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Discussion on Adequan vs. Chondroprotec

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Lori
Member
Username: Lccsi

Post Number: 6
Registered: 6-2004
Posted on Monday, Jan 17, 2005 - 6:38 pm:   Edit PostPrint Post

Adequan, ChondroProtec, Acetyl-D-Glucosamine.. I have heard of the first 2 but read about the 3rd being a generic adequan. Is this true? Are all 3 basically the same ?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11875
Registered: 1-1997
Posted on Tuesday, Jan 18, 2005 - 8:45 am:   Edit PostPrint Post

Hello Lori,
In the last year new experimental work has come to light about both Chondroprotec and acetyl-d-glucosamine. First, neither product is polysulfated glycoaminoglycan which is what Adequan is and when compared against Adequan in horses with induced inflammation of the knee (carpus), the Adequan group showed significant and markedly better improvement over the other 2 drugs. For more on this see, Equine Medications and Nutriceuticals » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » The Joint Protective Treatments.
DrO
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Lori
Member
Username: Lccsi

Post Number: 7
Registered: 6-2004
Posted on Tuesday, Jan 18, 2005 - 10:22 am:   Edit PostPrint Post

Thanks Dr. O. That is very interesting.. I've been using Chondroprotec for the last couple of months and seen an improvement in my horse as far as stiffness and just general way of going. This is the same horse I wrote about several months ago that had a problem going down hills. We started injections In November and have moved him to a paddock with gentle hills and he now goes down hill without any distress. It is possible given he was an import he never really went down hill. I may switch to adequan based on the info you've given me. It's worth trying for a month to see if he improves even more. Thanks
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11879
Registered: 1-1997
Posted on Wednesday, Jan 19, 2005 - 8:03 am:   Edit PostPrint Post

I thought it unfortunate they did not run a untreated control to compare all the treatments Lori so we do not know if the Chondroprotec is better than no treatment but the difference between the generics and Adquan was so remarkable that it is impossible to ignore: Adquan was just not significantly better but remarkably better. We should note that they were treating acute as opposed to chronic inflammation as seen in DJD.
DrO
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Loraine Scampini
New Member
Username: Loraine

Post Number: 1
Registered: 10-2004
Posted on Friday, Jan 28, 2005 - 6:30 pm:   Edit PostPrint Post

Does anyone know where I can get a full report on the study done to compare the three products?

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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11961
Registered: 1-1997
Posted on Wednesday, Feb 2, 2005 - 11:07 am:   Edit PostPrint Post

Hello Loraine,
Sorry to be so slow to get back with you. The presentation was given at the 2004 AAEP meeting and appears in the Proceedings:

Efficacy of Intramuscular Chondroitin Sulfate and Compounded Acetyl-d-Glucosamine in a Positive Controlled Study of Equine Carpitis

Gary W. White, DVM; Trent Stites, DVM; E. Wynn Jones, FRCVS, PhD; and Scott Jordan, PhD

The efficacy of injectable chondroitin sulfate and acetyl-d-glucosamine solutions was evaluated by comparing them to intramuscular (IM) polysulfated glycosaminoglycan (PSGAG) in the Complete Freund’s Adjuvant (CFA) carpitis model.

Summary: PSGAG was significantly (p  0.05) more effective in the recovery of model-induced deficits in lameness parameters than were chondroitin and glucosamine injectable solutions.

Authors’ addresses:
Sallisaw Equine Clinic, PO Box 733, Sallisaw, OK 74955 (White, Stites);
PO Box 1935, Starkville, MS 39760 (Jones);
and
Department of Systems Sciences, Arkansas Tech University, Russellville, AR 72801 (Jordan).
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Loraine
Member
Username: Loraine

Post Number: 2
Registered: 10-2004
Posted on Wednesday, Feb 2, 2005 - 7:43 pm:   Edit PostPrint Post

Thank you for the info Dr. O. I always hesitate to make changes based on just one study, but there are so few really good studies that I'm always making decisions on incomplete information. The fact that they could actually get statistical significance is impressive. Did you consider it a well done study? I have a horse currently on acetyl-d-glucosamine but because of a suspensory injury I could not really assess effectiveness. I now have an even more complicated issue...I've just gotten the news that my almost 6 year old appendix gelding has bilateral juvenile arthritis of the hocks. I will have to make some decisions about what to do and if psgag is that much better than the acetyl-d-glucosamine I've been using, I may just have to bite the bullet....adequan is 5 times more expensive! It will be just one part of a treatment program, but it's still a hard choice. I can actually get oral supplements for less than that. Thanks again for your help.
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Lori
Member
Username: Lccsi

