Glucosamine, Chondroitin Sulfate and the Two In Combination for Painful Knee Osteoarthritis

Source: Clegg DO, Reda DJ, Harris CL, et al. (N Engl J Med. 354:795-808, 2006.)

ABSTRACT

BACKGROUND

Glucosamine and chondroitin sulfate are used to treat osteoarthritis. The multi-center, double-blind, placebo- and celecoxib-controlled Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) evaluated their efficacy and safety as a treatment for knee pain from osteoarthritis.

METHODS

We randomly assigned 1,583 patients with symptomatic knee osteoarthritis to receive 1,500 mg of glucosamine daily, 1,200 mg of chondroitin sulfate daily, both glucosamine and chondroitin sulfate, 200 mg of celecoxib daily, or placebo for 24 weeks. Up to 4,000 mg of acetaminophen daily was allowed as rescue analgesia. Assignment was stratified according to the severity of knee pain (mild [n = 1,229] vs moderate to severe [n = 354]). The primary outcome measure was a 20 percent decrease in knee pain from baseline to week 24.

RESULTS

The mean age of the patients was 59 years, and 64 % were women. Overall, glucosamine and chondroitin sulfate were not significantly better than placebo in reducing knee pain by 20 %. As compared with the rate of response to placebo (60.1 %), the rate of response to glucosamine was 3.9 % points higher (p = 0.30), the rate of response to chondroitin sulfate was 5.3 % points higher (p = 0.17), the rate of response to combined treatment was 6.5 % points higher (p = 0.09). The rate of response in the celecoxib control group was 10.0 % points higher than that in the placebo control group (p = 0.008). For patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo (79.2 % vs 54.3 %, p = 0.002). Adverse events were mild, infrequent, and evenly distributed among the groups.

CONCLUSIONS

Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate
 

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Articles: Topical Cream for Osteoarthritis  |  Glucosamine  |  Transdermal Delivery Technology  |  Glucosamine On Painful Knee Osteoarthritis  |  Long-Term Effects of Glucosamine Sulphate on Osteoarthritis  |  Effect of Glucosamine On Regular Knee Pain  |  Management of Osteoarthritis  |  Glucosamine Effects in Humans  |  Effects of Glucosamine Derivatives on Equine Articular Cartilage Degradation  |  Effect of Glucosamine Supplementation on Fasting and Non-Fasting Plasma Glucose  |  Glucosamine Sulfate Use and Delay of Progression of Knee Osteoarthritis  |  Treatment of Knee Osteoarthritis Symptoms

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