• The MOSAIC clinical essay shows that chondroitin sulfate CS b-Bioactive® is superior to the anti-inflammatory drug celecoxib for delaying the disease’s progression
  • It also reveals that chondroitin sulfate CS b-Bioactive® possesses the same level of efficiency as celecoxib for the improvement of pain and mobility in knee osteoarthritis, with the added advantage of a higher safety profile


Chondroitin sulfate CS b-Bioactive® (made by Bioiberica) delays osteoarthritis progression and is as effective as the anti-inflamatory drug celecoxib for improving the disease’s symptoms. These are the main conclusions of a new published[1] clinical essay presented by Professor Jean Pierre Pelletier[2] at the recent celebrated Annual European Congress of Rheumatology; being held in Madrid, Spain.

The MOSAIC clinical essay (24 MOnth study on Structural changes in knee osteoarthritis Assessed by mrI with Chondroitin sulfate) is a multicenter, randomized, double blind, controlled and comparative study, conducted by Bioiberica, carried out in five medical centers in Quebec (Canada). 194 patients suffering from knee osteoarthritis with inflammation (synovitis) and moderate pain were recruited to assess the effects of chondroitin sulfate (1.200 mg/ day) and celecoxib (200 mg/ day) over the loss of cartilage volume in knee osteoarthritis after 24 months.

The participants underwent three Quantitative Magnetic Resonance scans: one at the beginning of the study, a second one after one year and a third one at the end of the study. The results revealed that the progression of knee osteoarthritis is slower in patients receiving chondroitin sulfate CS b-Bioactive®. More precisely, this group experienced a statistically significant lower loss of cartilage volume as soon as after the first year of treatment, in comparison with those patients who received the anti inflammatory drug. Patients treated with chondroitin sulfate had a decrease in synovitis which was associated with a statistical significant decrease in cartilage loss.

In addition to that, a published[3] post hoc analysis of this clinical trial concludes that chondroitin sulfate has also a protective effect on the subchondral bone, reducing the knee bone curvature and therefore the disease’s progression.

This data proves that chondroitin sulfate may delay the advance of osteoarthritis in the long term, and that it had a disease-modifying effect”, affirmed Professor Pelletier.

The MOSAIC study also evaluated the effects of both products on the disease’s symptoms. More precisely, the study evaluated their effects on pain, function, stiffness, joint efflux and swelling; concluding that both treatments were equally efficient across the entire study, reaching a clinically relevant symptom improvement of around 50%.

“The study confirms that both products are efficient for the treatment of osteoarthritis symptoms, although only chondroitin sulfate has the additional advantage of exerting a joint protection effect and a better safety profile”, concluded Professor Pelletier.

[1] Pelletier J-P, et al. Chondroitin sulfate efficacy versus celecoxib on knee osteoarthritis structural changes using magnetic resonance imaging: a 2-year multicentre exploratory study. Arthritis Research and Therapy 2016 Nov 3;18 (1):256.

[2] MD; professor of medicine, University of Montreal; director, Rheumatic Disease Unit, Department of Medicine, University of Montreal School of Medicine; head, Arthritis Division, University of Montreal Hospital Centre (CHUM); head, Chair in Osteoarthritis of the University of Montreal; and director, Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM).

[3] Raynauld JP, et al. Bone curvature changes can predict the impact of treatment on cartilage volume loss in knee osteoarthritis: data from a 2-year clinical trial. Rheumatology 2017 Jun 1;56(6):989-998.