Efficacy And Tolerability Of Unsaponifiables Of Avocado And Soy In The Treatment Of Symptomatic Hip And Knee Osteoarthritis [eficácia Sintomática Dos Insaponificáveis De Abacate E Soja (ias) No Tratamento De Osteoartrose (oa) De Quadril E Joelho]

Background: Osteoarthritis (OA) is an idiopathic, multifatorial disease characterized by a progressive and slow loss of articular cartilage. Objectives: To evaluate efficacy and tolerability of unsaponifiables of avocado and soy in the treatment of symptomatic hip and knee OA. Methods: Two hundred and thirty one patients of both sexes were included, aged 45 to 75 years old, that presented hip and/ or knee symptomatic OA. They entered an open label, non-randomized, controlled trial for 6 months. They followed a 15 days washout period for anti-inflammatory drugs (NAIDs). Efficacy was evaluated according to: 1) Lequesne Algo-Funcional Index (IFL) e 2) pain in the Visual Analogue Scale (VAS; 100 mm), NAIDs/analgesics ingestion and total incapacity score (EVA de 100 mm). Results: Two hundred and thirty one patients received IAS. The data for all patients were available in the final evaluation (6 months). The average +/- SEM in the LFI improved from 11,88+/-0,24 to 6,84+/-0,29 in the final evaluation-6 months (p < 0,001). Pain improved from 6,65+/-0,11 mm to 3,21+/-0,17 mm (p= 0,001). NAIDs consumption improved from 1,95+/-0,10 to 0,67+/-0,14 (p <0,001). Success rate was 42,3% in the IAS after 6 months. Tolerance was considered good or excellent. Conclusion: The ASU in this open label controlled multicentric study shown to be effective and safe for the symptomatic pain of AO of the hip and knee. Long term studies are needed to determine the possible mechanisms of action.6111711718Mauviel, A., Daireaux, M., Hartman, Dj., Galera, P., Loyan, G., Pujol, J.P., Effects des insaponifables d'avocat et de soja (PIAS) sur la production de collagene par des cultures des synoviocytes, chondrocytes articularis et fibroblasts dermiques (1989) Rev Rhum Mal Osteoartic, 56, pp. 307-311Mauviel, A., Loyan, G., Pujol, J.P., Effect des insaponifiables d'avocat et soja (Piascledine) sur l'activité collagénolytique des cultures de synoviocytes articulaires de lapin traits par l'interleukine-1 (1991) Rev. Rhum Osteoartic., 58, pp. 241-245Henrotin, Y., Labase, A., Zheng, S.X., De Groote, D., Jaspar, J.-M., Guillon, B., Effects of three avocato/soybean mixtures of metaloproteinases, cytokines, and prostaglandin E 2 production by human articular chondrocytes metabolism (1998) Clin Rheumatol, 17, pp. 31-39Boumediène, R., Bobdanowicz, P., Felisaz, N., Galera, P., Pujol, J.P., Avocado/soya unsaponiftables enhance expression of transforming growth factor β-1 and plasminogen activation inhibitor-1 in cultured articular chondrocytes (1999) Arthritis & Rheumatism, 42, pp. 148-156Mazièzes, B., Tempesta, C., Tiechard, M., Vaguier, G., Pathologic and biochemical effects of a lipidic avocado and soya extract on an environmental post-contusive model of OA (1993) Osteoarthritis Cartilage, 1, p. 46Blotman, F., Maheu, E., Wulwik, A., Caspard, H., Lopez, A., Efficacité et tolerance des insaponifiables d'avocat/soja dans le traitement de la gonarthrose et de la coxarthrose symptomatiques. Essai prospectif, multicentrique, de trois mois, randomize, en double insu, controlê versus placebo (1997) Revue du Rhumatisme - Edition Francaise, 64 (12), pp. 944-954Altman, R., Asch, E., Bloch, D., Bole, G., Borenstein, D., Brandt, K., Development of criteria for the classification and reporting of osteoarthritis: Classification off osteoarthritis of the knee (1986) Arthritis Rheum., 29, pp. 1039-1049Altman, R., Alarcón, G., Applerouth, D., Bloch, D., Borenstein, D., Brandt, K., The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip (1991) Arthritis Rheum., 34, pp. 505-514Lequesne, M., Méry, C., Samson, M., Gerard, P., Indexes of severity for the osteoarthritis of the hip and the knee (1987) Scand J Rhematol, 65 (SUPPL.), pp. 85-89Maheu, E., Mazieres, B., Valat, J.-P., Loyau, G., Le Loet, X., Burgeois, P., Grouin, J.-M., Rozenberg, S., Symptomatic efficacy or avocado/soybean unsaponifiables in the treatment of the knee and hip. A prospective, randomized, double-blind, placebo controlled, multicenter clinic trial with six month treatment period and a two-month follow-up demonstrating a persistent effect (1998) Arthritis Rheum, 41, pp. 81-91Appleboom, T., Schuermans, J., Verbruggen, G., Henrotin, Y., Reginster, J.Y., Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis (2001) Scand J Rheumatol, 30, pp. 242-247Lequesne, M., Brandt, K., Bellamy, N., Moskowitz, R., Menkes, C.J., Pelletier, J.P., Guidelines for testing slow acting drugs in osteoarthritis (1994) J Rheumatol, 21 (41 SUPPL.), pp. 65-71Altman, R., Brandt, K., Hochberg, M., Moskowitz, R., Bellamy, N., Block, D.A., Design and conduct of clinical trials in patients with osteoartriritis: Recommendations from a task force of the Osteoarthritis Research Society. Results of a workshop (1996) Osteoarthritis Cartilage, 4, pp. 217-43