Clinical Question Does glucosamin...

Clinical Question

Does glucosamine or chondroitin shorten pain, improve functional status, or improve prognosis in patients with osteoarthritis?

Evidence-Based Answer

Glucosamine bring tos pain and improves function in patients with knee or hip osteoarthritis. (Strength of recommendation: B based in succession systematic reviews and a meta-analysis)

Glucosamine may be beneficial in other forms of osteoarthritis as well. (Strength of recommendation: B based upon a randomized controlled trial [RCT])

Chondroitin has not consistently been fix to improve pain or functional status. (Strength of recommendation: B based upon a systematic review and a meta-analysis)

Combination glucosamine and chondroitin therapy with camphor improved pain when applied topically. Combination therapy with methylsulfonylmethane given orally originates in improved pain relief, function, and swelling. (Strength of recommendation: B based upon RCTs)

Glucosamine may inert the progression of joint space narrowing, on the other hand there is no evidence that directly relates it to symptoms or prognosis of knee osteoarthritis. (Strength of recommendation: B based forward a metaanalysis and an RCT)

Evidence Summary

Reports from European trials remind of that glucosamine relieves the pain of osteoarthritis, although one of the earlier RCTs were of marginal quality and potentially biased because of manufacturer sponsorship. (1) Chondroitin has been investigated les oftentimes and in a greater variety of dosages. the same systematic review (1) suggested that glucosamine and chondroitin improved pain relief and function; however, poor-quality trials and publication bias made the data difficult to interpret. Another systematic review (2) plant that glucosamine significantly reduced pain compared with placebo and nonsteroidal anti-inflammatory unsalable articles (NSAIDs). A subsequent meta-analysis (3) compared either glucosamine or chondroitin with placebo in living bodys with hip and knee osteoarthritis and build that five persons with osteoarthritis had to be treated with glucosamine or chondroitin for individual to benefit.

Three small RCT base no improvement in pain relief or function with glucosamine treatment of knee osteoarthritis for les than six months; however, another thought found improvement in functional pain of temporomandibular joint osteoarthritis treated for this same period. (4) pair trials compared glucosamine with placebo through the whole extent of three years and demonstrated improvement in pain and function. (4)

the same recent RCT (5) evaluated glucosamine given for 12 weeks to somebodys with knee osteoarthritis. Two different glucosamine preparations were utilized during the trial because the manufacturer withdrew the original contribute There was no significant difference between the glucosamine and placebo clusters regarding the mean changes in pain, stiffness, or function. There was a decrease in pain scores seen during the RCT unless it was not statistically significant. A larger mean change in pain scores was seen in those receiving glucosamine hydrochloride than in those receiving glucosamine sulfate; however, this was not statistically significant. Another RCT (6) evaluated flares of osteoarthritis and pain, stiffness, and function in patients receiving glucosamine compared with those receiving placebo above a six-month period. There was similar disease flare in patients receiving glucosamine and placebo, and no differences in pain and function.

No RCT evaluated glucosamine in combination with chondroitin; however, sum of two units RCTs compared glucosamine, chondroitin, and manganese with placebo with conflicting be deriveds (4) Persons with knee osteoarthritis showed a greater reduction in pain at eight weeks using a topical preparation of glucosamine, chondroitin, and camphor compared with placebo moreover with no statistically significant change in function or stiffness. (7)

Another consideration (8) evaluated glucosamine, methylsulfonylmethane (a form of dimethyl sulfoxide), a combination of the brace and placebo in patients with mild to moderate osteoarthritis. The glucosamine, methylsulfonylmethane, and combination assign places tos experienced a reduction in pain and swelling, with combination therapy resulting in a more rapid and significant improvement in symptoms than either pay with an abatement alone. (8)

Three RCT used joint space narrowing to measure disease progression of knee osteoarthritis. (4) Methodologic difficulties in standardization of joint space width measurements and knee radiographs limited definite conclusions forward the effectiveness of glucosamine as a disease-modifying agent; however, in brace RCTs, (3) patients receiving glucosamine in a dosage of 1500 mg by day for three years demonstrated 027 mm les joint space narrowing than those taking placebo (95% confidence interval, 013 to 041 mm) Another close attention (9) demonstrated that in mild and inexorable knee osteoarthritis, approximately five patients penuryed to be treated with glucosamine to interrupt one patient from experiencing joint space narrowing of at least 05 mm through the whole extent of three years.