Because of the publicity it has rec...

Because of the publicity it has received in the media, glucosamine has become the same of the most commonly used dietary supplys in the United States. Several studies sponsored according to the supplement industry have hinted that glucosamine is effective in the management of osteoarthritis. A meta-analysis of early trials of this supply discovered methodologic problems and possible publication bias, and in brace recent independent trials, glucosamine therapy was raise to be ineffective for osteoarthritis. Because trials of osteoarthritis treatment are oppressive and costly, McAlindon and associates expanded a method for performing clinical trials using the Internet, and used this technique to evaluate the safety and effectiveness of glucosamine in the management of knee osteoarthritis.

The authors course of lifeed a double-blind, placebo-controlled study of glucosamine in patients with osteoarthritis. The patients were recruited and followed using the Internet. Inclusion criteria were: 45 years or older; osteoarthritis of at least undivided knee, as established by radiography or magnetic resonance imaging; and pain, aching, or stiffness in either knee onward most days. Exclusion criteria were: a knee injection within 60 days of the study; arthroplasty of the knee; and common use of glucosamine, chondroitin, or other agents that claim to have osteoarthritis structure-modifying properties. The patients were randomized to receive 15 g of glucosamine or placebo daily for 12 weeks. The main result measure was the pain subscale onward the Western Ontario and McMaster Universities Osteoarthritis Index, which includes three subscales (pain, stiffness, and function) and generates scores for each subscale as well as an overall score. Analgesia use and adverse consequences also were recorded.

There were 205 patients enlisted in the study. The disposes receiving glucosamine and placebo did not differ with regard to pain scores, stiffness, physical function, overall scores forward the Index, and analgesic use. No significant differences were noted between the patients who received glucosamine and those who received placebo when the collections were stratified for severity of osteoarthritis, glucosamine consequence use of a nonsteroidal anti-inflammatory physic and the exclusion of opiate use. The clumps had similar numbers and images of adverse events recorded during the study

The authors end that glucosamine, while appearing to be safe, is no more effective than placebo in treating the symptoms of knee osteoarthritis. They add that Internet-based clinical trials may provide a quick and efficient orderly disposition for further studies on the effectiveness of glucosamine products

KARL E MILLER, MD

McAlindon T et al. Effectiveness of glucosamine for symptoms of knee osteoarthritis: proceeds from an Internetbased randomized double-blind controll trial. Am J M November 1 2004;117:643-9

COPYRIGHT 2005 American Academy of Family Physicians

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