Post Number: 8
Registered: 6-2004
Posted on Wednesday, Feb 2, 2005 - 11:06 pm:   Edit PostPrint Post

Hi Dr O. I asked about comparing the products last week.. you said that Chondroprotec is not Polysulfated glycosaminoglycan.. yet that is what it is advertised as by the manufacturer http://www.hymed.com/chondrop.htm .. I am now confused..
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11969
Registered: 1-1997
Posted on Thursday, Feb 3, 2005 - 10:33 am:   Edit PostPrint Post

Hello Lorraine,
The talk was moderated by Dr Wayne McIlwraith, one of the most knowledable researchers on joint disease and a whale of a good guy. He seemed to accept the conclusions with some reservations. There were also a young joint researcher in the audience who vociferously argued the study was not well done but I really could not understand her complaint(?). Questions were also raised about the size of the study, the lack of nontreated controls, the model used, that the research was supported by the Adequan company and a few other aspects used. I think Dr White answered these quite well. What we have to remember is that this product Chordroprotec has no research supporting its use. We used it in the past cause we were assured it was the chemical equivalent of Adequan which it is not or at least at the time of the study was not.

Lori, I too had been led to believe this was a generic PSAG but in the report cited above is this statement:

In this study, the products tested against PSGAG included a compound-labeled PSGAG sold as a medical device for the treatment of equine wounds (When you check the references they used Chondroprotec). Laboratory analysis of this compound has shown that it is actually chondroitin sulfate (a mono-sulfated GAG) with a molecular weight of 16,000– 33,000 kDa.(11) Thus, it is not chemically identical to PSGAG. Polysulfated glycosaminoglycan is a semisynthetic hypersulfated (three to four sulfate groups per disaccharide unit) polysaccharide and has a molecular weight of 3000–6000 kDa, both factors of functional significance. Despite these significant differences, this monosulfated chondroitin sulfate is commonly referred to as a “generic” version of Adequan in the marketplace. Additionally, the recommended dose and treatment schedule is said to be identical to that of Adequan IM (500 mg/5 ml, every 4 days for 4 wk). There has been no reported evidence of bioequivalence for this monosulfated chondroitin sulfate and Adequan IM, which is required for approval of such recommendations.

So, at least as of last summer PSAG is not what is in the bottle of Chondroprotec they used.
DrO
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Lori
Member
Username: Lccsi

Post Number: 9
Registered: 6-2004
Posted on Thursday, Feb 3, 2005 - 10:52 am:   Edit PostPrint Post

Hi Dr O. I've actually e-mailed Hy-Med the manufacturer to ask them what the chemical compound is of Chondroprotec.. Although once I run out of my supply I am going to bite the bullet and try Adequan.
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Loraine
Member
Username: Loraine

Post Number: 3
Registered: 10-2004
Posted on Thursday, Feb 3, 2005 - 12:14 pm:   Edit PostPrint Post

Thank you, Thank you, Thank you..Dr. O. I really appreciate the detailed discussion about potential issues with the study. It certainly sounds like at the very least these products are not chemically equivalent and this initial study indicates questions about their ability to perform comparably well. Having the study supported by the Adequan company certainly throws a wrench in the works. Hopefully someone unbiased will work on reproducing these results....that will be the real test.
Thanks again for all the info.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11973
Registered: 1-1997
Posted on Friday, Feb 4, 2005 - 6:28 am:   Edit PostPrint Post

Let us know what Hy-Med says Lori. Thanks for the kudos Loraine.
DrO
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Lori
Member
Username: Lccsi

Post Number: 10
Registered: 6-2004
Posted on Friday, Feb 4, 2005 - 9:41 am:   Edit PostPrint Post

Hi Dr O.. I actually got a call back from a very upset person at Hymed. He wanted to know where I got that information from.. Once I explained I asked him directly is it PSGAG in the bottle. He said yes.. but he went on to say that Chondroprotec was approved by the FDA for use in animals and humans.. for a variety of uses and Adequan was not. So I looked at the FDA web site.. where Chondroprotec is not listed at all. Hymed has not products listed. When you search for polysulfated glycoaminoglycan I was able to find Adequan approved for animal use.. as well as some notes to the manufacturer about the claims they make in their ad's not be proved throught clinical trials although those notes were from a few years ago so maybe they have done the clinical work to prove their advertisement claims. The problem with the study is that it is not done independently. I also find it hard to believe that Hymed is intentionally mis-labeling a product.. that would be fraud.. so... I'm going to do a little more hunting and e-mail Neogen who is the distributor and see what they have to say. I'll keep you all posted.
Lori
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Loraine
Member
Username: Loraine

