of a diet enriched with green-lipped mussel (GLM) on pain and functional outcomes in osteoarthritic dogs. Twenty-three client-owned dogs with osteoarthritis (OA) were fed a balanced control diet for 30 d and then a GLM-enriched balanced diet for the next 60 d. We assessed peak vertical force (PVF), which is considered to be the gold standard method, at Day (D)0 (start), D30 (end of control diet), and D90 (end of GLM-enriched diet). The owners completed a client-specific outcome measure (CSOM), which is a pain questionnaire, once a week. Motor activity (MA) was continuously recorded in 7 dogs for 12 wk. Concentrations of plasma omega-3 fatty acids were quantified as indicative of diet change. Statistical analyses were linear-mixed models and multinomial logistic regression for repeated measures. The GLM diet (from D30 to D90) resulted in an increase in concentrations of plasma omega-3 fatty acids (P < 0.016) and improvement of PVF (P = 0.003). From D0 to D30, PVF did not significantly change (P = 0.06), which suggests that the GLM diet had a beneficial effect on gait function. Moreover, PVF (P = 0.0004), CSOM (P = 0.006), and MA (P = 0.02) improved significantly from D0 to D90. In general, the balanced control diet could have contributed to reduced OA symptoms, an effect that was subsequently amplified by the GLM diet.
There are over 60 million dogs in the United States and it is suggested that up to 20% of the dog population suffers from osteoarthritic disease (OAD). This disease is the commonest form of chronic pain that practitioners deal with on a daily basis in dogs. Traditionally, chronic pain has been defined in terms of its duration and in human medicine it was often defined as pain lasting more than 3-6 months. It is now clear that chronic pain involves substantial changes in the central nervous system, which is more "plastic" than previously believed and these changes probably vary from one disease to another 1 . The changes in the neurobiology of nociceptive processing are likely responsible for what appears clinically to be "resistant pain" associated with many chronic pain syndromes including OAD. Limiting the central changes by early treatment of pain may be beneficial to the patient and highlights the importance of early diagnosis and intervention. Without doubt chronic pain affects an animal's quality of life and therefore becomes an important welfare and ethical issue. It is important to educate the client about this disease and actively involve them in the care of their pet. Osteoarthritis is not a curable disease and the goals of therapy are to control pain and lameness to acceptable levels. Due to the nature of chronic pain, such as that associated with osteoarthritis the accompanying behavioral changes can be insidious and subtle and easily missed. Indeed, many owners assume these changes as inevitable with advancing age. Data based on owner interviews, revealed changes in many types of behavior in dogs with chronic pain 2,3 . This study also indicated that the owners are the best evaluators of their pet's pain. Although still in the development phase, the Glasgow University Health-Related Quality of Life Questionnaire has identified some key indicators of chronic pain including, but not limited to decreases in mobility, activity, sociability and curiosity and increases in aggression, anxiety, daytime sleeping and vocalising 2,3 It is common for owners not to realize how debilitated their pet was until they see dramatic improvements following treatment, a common response being "he's like his old self now". KEY THERAPEUTIC POINTS Because chronic pain is a complex problem, treatment may be challenging but is ultimately very rewarding. The approach to treatment depends on the cause but may involve surgery, weight loss, controlled exercise, physical therapy, non-steroidal anti-inflammatory drugs, opioids, nutraceuticals, antidepressant drugs, gabapentin and complimentary therapies such as acupuncture and massage. As we look to the future exciting therapies such as molecular neurosurgery may become a reality for companion animals 4 .
Various treatments of osteoarthritis (OA) have been described, including use of nutraceuticals.
To review systematically the literature about the effects of nutraceuticals on clinical signs of pain or abnormal locomotion in horses, dogs, and cats, and to discuss methodological aspects of trials and systematic reviews.
