Abstract

BackgroundExtracts from perna canaliculus, the Green Lipped Mussel (GLM) are widely used as a complimentary therapy by patients with osteoarthritis (OA). The current study investigated the potential of a novel GLM formulation as a treatment for OA. A randomized double-blind placebo-controlled trial was undertaken to assess potential impacts on pain and quality of life following 12 weeks of treatment.MethodsEighty patients with moderate to severe OA of the hip or knee were randomized to receive either 600 mg of BioLex®-GLM daily or placebo for 12 weeks. Entry criteria included a minimum 100 mm Visual Analogue Scale pain score (VAS) of 30 mm at baseline.The primary outcome was patient reported pain, measured by the Western Ontario and McMasters OA Index (WOMAC) pain subscale and VAS pain scale. Secondary outcomes included: quality of life (OAQol), total WOMAC score, WOMAC −20 responder criteria, and change in medication use over the study period.Participants were assessed at baseline, 12 weeks (end of therapy) and 15 weeks (3-weeks post-intervention).ResultsAt week 12, there were no significant differences in VAS or WOMAC pain subscale between active and placebo groups, nor significant improvement in the WOMAC-20 responder criteria or OAQol. Joint stiffness (measured by WOMAC-B stiffness) in the GLM group improved compared with placebo (p = 0.046). There was a significant difference in paracetamol use between the GLM treated group and the placebo group after week 12 (p = 0.001).ConclusionsBioLex® -GLM extract did not confer clinical benefit in moderate to severe OA over the intervention period, however, a significant difference in paracetamol use in the post-intervention period was observed between the BioLex® -GLM group and placebo group. Higher doses and/or longer treatment periods are worthy of future investigation.Trial registrationAustralia and New Zealand Clinical Trials Registry: no. ACTRN12611000256976.

Highlights

  • Extracts from perna canaliculus, the Green Lipped Mussel (GLM) are widely used as a complimentary therapy by patients with osteoarthritis (OA)

  • Participants were identified from a variety of sources including advertisements in local newspapers, (n = 26), orthopaedic databases (n = 15), previous study database (n = 14), word of mouth (n = 8), Rheumatology outpatients (n = 6), Arthritis New Zealand website (n = 1), hospital outpatients (n = 1), hospital flyer (n = 1), with 8 participants not providing this information

  • The current study showed no benefit for Biolex®-GLM over placebo for either of the primary outcomes; Western Ontario and McMasters OA Index (WOMAC)- pain score, Visual Analogue Scale pain score (VAS) pain score and there was no evidence of a response at the 20% improvement level for WOMAC pain or WOMAC –total score

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Summary

Introduction

Extracts from perna canaliculus, the Green Lipped Mussel (GLM) are widely used as a complimentary therapy by patients with osteoarthritis (OA). Pain is poorly managed in patients with arthritis especially in the older age group, and such patients frequently use complementary and alternative medicine (CAM) in an attempt to alleviate symptoms and improve their quality of life [4]. New Zealand Green Lipped Mussel (GLM, Perna canaliculus) lipid extracts have shown promise as a treatment for OA [5] with several clinical trials showing benefit across a range of outcomes. Some of these studies had methodological deficiencies and others have been small pilot studies [7, 8]

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