Risk of Bias and Brand Explain the Observed Inconsistency in Trials on Glucosamine for Symptomatic Relief of Osteoarthritis: A Meta‐Analysis of Placebo‐Controlled Trials

  title={Risk of Bias and Brand Explain the Observed Inconsistency in Trials on Glucosamine for Symptomatic Relief of Osteoarthritis: A Meta‐Analysis of Placebo‐Controlled Trials},
  author={Patrick R G Eriksen and Else Marie Bartels and Roy Altman and Henning Bliddal and Carsten Bogh Juhl and Robin Christensen},
  journal={Arthritis Care \& Research},
To determine whether study sponsor, chemical formulation, brand of glucosamine, and/or risk of bias explain observed inconsistencies in trials of glucosamine's efficacy for treating pain in osteoarthritis (OA). 
Combined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With Knee Osteoarthritis: A Six‐Month Multicenter, Randomized, Double‐Blind, Placebo‐Controlled Clinical Trial
To assess the efficacy and safety of combination therapy with chondroitin sulfate (CS) and glucosamine sulfate (GS) compared to placebo in patients with symptomatic knee osteoarthritis (OA).
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
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.
[Symptomatic slow-acting drugs in the treatment of osteoarthritis: focus on glucosamine preparations].
The article discusses the place of symptomatic slow-acting drugs in current guidelines for the treatment of osteoarthritis and the results of experimental and clinical studies demonstrating the advantages of crystalline glucosamine sulfate over preparations/food additives of glucosamines hydrochloride are presented.
Efficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials
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
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.
Update on the role of pharmaceutical-grade chondroitin sulfate in the symptomatic management of knee osteoarthritis
New evidence on efficacy and safety suggests that recommendations for the use of CS in patients with knee OA cannot be extrapolated to other low-grade preparations as generics, nutraceutical-grade or over-the-counter preparations.
Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon
Six months of treatment with IA HA, pCGS, pCS, vitamin D and the combination of IA HA and triamcinolone improve pain and/or physical function in patients suffering from knee OA.


Glucosamine for pain in osteoarthritis: why do trial results differ?
Heterogeneity among trials of glucosamine is larger than would be expected by chance, and potential explanations include different glucosamines preparations, inadequate allocation concealment, and industry bias.
Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator.
The findings of this study indicate that glucosamine sulfate at the oral once-daily dosage of 1,500 mg is more effective than placebo in treating knee OA symptoms.
A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee.
As a symptom modifier in OA patients with a wide range of pain severities, glucosamine sulphate was no more effective than placebo.
Glucosamine therapy for knee osteoarthritis: pharmacokinetic considerations
  • R. Altman
  • Medicine, Biology
    Expert review of clinical pharmacology
  • 2009
The current knowledge regarding the pharmacokinetics of glucosamine is described to provide a means for the interpretation of the pharmacodynamic and clinical efficacy results obtained in the different clinical trials.
Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.
Long-term treatment with glucosamine sulfate retarded the progression of knee osteoarthritis, possibly determining disease modification.
The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest.
Two aspects of this issue deserve attention: the actual role of industry bias in clinical research, and an understanding of why the findings of the meta-analysis by Vlad et al are of concern.
Glucosamine therapy for treating osteoarthritis.
The results are not uniformly positive, and the reasons for this remain unexplained, but glucosamine was superior to placebo in the treatment of pain and functional impairment resulting from symptomatic OA.
Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis.
In patients with knee OA with at least moderate subjective improvement with prior glucosamine use, this study provides no evidence of symptomatic benefit from continued use of glucosamines sulfate.