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The evidence that glucosamine is an effective treatment for arthritis from
the
University of Oxford Clinical School Information Management
Services Unit
Conclusion/summary
"The bottom line is that there is a body of evidence
supporting the
efficacy of oral and intramuscular glucosamine in arthritis."
Chondroitin sulphate for osteoarthritis
Chondroitin sulphate given orally was found to be effective in reducing pain,
improving function, and reducing NSAID and analgesic consumption in seven
randomised double-blind trials involving 702 patients with osteoarthritis
of hip or knee over three months or more.
In all trials patients and/or physicians rated chondroitin
sulphate better than placebo.
A search of PubMed at the National Library of Medicine reveals hundreds of scientific trials... here is a random selection...
Glucosamine
sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized,
placebo-controlled, double-blind study
Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati
LC.
Department of Medicine and Rheumatology, Charles University, Prague, Czech
Republic. pavelka@revma.cz
Over a three year period... 200 patients, 100 were given a supplement containing
glucosamine the other 100 were given a placebo and the results monitored.
Conclusion: Long-term treatment with glucosamine sulfate
retarded the progression of knee osteoarthritis, possibly determining disease
modification.
Glucosamine
and chondroitin sulfates in the treatment of osteoarthritis: a survey
de los Reyes GC, Koda RT, Lien EJ.
Department of Pharmaceutical Sciences, School of Pharmacy, University of Southern
California, Los Angeles, CA 90089, USA.
For more than 30 years, non-steroidal anti-inflammatory drugs (NSAIDs) have
been used as standards in the treatment of osteoarthritis (OA). Serious and
often life-threatening adverse effects due to these agents are common. Clinical
findings have revealed that glucosamine sulfate and chondroitin sulfate are
effective and safer alternatives to alleviate symptoms of OA. Experimental
evidence indicates that these compounds and their low molecular weight derivatives
have a particular tropism for cartilage where they serve as substrates in
the biosynthesis of component building blocks. This paper is a literature
review of the chemistry, mechanism of action, pharmacokinetics, clinical efficacy
and safety of these two nutraceuticals.
Publication Types: Review, Tutorial
PMID: 11127967 [PubMed - indexed for MEDLINE]
Glucosamine.
A nutraceutical in osteoarthritis
Phoon S, Manolios N.
Westmead Hospital, New South Wales.
BACKGROUND: Glucosamine is an amine-sugar that has been marketed as a natural
product for the treatment of osteoarthritis. It has been popularized in the
complementary section of pharmacies as a safe over-the-counter treatment for
osteoarthritic pain. OBJECTIVE: We review the literature on the efficacy and
safety of glucosamine in osteoarthritis. DISCUSSION: Recent
research suggests that it may not only provide symptomatic pain relief, but
may have a role in chondroprotection.
Publication Types: Review Literature
PMID: 12154601 [PubMed - indexed for MEDLINE]
Glucosamine
therapy compared to ibuprofen for joint pain
Ruane R, Griffiths P.
Primary Care and Community Pharmacy, King's College London.
To determine the effectiveness of oral glucosamine with ibuprofen for the
relief of joint pain in osteoarthritis a mini-review (Griffiths, 2002) of
double-blind randomized controlled trials comparing the two was undertaken.
The population was adult patients diagnosed with osteoarthritis at any site.
The outcome was arthritic pain reduction. Searches on Medline, Embase, AMED,
the Cochrane Library and the Merck index identified four trials. Of these,
two studies were obtainable and were included in the review. Both compared
1.2 g ibuprofen daily with 1.5 g glucosamine sulphate daily, in three divided
doses. The combined number of participants in the studies was 218. The results
of these studies showed glucosamine to be of similar efficacy to ibuprofen.
The conclusion is that glucosamine is effective in relieving joint pain associated
with osteoarthritis. Glucosamine's pain-relieving effects
may be due to its cartilage-rebuilding properties; these disease-modifying
effects are not seen with simple analgesics and are of particular benefit.
In practice glucosamine can be used as an alternative to anti-inflammatory
drugs and analgesics or as a useful adjunct to standard analgesic therapy.
Publication Types: Review Literature
PMID: 11904551 [PubMed - indexed for MEDLINE]
Glucosamine
sulfate in osteoarthritis of the knee
Noack W, Fischer M, Forster KK, Rovati LC, Setnikar I.