A systematic search of controlled trials evaluating the impact of nutraceuticals on OA in horses, dogs, and cats was performed, using Medline, CAB Abstracts, and Google Scholar. Scientific evidence was evaluated by means of criteria proposed by the Food and Drug Administration (FDA), and a scoring system adapted from both the CONsolidated Standards of Reporting Trials (CONSORT) statement and recommendations for assessing trials by the Center of Evidence Based Medicine of Oxford.
Twenty-two papers were selected and reviewed, with 5 studies performed in horses, 16 in dogs, and 1 in cats. The strength of evidence was low for all nutraceuticals except for omega-3 fatty acid in dogs. There were limited numbers of rigorous randomized controlled trials and of participants in clinical trials.
The evidence of efficacy of nutraceuticals is poor, with the exception of diets supplemented with omega-3 fatty acids in dogs. Greater access to systematic reviews must be part of the objectives of the veterinary science in the future. Their reporting would be improved by internationally agreed-upon criteria for standards and guidelines.
The aim of the study was to determine if Lyprinol(®) is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improving performance in well trained athletes suffering from delayed onset muscle soreness (DOMS).
A double blind randomised placebo controlled trial.
Twenty well trained male volunteers, matched by VO(2max) were randomly assigned to consume 200mg of Lyprinol(®) or an indistinguishable placebo daily for 8 weeks prior to a downhill treadmill running episode designed to induce DOMS.
Performance measures (Kin-Com, counter movement and squat jump), pain assessments (visual analogue scale, algometer) and blood analyses (Interleukin-1, Interleukin-6, Interleukin-10, tumour necrosis factor-α, C-reactive protein, myoglobin, creatine kinase) were assessed at 7 time points over 5 days (pre, post, 4, 24, 48, 72 and 96h after the downhill run).
No statistically significant differences were identified in any parameters between the active and placebo groups at any time point.
After 2 months ingestion of Lyprinol(®) at the currently recommended dosage (200mg/day) and a demanding eccentric exercise intervention, Lyprinol(®) did not convincingly affect DOMS and indicators of muscle damage.
Feline degenerative joint disease (DJD) is common and there are no approved therapies for the alleviation of the associated pain.
To test a diet high in eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) content and supplemented with green-lipped mussel extract and glucosamine/chondroitin sulfate (test-diet) for its pain-relieving and activity-enhancing effects in cats with painful, mobility-impairing DJD over a 9-week period.
Forty client-owned cats.
Randomized, controlled, blinded, parallel group, prospective clinical study. Cats with no detectable systemic disease, and with at least 1 appendicular joint with radiographic evidence of DJD where manipulation elicited an aversive response were included. Cats were randomly allocated to the test-diet or control diet (C-diet). Outcome measures were subjective owner and veterinarian assessments, and objective activity monitoring (accelerometry). Nonparametric statistics were used to evaluate changes within and between groups for both subjective and objective data, and locally weighted scatterplot smoothing regression analysis was used to predict activity changes.
The primary objective outcome measures indicated that activity declined significantly (P < .001) in the C-diet group, significantly increased (P < .001) in the test-diet group and there was a significant difference between the groups (P < .001).
A diet high in EPA and DHA and supplemented with green-lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility. Dietary modulation might be 1 method to use to improve mobility in cats with DJD-associated pain.
