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Vietnam Human Gout Study

Assessment of Movement Improvement and Pain Relief in Gout Patients

Treated with a Hyaluronic Acid – Chondroitin Oral Complex

Dr Phan Huu Chinh

Department of Burn, Trauma and Orthapedics

Khanh Hoa Hospital Vietnam

Study Design and Research Methods

  • The clinical study was designed to evaluate the effectiveness of an oral supplement containing a complex of hyaluronic acid and chondroitin sulphate (DuoVital) for the improvement in movement and relief of pain in gout patients
  • Study subjects were gout patients in the trauma and orthopedics faculty in Khanh Hoa Hospital and a rheumatology clinic in Nha Trang, Vietnam
  • 60 patients were divided into 2 groups of 30 and randomized on an odd number - even number basis
  • The control group (odd numbers) were treated with the current hospital standard of care
    • Colchicine
    • Allopurinol
    • NSAID
  • The treatment group (even numbers) were treated with the current hospital standard of care and DuoVital (hyaluronic acid/chondroitin sulphate)
    • DuoVital was taken for 1 month (30 ml daily)
    • DuoVital was repeated after 3 months
  • Exclusion criteria for subjects included:
    • Patient cannot be followed for the study period
    • Failure to consent to participate in the study
    • Patients taking corticosteroids
    • Patients with kidney failure or hepatic insufficiency
    • Patients not following the recommended diet for gout
    • Patients with the following conditions:
      • Spine disease
      • Knee osteoarthritis stage 3 or 4
      • Cerebral vascular disease
      • Avascular necrosis of the femoral head
    • The data was analyzed according to the Linear Mixed Model (LMM) test
    • Patients were evaluated by the standards of ILAR and Omeract (2000)
    • Pain was assessed according to the Visual Analog Scale (VAS) with 0 being no pain and 10 being unbearable, agonizing pain
  • Assessments were made:
    • When diagnosed
    • 1 month
    • 3 months
    • 6 months
  • Movement improvement was assessed using 10 questions. Patients ranked every task from easy (0) to impossible (10)
  1. Put on socks without help
  2. Bend back to pick up pen from the floor without help
  3. Stretch to reach the top shelf without help
  4. Stand from sitting in an armchair without using hands or help
  5. Sit up from lying position
  6. Stand still without support for 10 minutes
  7. Climb 12-15 stairs without handrail or help
  8. Turn head without turning whole body
  9. Daily exercise
  10. Daily work at home or work plac

Results

Visual Analog Scale (VAS) Pain Scores

Time Point

Control Group

Treatment group

Diagnosis

2.70

2.83

1 Month

2.40

2.13

3 Months

1.96

1.66

6 Months

1.90

1.40

% Improvement

29.6%

50.5%

 

Movement Improvement Assessment

Control Group

 

Diagnosis

1 Month

3 Months

6 Months

% Change from Diagnosis

Put on socks

1.93

2.03

1.83

1.86

3.6%

Pick up pen from the floor

 

3.30

 

2.73

 

2.53

 

2.36

 

28.5%

Stretch to reach top shelf

 

2.83

 

2.73

 

2.70

 

2.20

 

22.3%

Stand up from arm chair

 

2.43

 

2.16

 

2.06

 

2.03

 

16.5%

Sit up from lying position

1.90

1.83

1.83

1.70

10.5%

Stand still for 10 minutes without support

 

2.10

 

1.96

 

1.80

 

1.70

 

19.0%

Climb 12-15 stairs

5.13

4.33

4.60

3.76

26.7%

Turn head without turning whole body

 

2.16

 

2.00

 

 

1.86

 

1.83

 

15.3%

Daily exercise

5.70

5.20

4.83

4.30

24.6%

Daily work

6.40

5.66

5.53

4.30

32.8%

 

33.88

 

 

26.04

23.1%

 

Treatment Group

 

Diagnosis

1 Month

3 Months

6 Months

% Change from Diagnosis

Put on socks

2.06

1.66

1.63

1.40

32%

Pick up pen from the floor

 

3.23

 

2.33

 

1.96

 

1.50

 

53.6%

Stretch up to reach top shelf

 

2.96

 

2.23

 

2.10

 

1.86

 

37.2%

Stand up from arm chair

 

2.66

 

1.80

 

1.83

 

1.36

 

48.9%

Sit up from lying position

1.70

1.56

1.36

1.13

33.5%

Stand still for 10 minutes without support

 

2.30

 

1.80

 

1.30

 

0.96

 

58.3%

Climb 12-15 stairs

5.30

4.03

2.96

2.03

61.7%

Turn head without turning whole body

 

2.06

 

1.93

 

1.56

 

1.30

 

36.9%

Daily exercise

6.00

4.40

3.70

3.30

45.0%

Daily work

6.26

5.56

4.76

3.66

41.5%

 

34.53

 

 

18.50

46.4%

 

  • At all time points evaluated, reduction in pain of the treatment group was greater than the control group
    • The treatment group achieved a 50.5% reduction in pain at 6 months compared to a 29.6% reduction for the control group
  • With limited exceptions, at all time points and for all parameters evaluated, the treatment group experienced a greater improvement in mobility
    • Despite this being a small study group, statistical significance (p<0.05) was achieved for two parameters, standing still without support and climbing 12-15 stairs (statistical significance was achieved after both 3 and 6 months)
  • Compared to diagnosis, the total movement assessment of all parameters improved 46.4% for the treatment group compared to 23.1% for the control group

Discussion and Conclusion

  • Previously in 2013 the Vietnam Rheumatology Association concluded that the hyaluronic acid-chondroitin sulphate complex in DuoVital had an important role in the treatment of osteoarthritis
  • This study further demonstrates the positive attributes of the DuoVital hyaluronic acid-chondroitin sulphate complex in movement improvement and pain relief in gout patients