The use of ASU in the treatment of osteoarthritis Review article
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Published:
Jun 30, 2023
Keywords:
osteoarthritis (OA), pain, functional disability, ASU (avocado soybean unsaponifiables)
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Abstract
Osteoarthritis (OA) is associated with chronic pain and is one of the most common causes of disability worldwide. In recent years, there has been a shift in the understanding of OA pathogenesis from “wear and tear” disease to an inflammatory condition. Avocado/soybean unsaponifiables (ASU), one of the symptomatic slow acting drugs for OA (SYSADOA), modulates the inflammatory response and may slow down cartilage degradation. Chondroprotective effects are mediated by inhibition of inflammatory factors such as interleukins (IL-1, IL-6) and tumor necrosis factor (TNF). At the clinical level, ASU reduces pain and stiffness while improving joint function, resulting in decreased dose of analgesics. ASU demonstrated efficacy in clinical trials including knee, hip and hand OA.
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Rupiński, R., & Rell-Bakalarska, M. (2023). The use of ASU in the treatment of osteoarthritis. Medycyna Faktow (J EBM), 16(2(59), 243-247. https://doi.org/10.24292/01.MF.0223.18
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References
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13. Głuszko P, Stasiek M. Symptoms modifying effects of oral avocado/soybean unsaponifiables (ASU) in a routine treatment of knee osteoarthritis (OA) in Poland. An open prospective observational study of patients adherent to 6-month treatment. Reumatologia. 2016; 54(5): 217-26.
14. Darestani RT, Bakhshi H, Sahraee R. Comparing the efficacy and safety of Diclofenac and Piascledine in patients with knee osteoarthritis. Pajoohandeh J. 2013; 17(6): 272-8.
15. Lequesne M, Maheu E, Cadet C et al. Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip. Arthritis Rehum. 2002; 47(1): 50-8.
16. Maheu E, Cadet C, Marty M et al. Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: The ERADIAS study. Ann Rheum Dis. 2014; 73(2): 376-84.
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20. Alekseeva L, Chichasova N, Kashevarova N et al. Application piascledina in osteoarthrosis of hand joints. Farmateka. 2010; 10: 48-55 (abstrakt).
2. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003; 81(9): 646-56.
3. Pincus T, Castrejon I, Yazici Y et al. Osteoarthritis is as severe as rheumatoid arthritis: evidence over 40 years according to the same measure in each disease. Clin Exp Rheumatol. 2019; 37 suppl 120(5): 7-17.
4. Deligne C, Casulli S, Pigenet A et al. Differential expression of interleukin-17 and interleukin-22 in inflamed and non-inflamed synovium from osteoarthritis patients. Osteoarthritis Cartilage. 2015; 23: 1843-52.
5. Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006; 20(1): 3-25.
6. Bruy O, Honvo G, Veronesec N et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019; 49(3): 337-50. http://doi.org/10.1016/j.semarthrit.2019.04.008.
7. Christiansen BA, Bhatti S, Goudarzi R et al. Management of osteoarthritis with avocado/soybean unsaponifiables. Cartilage 2015; 6(1): 30-44.
8. Boumediene K, Felisaz N, Bogdanowicz P et al. Avocado/soya unsaponifiables enhance the expression of transforming growth factor beta1 and beta2 in cultured articular chondrocytes. Arthritis Rheum. 1999; 42(1): 148-56.
9. Henrotin YE, Labasse AH, Jaspar JM et al. Effects of three avocado/soybean unsaponifiable mixtures on metalloproteinases, cytokines and prostaglandin E2 production by human articular chondrocytes. Clin Rheumatol. 1998; 17(1): 31-9.
10. Boileau C, Martel-Pelletier J, Caron J et al. Protective effects of total fraction of avocado/soybean unsaponifiables on the structural changes in experimental dog osteoarthritis: inhibition of nitric oxide synthase and matrix metalloproteinase 13. Arthritis Res Ther. 2009; 11(2): R41.
11. Salehi B, Rescigno A, Dettori T et al. Avocado–soybean unsaponifiables: a panoply of potentialities to be exploited. Biomolecules. 2020; 10(1): 130. http://doi.org/10.3390/biom10010130.
12. Appelboom T, Schuermans J, Verbruggen G et al. Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. Scand J Rheumatol. 2001; 30(4): 242-7.
13. Głuszko P, Stasiek M. Symptoms modifying effects of oral avocado/soybean unsaponifiables (ASU) in a routine treatment of knee osteoarthritis (OA) in Poland. An open prospective observational study of patients adherent to 6-month treatment. Reumatologia. 2016; 54(5): 217-26.
14. Darestani RT, Bakhshi H, Sahraee R. Comparing the efficacy and safety of Diclofenac and Piascledine in patients with knee osteoarthritis. Pajoohandeh J. 2013; 17(6): 272-8.
15. Lequesne M, Maheu E, Cadet C et al. Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip. Arthritis Rehum. 2002; 47(1): 50-8.
16. Maheu E, Cadet C, Marty M et al. Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: The ERADIAS study. Ann Rheum Dis. 2014; 73(2): 376-84.
17. Bannuru RR, Osani MC, Vaysbrot EE et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019; 27(11): 1578-89.
18. Charakterystyka produktu leczniczego PIASCLEDINE®. Expanscience Laboratoires.
19. Henrotin YE, Sanchez C, Deberg MA et al. Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes. J Rheumatol. 2003; 30(8): 1825-34.
20. Alekseeva L, Chichasova N, Kashevarova N et al. Application piascledina in osteoarthrosis of hand joints. Farmateka. 2010; 10: 48-55 (abstrakt).