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Glucosamine therapy for treating osteoarthritis.
T E Towheed1, L Maxwell, T P Anastassiades
1Medicine, Community Health and Epidemiology, Queen's University, Room 2066 Etherington Hall, Queen's University, Kingston, Ontario, Canada, K7L 3N6. tt5@post.queensu.ca
The Cochrane Database of Systematic Reviews
|April 23, 2005
Summary
Glucosamine may improve pain and function in osteoarthritis, particularly the Rotta preparation. However, results vary, and it shows no benefit for WOMAC outcomes. Glucosamine is as safe as placebo.
Area of Science:
- Rheumatology
- Pharmacology
- Clinical Trials
Background:
- Osteoarthritis (OA) is a prevalent degenerative joint disease causing disability and reduced quality of life.
- Current treatments for OA have limitations, necessitating exploration of alternative therapies.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) assessing the efficacy and safety of glucosamine for OA treatment.
- To analyze pooled data on pain, function, and radiological progression in OA patients treated with glucosamine.
Main Methods:
- Comprehensive literature search of multiple databases (MEDLINE, EMBASE, etc.) updated to January 2005.
- Inclusion of RCTs (placebo-controlled and comparative) evaluating glucosamine's effectiveness and safety in OA.
- Quality assessment using Jadad scale and data synthesis via standardized mean differences (SMD) and relative risk ratios (RR).
Main Results:
- Pooled analysis of 20 RCTs indicated glucosamine favored placebo for pain (SMD -0.61) and Lequesne function (SMD -0.51), though not uniformly positive.
- Studies using the Rotta preparation showed significant improvement in pain (SMD -1.31) and Lequesne function (SMD -0.51) compared to placebo.
- No statistically significant benefits were observed for WOMAC pain, function, or stiffness outcomes across preparations.
- The Rotta preparation slowed radiological knee OA progression (SMD 0.24) over three years and was comparable to NSAIDs.
- Glucosamine demonstrated a safety profile similar to placebo (RR=0.97).
Conclusions:
- Glucosamine, particularly the Rotta preparation, may offer benefits for pain and function in symptomatic OA.
- Lack of consistent efficacy across different glucosamine preparations and outcome measures (WOMAC) warrants further investigation.
- Glucosamine is a safe treatment option for OA, comparable to placebo and NSAIDs in safety and radiological progression.