By the pricking of my thumbs: shark and crustacean extracts may fight osteoarthritis

Can an extract of shark cartilage and crustacean shells alleviate the pain and inflammation of symptoms of osteoarthritis, the most common disease of aging?

It’s a multi-billion question that medical science has shown little interest in answering, according Melbourne rheumatologist and osteoarthritis expert Dr Daniel Lewis.

Despite the wealth of anecdotal accounts of the renowned New Age nostrum’s efficacy in alleviating the symptoms of osteoarthritis, the orthodox medical research literature is almost silent on the subject, says Lewis.

Big Pharma has given it the thumbs-down: there’s no money for research, because there’s no money in the potentially drug-free remedy.

Chondroitin sulfate (from shark cartilage) and glucosamine (from crustacean shells) are not patentable compounds, alone or in combination.

So Lewis, an honorary lecturer in Monash University’s Department of Medicine and a senior staff member in Monash Medical Centre’s Rheumatology Department, is recruiting volunteers for an unusual clinical trial – on arthritic thumbs.

Its focus will be the basal joint of the thumb – which, after the knee, is the joint most commonly affected by osteoarthritis.

Arthritic thumbs make it difficult and painful to twist taps, doorknobs and screw-top jars. Women are most commonly affected -– simply because osteoarthritis affects 2.5 times as many females as males.

The new trial, to be conducted jointly by Deakin University and Dr Lewis’ own Lewis Institute for Health and Wellbeing, follows on a double-blind, placebo-controlled trial by RMIT University in 2002, which found patients with arthritic knees experienced significant pain relief after topical treatment with a proprietary cream containing chondroitin and glucosamine.

Dr Lewis, who was involved in the RMIT trial, says an effective, non-drug therapy for osteoarthritis would be a boon not only to sufferers, but to the health system.

He says the cost of osteoarthritis to the Australian community in 2001 was $1 billion. That figure will double during the next 25 years.

The rising median age of Australia’s graying population will be one factor – another is the rising mass of the Australian masses, and the as yet-unexplained link between obesity and osteoarthritis of the hand.

In a search of the orthodox medical literature for evidence of the potential therapeutic benefit of chondroitin sulfate and glucosamine for osteoarthritis patients, Lewis says he was able to find fewer than half a dozen studies.

There were several 1986 reports by an Italian research group that investigated the ability of chondroitin sulfate to reduce the pain and inflammation of osteoarthritis..

The Italian researchers tested an oral cocktail of chondroitin sulfate and glucosamine therapy osteoarthritis of the knees and tempero-mandibular joint of the lower jaw. Lewis could find only one other report, on its topical application for osteoarthritis of the spine.

“All the research dollars are going into investigating rheumatoid arthritis and other immune-system disorders,” he said.

“Yet the number of people disabled by osteoarthritis far exceeds those affected by rheumatoid arthritis. Rheumatoid arthritis is more dramatic because it causes deformities of the joints.

“So we know very little about which combinations of chondroitin sulfate and glucosamine, what dosage is most beneficial, and the contribution of the placebo effect to alleviating the symptoms.

“There has been no independent testing of commercial formulations – sometimes there is little relation between the contents, and what’s on the label.”

The new trial will use a commercial formulation sold by the natural therapies company Arkopharma, which is also providing sponsorship.

Deakin University psychologists will help Dr Lewis to discount the role of placebo effect in any therapeutic benefit for arthritis of the thumb.