Post Number: 4
Registered: 10-2004
Posted on Friday, Feb 4, 2005 - 10:56 am:   Edit PostPrint Post

Lori,
Definitely keep us posted. I would really like to know whether I need to spend the outrageous prices adequan is charging. Acetyl-d-glucosamine is only costing me about $18/month(for two shots/month) vs $100/month for two shots/month of adequan. I will be seeing our vet next week for a long discussion about both my horses. He's usually pretty up on this stuff so I'll let you know if I get any important facts.
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Ann C
New Member
Username: Coomber

Post Number: 1
Registered: 5-2005
Posted on Monday, Aug 1, 2005 - 8:15 am:   Edit PostPrint Post

Lori, What did you find? Did you switch to Adequan? Is so what were the results?
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Jan Toberer
New Member
Username: Jjet

Post Number: 1
Registered: 4-2005
Posted on Monday, Oct 31, 2005 - 12:04 pm:   Edit PostPrint Post

Hi, is anyone up on the Adequan/Chondroprotec debate? This thread effectively stopped in February, without having been resolved. It would be very interesting to know if this has gone any further, and if not, why not.

Anyone have news? Was the topic addressed in another discussion?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14026
Registered: 1-1997
Posted on Tuesday, Nov 1, 2005 - 6:59 am:   Edit PostPrint Post

All the questions posted in the original post where answered Jan. After that was just folks opinion.
DrO
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Jan Toberer
New Member
Username: Jjet

Post Number: 2
Registered: 4-2005
Posted on Tuesday, Nov 1, 2005 - 9:05 pm:   Edit PostPrint Post

I guess what I really meant was, has the company ever been taken to account for false advertising? Because that is what it is. Or, have they adjusted their claims?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14027
Registered: 1-1997
Posted on Wednesday, Nov 2, 2005 - 8:17 am:   Edit PostPrint Post

I did not hear back and Lori is still an active member, perhaps she will respond.
DrO
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Lori
Member
Username: Lccsi

Post Number: 23
Registered: 6-2004
Posted on Wednesday, Nov 2, 2005 - 10:27 am:   Edit PostPrint Post

I am now switched over to adequan.. and will keep you posted.. We have slowed down to twice monthly injections It's hard to see a difference because he had been on chondroprotec before and there was significant improvement when we started that .. My horse continues to be improved from prior to the shots but... It's only one of several things we do to make him comfortable.. in addition he gets monthly massage and chiro/accupunture when necessary.. All these things have helped keep him together and comfortable as we are now regularly working on 1/2 pirouettes and single flying changes and he seems to be holding up to the work.. Given a year ago he was like riding a stiff board.. Someone would really need to run an independent controlled study to compare all the meds + a control group in order to really have an answer (and it can't be the manufacturer :-) ..
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Angel Roberts
Member
Username: Angelvet

Post Number: 10
Registered: 5-2005
Posted on Wednesday, Nov 2, 2005 - 11:13 am:   Edit PostPrint Post

One of the tough things about answering the "which is better" question in research or in practise is taking into account that not every horse's physiology reacts identically to every medication. If you ask a group of people what they use for pain relief, you usually get a mix of products listed and quite a debate as to which works best.One person swears the only thing that works for them is tylenol, while the next says tylenol does nothing for their pain, but ibuprofen eliminates their discomfort and so on. At a recent talk I attended where Dr McIlwraith was speaking, he said that while investigating another product, he used IM adequan as one of the control groups for comparison and found that it had little to no effect on resolving the lameness. Yet as evidenced by this discussion as well as from other experiences I have seen, obviously there are horses that respond well to adequan. I think the key is using reputable licensed products that you and your vet feel safe trying on your horse and seeing what works for you.
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Jan Toberer
New Member
Username: Jjet

Post Number: 3
Registered: 4-2005
Posted on Thursday, Nov 3, 2005 - 8:16 am:   Edit PostPrint Post

I appreciate the new comments and can see that both products may be useful in the right set of circumstances. What really upsets me is that chondroprotec is advertised as being the same, yet according to this statment,

"Laboratory analysis of this compound has shown that it is actually chondroitin sulfate (a mono-sulfated GAG) with a molecular weight of 16,000? 33,000 kDa.(11) Thus, it is not chemically identical to PSGAG. Polysulfated glycosaminoglycan is a semisynthetic hypersulfated (three to four sulfate groups per disaccharide unit) polysaccharide and has a molecular weight of 3000?6000 kDa, both factors of functional significance."