Kliinisen hevos- ja pieneläinlääketieteen laitos, kirurgian ja eläinlääketieteellisen farmakologian ja toksikologian oppiaineet. Nivelrikko on maailmanlaajuisesti merkittävä pitkäaikaissairaus koirilla. Nivelrikkoa ei voida parantaa ja se aiheuttaa kroonista kipua erityisesti iäkkäämmillä koirilla. Oireita kuitenkin voidaan lievittää ja jokaiselle koiralle onkin suunniteltava yksilöllinen hoitomuoto, joka juuri kyseiselle koiralle mahdollistaa parhaan mahdollisen elämänlaadun. Suuri osa nivelrikkoisista koirista lääkitään perinteisesti tulehduskipulääkkeillä, joista karprofeeni on ensimmäinen koirille indikoitu valmiste ja yhä yleisesti käytössä. Tulehduskipulääkkeillä erityisesti pitkäaikaiskäytössä saattaa kuitenkin ilmaantua haittavaikutuksia, joista maha-suolikanavan ärsytysoireet ovat yleisimmät. Ravinnelisät (nutraceuticals) ovat tulleet tulehduskipulääkkeiden rinnalle tai jopa vaihtoehdoksi niille, mutta lisää tieteellisiä tutkimuksia kaivataan niiden osalta. Ravinnelisät sisältävät pääasiassa glykosaminoglykaania vaikuttavana aineena ja niillä todetut haittavaikutukset ovat olleet hyvin harvinaisia ja lieviä. Perna canaliculus (Lyproflex®) on Uuden Seelannin vihersimpukoista patentoidulla kylmäkuivaustekniikalla prosessoitu vihersimpukkauutevalmiste, jonka vaikuttavana aineena ovat eikosatetraenoikhapot. Prospektiivinen, kaksoissokkoutettu ja kontrolloitu tutkimuksemme vertasi Lyproflexin tehoa positiiviseen kontrolliin (karprofeeni) ja negatiiviseen kontorolliin (plasebo) nivelrikkoisten koirien 8vk kestävässä hoitojaksossa. Tutkimuksessa oli mukana yhteensä 62 lonkka- tai kyynärvikaista koiraa iältään 1-11- vuotiaita ja painoltaan 18-56 kg. Koirat oli valittu tutkimukseen ilmoitusten avulla, joiden jälkeen puhelinhaastatteluilla sopivat koirat poimittiin kiinnostuneiden joukosta. Koiran kipua mitattiin omistajakyselyn perusteella kootulla käyttäytymisindeksillä, liikkumisindeksillä, joka perustui kahden eläinlääkärin suorittamiin ortopedisiin tutkimuksiin sekä voimalevyn mittaamien arvojen avulla. Oletuksenamme oli, että Lyproflexin kivunlievitysteho asettuu karprofeenin ja plasebon välille. Tilastollisesti merkitsevät erot saatiin Lyproflex- ryhmän ja plasebo-ryhmän välille eläinlääkäreiden suorittamassa ontumaindeksissä ja kipujanassa. Myös neljän muun muuttujan tulos oli samansuuntainen, vaikka tilastollisesti merkitseviä eroja ei saatukaan. Tutkimustulokset ovat samansuuntaiset kuin aiemmat vastaavantyyppiset vihersimpukkauutevalmisteen tehoa käsittelevät tutkimukset nivelrikkoisilla koirilla. Tämän tutkimustiedon valossa, voidaan erityisesti lievän ja keskivaikean koiran nivelrikko-oireilua lievittää vihersimpukkauutevalmisteiden avulla joko ainoana keinona tai esimerkiksi tulehduskipulääkehoidon kanssa yhdistettynä, jolloin tulehduskipulääkevalmisteen annosta voidaan kenties laskea ja haittavaikutusriskiä alentaa. Kuitenkin tarvetta erityisesti nivelrikkoisilla koirilla suoritetuille pidempikestoisille vihersipukkauutevalmisteen kivunlievitystehoa koskeville tutkimuksille on yhä edelleen.
