Use of a glycosamine sulfate for patients with osteoarthritis and a comorbidity with high risk of the side effects from NSAIDS.

The literature review is devoted to the peculiarities of treating co-morbid patients with acute conditions of chronic pain. The proved effect of NSAIDS must always correlate with the side effect risk. Patented microcrystalline glucosamine sulfate (pCGS) is likely to have an effect similar to NSAIDS because it can cause decrease of COX-2 and PGE2 gene expression. Randomized trials show, that patented microcrystalline glucosamine sulfate can impede complex structure changes and have a positive effect on the symptoms at the early stage of knee OA. Pharmacokinetic evidence demonstrates that repeated oral intake of microcrystalline glucosamine sulfate can cause the increase of GS in synovial fluid. It is necessary to monitor OA biomarkers during microcrystalline GS treatment, recommend appropriate physical exercise and study the neuropathic component of chronic pain.