It is wrong to advertise this as identical; many other ways of describing it would serve the purpose: 'functionally equivalent,' 'in the same family of drugs, etc.

It may sound nitpicky but I feel the issue is crucial when it comes down to choosing a drug to use on your animals. It even may steer you away from trying the second drug if you tried the first and it didn't work, you don't experiment with the second because it's 'the same drug.' But it may have helped your horse because it's different.

I was wondering if Lori had e-mailed Neogen. the distributor. If not, that's ok, I should have got to the point in my first post.

Done with the rant, sorry.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14049
Registered: 1-1997
Posted on Friday, Nov 4, 2005 - 9:17 am:   Edit PostPrint Post

It is not nit picky at all Jan. Inaccurate advertising of a pharmaceutical is harmful to the public and is illegal.
DrO
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Anita Ketelsen
Member
Username: rusty

Post Number: 29
Registered: 2-2005
Posted on Friday, Mar 9, 2007 - 3:42 pm:   Edit PostPrint Post

Dr. O..my vet prescribed Chondroprotec injections 1st was yesterday (every 4 days for total 6 inj.) due to stifle soreness and he said it was a generic Adequan. Obviously, from what I am reading here that is incorrect. So, now I am thinking I have spent $$ for a product that may not be of benefit to my horse and am concerned. Today he appears to limp some, before he did not, but he was palpated & examined yesterday. I did not ride today, I free lounged at a walk for about 30 minutes and could see a hesitation in his right rear. Before I had noticed his neck & head carriage to be off, usually at a trot/gait neck slight bend to the left head tilted nose out to the right, intermittent lifting like pivoting out some the right rear when I picked up the left front, intermittent giving of the right rear while gaiting...I took him to a MFT clinic for evaluation & was told he needed further vet exam.to see what was up with him. The vet was out the week before the clinic & told me to take him there & if they looked him over with no results than it would be back in his court. Rusty has been examined by the same vet three times in three weeks. After the clinic I was told his back was sore & my saddle did not fit & he was sore from the mandible to the stifle on the right with atrophy behind the right wither. Vet said my saddle rocked forward to back, but I can not reproduce the rock & he tells me I am not strong enough. He wanted me to ride bareback & eval with & without bit..no change. & Now this week I am told it's his stifle. "sensitive in the caudal thigh & tuber coxae points associated with his stifle R>L. Sensitive on palpation +right on muscle testing of right stifle" Vet decided this after we talked about what I was seeing & further evaluation. Now injections, double dose on joint supplements (four flex with ha) flat work no circles for 30 days. Any suggestions, should I think about Adequan or continue on this path...then there's my saddle. I have three tried the one vet said would be best & that was a disaster (Rusty has never worked well in that saddle). We were going down an incline & I think he was pinched & bucked out of no where...very atypical for him. Luckily I stayed on. He has never reacted like that with my Tucker saddle and that's the one vet says rocks front to back..I am questioning his evaluation of the saddle fit now. I have someone who is going to look at saddle fit next Saturday, but I just want to make sure I am on the right track here. Sorry to ramble on...
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 17970
Registered: 1-1997
Posted on Friday, Mar 9, 2007 - 4:40 pm:   Edit PostPrint Post

Hello Anita,
you should post (easiest is to cut and paste) this in a new discussion rather than adding it to the bottom of Lori's.
DrO
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SG
New Member
Username: sgpht

Post Number: 3
Registered: 7-2010
Posted on Friday, Aug 20, 2010 - 11:42 am:   Edit PostPrint Post

How long is the therapeutic blood levels maintained after a dose of Adequan assuming you have done the loading dose
Is it 96 hours or 21 days
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 25106
Registered: 1-1997
Posted on Friday, Aug 20, 2010 - 6:50 pm:   Edit PostPrint Post

Welcome to Horseadvice ,
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DrO
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