Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens

@article{Fransen2015GlucosamineAC,
  title={Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens},
  author={Marlene Fransen and Maria Agaliotis and Lillias Nairn and Milana Votrubec and Lisa A Bridgett and Steve Su and Stephen Jan and Lyn March and John P Edmonds and Robyn Norton and Mark Woodward and Richard Osborne Day},
  journal={Annals of the Rheumatic Diseases},
  year={2015},
  volume={74},
  pages={851 - 858}
}
Objective To determine if the dietary supplements, glucosamine and/or chondroitin, result in reduced joint space narrowing (JSN) and pain among people with symptomatic knee osteoarthritis. Methods A double-blind randomised placebo-controlled clinical trial with 2-year follow-up. 605 participants, aged 45–75 years, reporting chronic knee pain and with evidence of medial tibio-femoral compartment narrowing (but retaining >2 mm medial joint space width) were randomised to once daily: glucosamine… 
Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials
TLDR
Oral supplementation with glucosamine or chondroitin sulfate reduces pain in knee OA, however, there is no additional effect using both therapeutic agents in combination for the management of symptomatic knee Oa.
Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT)
TLDR
A 800 mg/day pharmaceutical-grade CS is superior to placebo and similar to celecoxib in reducing pain and improving function over 6 months in symptomatic knee osteoarthritis patients and should be considered a first-line treatment in the medical management of knee OA.
The efficacy and safety of a combination of glucosamine hydrochloride, chondroitin sulfate and bio-curcumin with exercise in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled study.
TLDR
Treatment of knee OA with curcuminoids plus glycosaminoglycans, added to physical therapy, improves VAS at motion and Lequesne Index scores and may ameliorate pain and help to improve algofunctional score in knee Oa patients.
Efficacy of glucosamine plus diacerein versus monotherapy of glucosamine: a double-blind, parallel randomized clinical trial
TLDR
This study did not demonstrate that coadministration of diacerein with pCGS improves pain and WOMAC score compared withpCGS monotherapy in patients with mild to moderate OA of the knee.
Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials
TLDR
Given the effectiveness of these symptomatic slow-acting drugs, oral chondroitin is more effective than placebo on relieving pain and improving physical function, and glucosamine showed effect on stiffness outcome.
Efficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials
TLDR
This new meta-analysis suggests that CS provides a moderate benefit for pain and has a large effect on function in knee OA, however with large inconsistency.
Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis
TLDR
The JKOM meta-analysis indicated that glucosamine is superior to a placebo in alleviating knee OA symptoms, and it was concluded thatglucosamine has the potential to alleviate knee Oa pain.
Response to: ‘Is chondroitin sulfate plus glucosamine superior to placebo in the treatment of knee osteoarthritis?’ by Zeng et al
  • M. Hochberg
  • Medicine
    Annals of the rheumatic diseases
  • 2015
TLDR
Commentary on the Multicentre Osteoarthritis interVEntion trial with SYSADOA and the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) and its long-term follow-up brought up some interesting points.
Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank
TLDR
There is no goodEvidence to support the use of glucosamine for hip or knee OA and an absence of evidence to support specific consideration of glucOSamine for any clinically relevant OA subgroup according to baseline pain severity, BMI, sex, structural abnormalities or presence of inflammation.
Efficacy and safety of the combination of glucosamine and chondroitin for knee osteoarthritis: a systematic review and meta-analysis
TLDR
The study confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent and it is worthwhile to popularize and apply the combination in KOA treatment considering the point of effect, tolerability and economic costs.
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TLDR
Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain, and the efficacy and safety of these treatments as a treatment for knee pain from osteoarthritis are evaluated.
Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT
TLDR
Over 2 years, no treatment achieved a clinically important difference in WOMAC pain or function as compared with placebo, however, glucosamine and celecoxib showed beneficial but not significant trends.
Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.
TLDR
Long-term treatment with glucosamine sulfate retarded the progression of knee osteoarthritis, possibly determining disease modification.
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TLDR
Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space and health authorities and health insurers should not cover the costs.
The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial.
TLDR
At 2 years, no treatment achieved a predefined threshold of clinically important difference in JSW loss as compared with placebo, however, knees with K/L grade 2 radiographic OA appeared to have the greatest potential for modification by these treatments.
Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI
TLDR
CS treatment significantly reduced the cartilage volume loss in knee OA starting at 6 months of treatment, and BML at 12 months, suggesting a joint structure protective effect of CS and provide new in vivo information on its mode of action in knees OA.
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TLDR
A systematic review and meta-analysis of all available randomized, controlled trials to determine the effects of chondroitin on pain and joint space width and to explore whether reported beneficial effects could be explained by biases affecting individual trials or publication bias.
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