Department of Orthopedics-Evangelisches Waldkrankenhaus, Berlin, Germany.
Glucosamine sulfate is a drug used for the treatment of osteoarthritis (OA),
based on its pharmacological and metabolic activities on the cartilage and
chondrocytes, complemented by mild anti-inflammatory properties and a favorable
pharmacokinetic profile. The aim of this study was to define the activity
and safety of glucosamine sulfate on the symptoms of patients with OA, using
a multicenter, randomized, placebo-controlled, double-blind, parallel-group
study design. The study included 252 outpatients with OA of the knee (Lequesne's
criteria), radiological stage between I and III, and Lequesne's severity index
of at least 4 points and symptoms for at least 6 months. Patients were treated
with either placebo or oral glucosamine sulfate 500 mg t.i.d. for 4 weeks,
with weekly, with weekly clinic visits. Responders to treatment were defined
as patients with a reduction of at least 3 points in the Lequesne's index
with a positive overall assessment by the investigator. The Lequesne's index
was 10.6 +/- 0.45 S.E.M. points in both groups at the start of the study.
This decreased to 7.45 +/- 0.5 points in the treatment group (average 3.2)
and 8.4 +/- 0.4 points in the placebo group (average 2.2) (P < 0.05, Student's
t-test). The responder rate in the evaluable patients was 55% with glucosamine
(N = 120) vs 38% with placebo (N = 121). These proportions were 52% vs 37%
in an intention-to-treat analysis (P = 0.014 and 0.016, respectively; Fisher's
Exact Test). The medications were well tolerated throughout the study, with
no difference between the glucosamine and placebo treated groups. It
is concluded that glucosamine sulfate may be a safe and effective symptomatic
Slow Acting Drug for OA.
Publication Types: Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 11548224 [PubMed - indexed for MEDLINE]
Glucosamine sulfate's role in halting or reversing joint degeneration appears to be directly due to its ability to act as an essential substrate for, and to stimulate the biosynthesis of, the glycosaminoglycans and the hyaluronic acid backbone needed for the formation of the proteoglycans found in the structural matrix of joints. Successful treatment of osteoarthritis must effectively control pain and should slow down or reverse the progression of the degeneration. Biochemical and pharmacological data combined with animal and human studies demonstrate that glucosamine sulfate is capable of satisfying both of these criteria.
PMID: 10383484 [PubMed - indexed for MEDLINE]Effect
of glucosamine on interleukin-1-conditioned articular cartilage
Fenton JI, Chlebek-Brown KA, Caron JP, Orth MW.
Department of Animal Science, Michigan State University, East Lansing 48824,
USA.
Glucosamine inhibits recombinant human interleukin-1 stimulated cartilage
degradation in equine cartilage explants. Recently, recombinant equine interleukin-1
has been cloned and purified. Therefore, the objective of this study was to
characterise the effects of glucosamine on indices of cartilage degradation
in recombinant equine IL-1beta-stimulated equine articular cartilage explants.
Cartilage discs were harvested from the weight-bearing region of the articular
surface of the antebrachiocarpal and middle carpal joints of horses (age 2-8
years) and cultured under standard conditions. Explants were exposed to recombinant
equine interleukin-1beta (reIL-1beta) on Days 1-4 in the presence or absence
of glucosamine (0.25, 2.5 or 25 mg/ml), with appropriate controls. Nitric
oxide, prostaglandin E2, sulphated proteoglycan, stromelysin and gelatinase/collagenase
activity released into conditioned media and total tissue proteoglycan content
were measured as indicators of cartilage catabolism. Glucosamine inhibited
cartilage catabolic responses in a dose dependent manner that was statistically
significant at a dose of 0.25 mg/ml for stromelysin activity and 2.5 mg/ml
for collagenase/gelatinase activity. At 25 mg/ml glucosamine also prevented
IL-1beta-induced increases in nitric oxide production, prostaglandin E2 and
proteoglycan release to media. Glucosamine prevents equine
articular cartilage degradation experimentally induced by reIL-1beta in vitro.
These data provide further support for the use of glucosamine in treatment
or prevention of cartilage loss in athletic horses.
PMID: 12405690 [PubMed - indexed for MEDLINE]
