Authors' objectives:

This study provides a review of the effectiveness of glucosamine in treating knee osteoarthritis (OA).

Authors' recommendations: There is some level 1 evidence on the short and long term effectiveness of glucosamine in alleviating OA symptoms, as measured by pain index, Lequesne index or WOMAC, particularly of the hip or knee joint. There is also some level 1 evidence on the possible role of glucosamine as a structure-modifying drug for OA as measured by x-ray imaging of the joint space. The majority of research regarding glucosamine and OA were undertaken on patients with either knee or hip OA. This limitation raises questions regarding the generalizability of the outcome toward OA of other joints such as those in the hand/wrist, shoulder and ankle. The majority of clinical studies were done with glucosamine sulphate and little evidence is available on the efficacy of other forms of glucosamine (e.g. hydrochloride, chlorhydrate salt, hydroiodide, combination with herbs, vitamin A, vitamin E, or minerals including Mg, K, Cu, Zn or Se). The majority of the primary research on glucosamine is funded by manufacturers of the compound. The longest reported clinical trial on glucosamine and OA is for 3 years. Given the nature of OA as a chronic disease process, the information on the long-term toxicity/side effects of glucosamine administration is still lacking. Information on possible drug interaction(s) is still lacking. The use of combination glucosamine and chondroitin for treatment of OA has become extremely popular. However, there is no evidence that this combination is more effective than either supplement alone. Currently, the National Center for Complementary and Alternative Medicine (part of the US National Institute of Health) is conducting a large, well designed (as of September 16, 2003 is still recruiting participants) Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). This study is designed to compare the efficacy of glucosamine, chondroitin, glucosamine and chondroitin, celecoxib (COX-2 inhibitor) and placebo on patients with OA. The results of this major clinical trial are expected to be published in 2004 and will provide more definitive evidence on the efficacy of glucosamine in particular. The Evidence Based Practice Group will update this review accordingly.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.worksafebc.com/health_care_providers/related_information/evid ence_based_medicine/default.asp

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC