[General Spine] Glucosamine and Chondroitin, for Hip or Knee Osteoarthritis

[Justin]

Note: Even though this article focuses on hip and knee osteoarthritis, the results are pertinent as many Spine Patients use these supplements for their spines.

Published in Journal Watch General Medicine October 7, 2010

Summary and Comment
Glucosamine and Chondroitin, for Hip or Knee Osteoarthritis
Alone or in combination, the supplements do not reduce joint pain or limit joint-space narrowing.

Original Publication: Wandel S et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: Network meta-analysis. BMJ 2010 Sep 16; 341:c4675. Link

Randomized trials on the effectiveness of glucosamine and chondroitin for osteoarthritis (OA) have yielded mixed results; the largest trial showed no benefit for these agents, used alone or in combination for knee OA (JW Gen Med Feb 28 2006). Now, researchers have conducted a meta-analysis of 10 randomized controlled trials in which about 3800 patients (68% women; median age, 62) with OA of the hip or knee received glucosamine, chondroitin, both supplements, or placebo; all patients were evaluated for joint pain — and some for radiological progression of disease — during follow-ups that ranged from 1 to 36 months.

On a 10-cm visual analog pain scale, the difference in pain intensity (compared with placebo) was –0.4 cm for glucosamine, –0.3 cm for chondroitin, and –0.5 cm for the combination. These results were of borderline statistical significance, but they did not approach the researchers' prespecified minimally important clinical difference of 0.9 cm. Six trials contributed data on radiological joint-space narrowing. Glucosamine, chondroitin, and the combination had no effect on joint-space narrowing. The supplements, either alone or in combination, however, caused no reported adverse effects

Comment: Glucosamine, chondroitin, and the combination are no better than placebo in attenuating joint pain or limiting joint-space narrowing in patients with hip or knee OA. Nevertheless, clinicians likely will encounter patients who are interested in, or report benefit from, using these preparations. In these situations, clinicians should inform patients of the results of clinical trials. For patients who remain steadfast in their desire to take glucosamine, chondroitin, or both, clinicians should be open to empirical trials of these preparations — given their apparent safety — as long as the patients are willing to pay for the compounds.

— Paul S. Mueller, MD, MPH, FACP

Dr. Mueller is the Chair of the Division of General Internal Medicine at Mayo Clinic in Rochester, Minnesota. He received his medical degree, master of public health degree, and internal medicine residency training at the Johns Hopkins University and the Johns Hopkins Hospital in Baltimore. He is a fellow of the American College of Physicians. Dr. Mueller’s clinical practice includes outpatient and inpatient consultative general internal medicine, hospital practice, and ethics consultation. He is engaged in teaching at all levels of medical training, and his academic interests include medical ethics and professionalism, medical history, and a variety of general internal medicine topics. Dr. Mueller has been writing for Journal Watch since 2007.

[helmut]

Some swear by it others don't bother, the chiropractor I know who likes it says that it has to be in combination with MSM. I myself never got into and a friend of mine who is one of the best informed regarding supplements also doesn't really believe in it. But who knows, some people say its great.

[KBear]

I tried it early on, thinking what could it hurt. It never helped me and I quit taking it after about 6 months of trying it.