29 Aug 2018

Aquamin: Evidence-Based Alternative to Glucosamine for Osteoarthritis

04 Jul 2018

Asia Pacific – Plant Milks #adaywithvelvet

07 Jun 2018

Marigot Group | Lagg Cask Society

01 May 2018

CMA – Innovation Day

24 Apr 2018

CMA Innovation Day – Deltagen / Marigot / Aquamin Forte

29 Aug 2018

Aquamin: Evidence-Based Alternative to Glucosamine for Osteoarthritis

A recent guide [1] from the Royal Australian College of General Practitioners (RACGP) details a set of recommendations on managing hip and knee OA. Doctors have come out against “fad” treatments including:

– opioids

– acupuncture

– glucosamine

– stem cell therapy

– insoles and surgery

The guidelines are aimed at assisting the millions of Australians living with this chronic condition and recommend:

– no-drug, non-surgical options including weight loss

– exercise

– cognitive behavioural therapy (CBT)

Aquamin | Osteoarthritis Studies

Initial anecdotal reports of the anti-inflammatory effects of Aquamin were conclusively corroborated in two double-blind, placebo-controlled pilot trials in human patients suffering from knee osteoarthritis performed at the Minnesota Applied Research Centre. In the first of these trials [3], 70 subjects with moderate to severe knee osteoarthritis were randomly assigned to one of four 12-week treatment groups. These were 1) glucosamine sulphate (GS), 2) glucosamine sulphate plus Aquamin (G + A), 3) Aquamin (A), 4) placebo (PBO). Patients were assessed using the WOMAC pain score method, and the 6-minute walk test. Patients that consumed Aquamin for the duration of the trial reported less pain in all WOMAC categories, whereas those who consumed glucosamine reported improvement in some symptoms – but not in stiffness.

Overall, Aquamin out-performed glucosamine sulphate, and the combination of glucosamine and Aquamin resulted in no significant improvement in pain on the WOMAC score, and was no better than placebo in these parameters. See Figure. Furthermore, 6-minute walk test scores for those patients consuming Aquamin were significantly improved (7%, 101 feet) by the end of the trial, whereas those patients consuming glucosamine sulphate were only able to walk 56 feet further by the end of the trial (see figure below).

In a second trial [4], 22 patients with moderate to severe knee osteoarthritis were randomly assigned to one of 2, 12-week treatment groups, 1)Aquamin, and 2) Placebo. Patients were assessed while undergoing gradual reductions in non-steroidal anti-inflammatory drug (NSAID) use. At a 50% reduction of NSAID use, patients in the Aquamin group had improved WOMAC pain scores, passive range of joint motion and 6 minute walk test distances compared to the placebo group.

While Aquamin is not a pharmaceutical these data indicate that Aquamin may allow partial reductions in NSAID usage in patients with moderate to severe OA and in line with recent recommendations from the RACGP,  allow for an increase in physical activity. 

A third trial performed in Ireland [5] indicated that the addition of pine bark and green tea extract to Aquamin further enhanced the anti-inflammatory effects of Aquamin in knee osteoarthritis, as evidenced by significantly lower serum levels of the inflammatory cytokine TNF-. A series of in vitro studies have shed more light on how Aquamin exerts its anti-inflammatory effects in common and debilitating conditions such as OA. Production of key pro-inflammatory cytokines including TNF-  and IL-1 are inhibited in the presence of Aquamin and an inflammatory stimulus

(LPS) [6]. Importantly – the upstream mediator of inflammation, NFB is also inhibited by Aquamin in a dose-dependent manner, as is the downstream inflammatory mediator most commonly targeted by NSAIDS, COX-2 [7].

 Living Life with Osteoarthritis

Currently, no effective disease-modifying treatment options are available to cure Osteoarthritis  OA; the existing symptomatic treatments can only relieve pain and improve joint function. According to reports from a prospective, longitudinal cohort study conducted at 53 centres, 54% of OA patients receiving treatment reported inadequate pain relief. Non-steroidal anti-inflammatory drugs (NSAIDs), both traditional NSAIDs (tNSAIDs) and cyclooxygenase 2 (COX-2) inhibitors (COXIBs), are the most frequently prescribed medicines and considered as cornerstones in the treatment of OA [1] NSAIDS cause a wide variety of adverse effects, such as gastrointestinal reactions, obesity, and osteonecrosis, resulting in limited clinical applications.

Current Research Activities 

Current research on the role of Aquamin in OA is focussing on the assessment of Aquamin on the impact of specific biomechanic paramaters with a role in the improvement of quality of life for OA sufferers. This double blinded placebo controlled intervention study will provide significant information on the impact of Aquamin on parameters used clinically to assess manangement of OA symptoms and disease progression.

 

References:

[1] Rachel Wittenauer, Lily Smith, and Kamal Aden, 2013, Priority Medicines for Europe and the World “A Public Health Approach to Innovation” Background Paper 6.12 Osteoarthritis, World Health Organisation. Accessed at http://www.who.int/medicines/areas/priority_medicines/BP6_12Osteo.pdf

[2] https://www.theage.com.au/healthcare/the-osteoarthritis-treatment-fads-that-don-t-work-gp-guidelines-20180828-p5009f.html

[3] Frestedt JL, Walsh M, Kuskowski MA, Zenk JL, 2008, A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Nutr J 7: 9.

[4] Frestedt JL, Kuskowski MA, Zenk JL, 2009, A natural seaweed derived mineral supplement (Aquamin F) for knee osteoarthritis: a randomised, placebo controlled pilot study. Nutr J 8: 7–14.

[5] Murphy CT, Martin C, Doolan AM et al., 2014, The marine-derived, multi-mineral formula AquaPT reduces TNF-  _levels in osteoarthritis patients. J Nutr Health & Food Sci. 2014 2(3):1-3.

[6] Ryan S, O’Gorman DM, Nolan YM., 2011, Evidence that the marine-derived multi-mineral Aquamin has anti-inflammatory effects on cortical glial-enriched cultures. Phytotherapy research 2011;25(5):765-7.

[7] O’Gorman DM, O’Carroll C, Carmody RJ., 2012, Evidence that marine-derived, multi-mineral, Aquamin inhibits the NF-kappaB signaling pathway in vitro. Phytotherapy research 2012;26(4):630-2

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