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Eight out of every ten menopausal women suffer from joint pain

2 Nov 2011

The decrease in estrogen levels caused by the arrival of menopause is one of the risk factors for the development of osteoarthritis. Gynecologists are now beginning to diagnose and treat post menopausal osteoarthritis. Osteoarthritis in menopausal women is under diagnosed, and affects negatively their quality of life.

Barcelona, October 28, 2011. In Spain more than seven million people suffer from osteoarthritis. According to the EPISER1 study, there is a brisk increase in the prevalence of this disease in women older than 45. It has been demonstrated that this fact is caused by the loss of estrogens which follows menopause.

According to the study Mujer menopáusica y Artrosis2, appeared in 2010, 84% of menopausal women suffer from joint pain. Of these, 61% qualify her pain as intense or unbearable. Out of 1102 women studied, 33.6% have been diagnosed with osteoarthritis. However, if we follow the criteria set by the American College of Rheumatism, in fact 59% of these women are affected by osteoarthritis. The study’s conclusions are that osteoarthritis in menopausal women is a under diagnosed disease that affects negatively their quality of life.

One of the clinical studies explaining the possible causes of those results is “Estradiol and its metabolites and their association with knee osteoarthritis” published in 2006 by the prestigious journal of the American College of Rheumatism, Arthritis & Rheumatism.3 This study concluded that lower estrogen levels is a risk factor for the onset of knee osteoarthritis in pre menopausal women. The study’s conclusions unveiled the effects of sex hormones in the development of osteoarthritis, as they are associated to tissue inflammation. This is why the role of the gynecologist is increasingly important in the prevention and to diagnosis of osteoarthritis. When they ask patients that have reached menopause about their health condition a very common answer is that it is good in general but that they have osteoarticular pain.

The 2nd Permanent Education Course for Gynecologists entitled “Osteoarthritis in menopausal women” hosted by the Spanish Society for the Study of Menopause (AEEM) and by the Menopause Section of the Catalan Society of Obstetrics and Gynecology, with the support of Bioiberica Farma, reviewed the latest studies performed in Spain as well as provided specialists with the adequate tools to diagnose and to treat osteoarthritis.

Dr. Esteban Rodríguez Bueno, gynecologist and national coordinator of the osteoarthritis workgroup of the AEEM, defines osteoarthritis as the “three ‘F’ disease: F for Feminine, because it affects women more than men; F for Frequent, because 80% of menopausal women suffer from joint pain, and F for Facile, because it is relatively easy to diagnose. Although osteoarthritis is difficult to detect early, once it begins causing problems it is really easy to diagnose”, he explained.

There is no cure for osteoarthritis. However, osteoarthritis patients can improve its quality of life. The AEEM, for instance, recommends controlling body weight, avoid high heels, moderate exercise, and using a cane if necessary. They also recommend using chondroprotector drugs to protect the joint cartilage and improve pain.

On osteoarthritis and its treatment
Pain and functional inability are the main symptoms of osteoarthritis, which is a degenerative, inflammatory and chronic disease of the locomotor system caused by the wear and tear of joints. All treatments always aim at improving pain, minimizing functional disability, delay the evolution of that disease and also to guarantee security. Traditionally, the treatment of osteoarthritis has been based on the administration of anti inflammatory drugs that alleviate pain quickly but cannot stop the disease’s evolution; symptoms return immediately after stopping treatment. Moreover, these drugs have security issues (they can cause gastrointestinal, cardiovascular, hepatic, and renal problems) and may also lead to problems when interacting with other drugs.

On the other hand, chondroprotectors (this word literally means cartilage-protection drugs) are SYSADOAs, or Symptomatic Slow Acting Drugs for Osteo Arthritis. They act directly on the three joint structures affected by osteoarthritis: joint cartilage, synovial membrane and subchondral bone. SYSADOAs not only alleviate the symptoms of osteoarthritis; it has been demonstrated that they act directly on the causes of the disease, halting the degenerative process affecting joints. The use of chondroprotectors is supported by a number of studies because of its low cost and high security, and efficacy profiles.

Security. Chondroprotectors are products of natural origin. Therefore, they are highly secure drugs; they have no secondary effects and can be taken over long periods of time. Chondroitin sulphate is a glyccosaminoglycan of natural origin that can be found in the extracellular matrix of the cartilage and in many other tissues. Its main advantage is that is not metabolized by Cytochrome P450, as happens with most other drugs. This means that chondroitin sulphate does not present interaction issues with other drugs.

Efficacy. Chondroprotectors have a efficacy similar to that of anti inflammatory drugs. The advantages of its usage lay in that its long lasting effects: up to two or three months after stopping the treatment. On the other hand, they are slow action drugs: they need several weeks to take effect.

Cost. Chondroprotectors present several economical and pharmaceutical advantages, i.e., cost reduction for the National Healthcare System. A recent study4 determined that the cost of a six month treatment with chondroitin sulphate is €141; the cost of the treating the same patient with anti-inflammatory drugs would be €182. If only 15% of patients would switch to chondroitin sulphate during a three-year period, this would mean a cost reduction of 38 million Euros.

The therapeutic guidelines for the treatment of osteoarthritis endorsed by the Spanish (SER, SEMERGEN) and by the international scientific associations (OARSI, EULAR), give the maximum scientific evidence (1A) and the highest recommendation levels (A) to the use of chondroitin sulphate and glucosamine sulphate in the treatment of osteoarthritis.

Bioiberica Farma
Bioiberica Farma is the only Spanish laboratory specializing in research and development of drugs efficient in the treatment of osteoarthritis. To be more precise, BIOIBERICA specializes in chondroprotection, that is, in the prevention, diagnosis and treatment of cartilage, synovial membrane and subchondral bone injuries.

For further information:
Alba Soler
Bioiberica Farma Communications Manager
+34 682 040 776 or +34 93 490 49 08
The semFYC Press Department

1 Estudio EPISER “The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Carmona L, Ballina J, Gabriel R, Laffon A; EPISER Study Group. Ann Rheum Dis. 2001 Nov;60(11):1040-5.
2 Estudio MMYA. Mujer menopáusica y artrosis. E. Rodríguez Bueno ; F. Baró Mariné; S.Palacios Gil de Antuñano y cols. Póster al Congreso Nacional de la AEEM. Junio 2010 en Málaga.
3 Estradiol and its metabolites and their association with knee osteoarthritis. Sowers MR, McConnell D, Jannausch M, Buyuktur AG, Hochberg M, Jamadar DA. Arthritis Rheum. 2006 Aug;54(8):2481-7.
4 Estudio Vectra 2010, datos de 2007.(Carlos Rubio-Terrés y Grupo del estudio VECTRA. Evaluación económica del uso de condroitín sulfato yantiinflamatorios no esteroideos en el tratamiento de la artrosis. Datos del estudio VECTRA. ReumatolClin., 2010; 6(4): 187-195)