A green-lipped mussel (GLM) preparation was evaluated in a randomized, double-controlled and double-blinded clinical trial. It was hypothesized that the treatment effect would be less than that of the positive control (carprofen) but more than that of the negative control (placebo). Forty-five dogs with chronic pain and a radiographic diagnosis of osteoarthritis that were randomly allocated into one of three groups completed the study. All dogs were fed the test products or placebo for 8 weeks. The dogs were evaluated four times, at 4-week intervals. Six different variables were assessed: veterinary-assessed mobility index, two force plate variables, owner-evaluated chronic pain index and pain as well as locomotion visual analogue scales (VASs). Intake of extra carprofen was also evaluated. A chi-squared and a Mann-Whitney test were used to determine significance between groups. When changed to dichotomous variables, there were more dogs in the GLM than in the placebo group that improved, according to veterinary-assessed mobility, owner-evaluated chronic pain index and pain VAS (P = 0.031, P = 0.025, P = 0.011, respectively). For the same three, the odds ratio and their confidence interval were over one. The extent of improvement was significantly different between the GLM and the control in veterinary-assessed mobility (P = 0.012) and pain VAS (P = 0.004). In conclusion, GLM alleviated chronic orthopedic pain in dogs although it was not as effective as carprofen. As no side-effects were detected, GLM may be beneficial in dogs e.g. when non-steroidal anti-inflammatory drugs cannot be used.
To identify and critically evaluate the quality of evidence of the most commonly used pharmacologic, nutraceutical, and purported slow-acting drugs of osteoarthritis for the management of osteoarthritis in dogs by use of the FDA's evidence-based medicine scoring system.
Systematic review.
16 clinical trials.
A broad bibliographic search was performed prior to May 2006. Inclusion criteria focused on prospective trials evaluating commonly used medical treatment interventions for the management of osteoarthritis in dogs and published in peer-reviewed journals. The analysis consisted of the following: study design rating, quality factor rating, quantity rating, consistency rating, relevance to disease risk reduction rating, and cumulative strength of evidence ranking.
4 trials evaluating meloxicam were rated as type I. Three trials evaluating carprofen were rated as type I, and 2 trials were rated as type III. One trial evaluating each of the following agents was rated as type 1: etodolac; P54FP; polysulfated glycosaminoglycan; and a combination of chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate. Two trials evaluating pentosan polysulphate and 2 trails evaluating green-lipped mussels were rated as type I. One trial evaluating hyaluronan was rated as type III.
A high level of comfort exists for meloxicam that the claimed relationship is scientifically valid and that its use is clinically efficacious for the treatment of osteoarthritis in dogs. A moderate level of comfort exists for carprofen; etodolac; pentosan polysulphate; green-lipped mussels; P54FP; polysulfated glycosaminoglycans; and a combination of chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate. An extremely low level of comfort exists for hyaluronan.
A lipid-rich extract, preparared by supercritical fluid extraction of fresh stabilized mussel powder (Lyprinol), showed significant anti-inflammatory (AI) activity given therapeutically and prophylactically po to Wistar and Dark Agouti rats developing either (a) adjuvant-induced polyarthritis or (b) collagen(II)-induced autoallergic arthritis, with ED50≤15 mg/kg; c.f. naproxen≥25 mg/kg or various therapeutic oils (flaxseed, evening primrose, fish)≥1800 mg/kg given orally. Lyprinol showed little or no activity in acute irritation assays (carrageenan, kaolin, histamine) indicating it is not mimicking rapid-acting NSAIDs.
Incorporating Lyprinol into arthritigenic adjuvants composed of heat-killed Mycobacterium. tuberculosis suspended in olive oil or squalane, effectively prevented arthritis development at a dose of 5 mg/rat. By contrast, ‘dummy adjuvants’ prepared with Mycobacterium tuberculosis and flaxseed, evening primrose or fish oils were still arthritigenic in Dark Agouti rats (doses of oil=90 mg/rat).
Lyprinol subfractions inhibited leukotriene-B4 biosynthesis by stimulated human polymorphonuclear leukocytes in vitro, and prostaglandin-E2 production by activated human macrophages in vitro. Much of this AI activity was associated with polyunsaturated fatty acids and natural antoxidants (carotenoids, etc.).
In contrast to NSAIDs, Lyprinol is non-gastrotoxic in disease-stressed rats at 300 mg/kg po and does not seem to affect platelet aggregation (human, rat). These data show Lyprinol to be a reproducible, relatively stable, source of bioactive lipids with much greater potency than plant/marine oils currently used as nutritional supplements to ameliorate signs of inflammation.