Glucosamine For Osteoarthritis
This summary of a Cochrane review presents what we know from research about the effect of glucosamine on osteoarthritis.
People With Osteoarthritis who take Glucosamine:
- may reduce their pain
- may improve their physical function
- will probably not have side effects
What are Osteoarthritis and Glucosamine?
Osteoarthritis (OA) is the most common form of arthritis that can affect the hands, hips, shoulders and knees. In OA, the cartilage that protects the ends of the bones breaks down and causes pain and swelling. Drug and non‐drug treatments may relieve pain and/or swelling.
Glucosamine can be found naturally in the body as one of the building blocks of cartilage. It can come in combination with other supplements (such as chondroitin) or by itself in the form of glucosamine hydrochloride or sulphate. Glucosamine can also be taken as a pill to supplement the diet or sometimes as an injection. The usual dose recommended on packages is 1500 mg per day or 500 mg three times a day.
Best Estimate of what happens after about 6 months
The high-quality studies showed that pain improved about the same whether people took glucosamine or fake pills. If all of the studies are examined (including low quality and old studies), glucosamine improved pain more than the fake pills.
People who took fake pills had a pain score of 7 points on a 0 to 100 scale. Pain may improve by ten more points with glucosamine than with fake drugs.
Studies testing only the Rotta brand of glucosamine (including low quality and older studies) showed that glucosamine improved pain more than fake pills. People who took fake drugs had a pain score of 6 points on a 0 to 20 scale. People who took the Rotta brand of glucosamine rated their pain 3 points lower than people who did not take glucosamine.
The high-quality studies show that glucosamine improved function more than fake pills when measured by one type of scale but improved the same amount as fake pills when measured by another scale.
Studies testing only the Rotta brand of glucosamine (including low quality and older studies) showed that glucosamine improved function more than fake pills. People who took fake drugs had a function score of 22 points on a 0 to 68 scale. People who took the Rotta brand of glucosamine had their ability to function improve by 2 points compared to people who did not take glucosamine.
There was no difference in the number of people who had side effects. Side effects mainly included stomach upset and other joint pain.
What are Non-Steroidal Anti-Inflammatory Drugs (NSAID’s)
NSAIDs are the most widely prescribed medication for osteoarthritis. Unfortunately, they have numerous side effects, including an increased likelihood of stroke and blood pressure issues. NSAID’s are estimated in the U.S. alone to cause as many as 16,500 deaths and more than 100,000 hospitalisations annually due to gastric bleeding. There is also early evidence to suggest that these drugs may also be toxic to articular cartilage, hastening the deterioration of your articular cartilage.
Common Brands of NSAID’s include:
Mobic, Celebrex, Vioxx, Voltaren, Naprosyn, Feldene, Prexige, Brufen, Nurofen, Ibuprofen, Indocid, Aspirin
For specific advice regarding the suitability of glucosamine or NSAIDs for your condition, please consult your doctor.
List of References
Bassleer C, et al. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic cartilage in vitro. Osteoarthritis Cartilage 1998;6:427-434.
G. R. Dodge Ph.D et al. Glucosamine sulfate modulates the levels of aggrecan and matrix metalloproteinase – 3 synthesized by cultured human osteoarthritis articular chondrocytes.
Richy, F. et al. Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee Osteoarthritis: A Comprehensive Meta-analysis. Archives of Internal Medicine. 163(13):1514-1522, July 14, 2003.
Muller-Fasbender H, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoart Cart 1994;2:61-69.
Towheed TE, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MC. Glucosamine therapy for treating osteoarthritis (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.
Pavelka, K, et al. Glucosamine Sulfate Use and Delay of Progression of Knee Osteoarthritis: A 3-Year, Randomized, Placebo-Controlled, Double-blind Study. Archives of Internal Medicine. 162(18):2113-2123, October 14, 2002.
Reginster JY, et al. Long-term effects of glucosamine Sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial. Lancet. 2001;357:251-256.
Scroggie, D.The Effect of Glucosamine-Chondroitin Supplementation on Glycosylated Hemoglobin Levels in Patients With Type 2 Diabetes Mellitus: A Placebo-Controlled, Double-blinded, Randomized Clinical Trial. Archives of Internal Medicine. 163(13):1587-1590, July 14, 2003.
Wolfe M. et al Gastrointestinal toxicity of nonsteroidal anti-inflammatory drugs. N Engl J Med 1999;340(24):1888-99
Rainsford K (1999) Profile and mechanisms of gastrointestinal and other side effects of NSAIDs. American Journal of Medicine. 107,6A, 27S-35S.
Chard J, et al., Glucosamine for osteoarthritis: magic, gype, or confusion? Editorial, BMJ,BMJ. 322(7300):1439-1440, June 16,2001.