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Glucosamine sulphate trials for osteoarthritis

A review article of 18 trials investigating the effectiveness of glucosamine sulphate in treating osteoarthritis was published in 2005. A further four trials published since 2007 evaluated the effect of glucosamine sulphate in the treatment of hip and knee osteoarthritis. A second review article compared the clinical effectiveness and safety of glucosamine sulphate with those of non-steroidal anti-inflammatory drugs (NSAIDs).

Review article (2005)

The number of participants in the RCTs included in this article ranged from 30 to 319. The trials lasted from three weeks to three years.

  • Seven trials out of 13 which compared glucosamine sulphate to a placebo found that the glucosamine sulphate was significantly better than the placebo in relieving pain.
  • In all 13 RCTs, the number and severity of side-effects reported by participants who were given glucosamine sulphate weren’t significantly different from those reported by participants who got the placebo.
  • Three trials out of five found that glucosamine sulphate was significantly better than the placebo in improving problems associated with walking and other daily activities.
  • No trials found that glucosamine sulphate was significantly effective, as compared to a placebo, in improving all the main osteoarthritis-related symptoms (pain, disability and joint stiffness).
  • Trials that used one company’s (Rotta Pharm) supplement showed a positive effect for pain and function while those that used other brands didn’t.
  • Trials that used the best methods to make sure participants didn’t know which treatment they were getting didn’t show significant benefits in pain relief and improved physical function in those who received glucosamine sulphate.

Trial 1

The first trial involved 222 people over two years. The supplement didn’t show any beneficial effects, compared to a placebo, in relieving pain and improving function.

Trial 2

In this six-month trial, which included 318 participants, glucosamine had a clear significant benefit over a placebo and an even stronger effect than paracetamol in improving both pain and function.

Trial 3‡

The 64 participants with osteoarthritis of the knee in this study received either 500 mg glucosamine sulphate three times a day or 400 mg vitamin E made from palm oil once a day for six months. Both groups improved in pain and function, but there was no difference between them.

Trial 4

60 participants with primary osteoarthritis in either one or both knees were randomised to receive a 1500 mg sachet of glucosamine sulphate or a placebo. After 12 weeks, there were no improvements in the placebo group but those who received glucosamine reported significant improvements in resting and moving pain, overall pain, stiffness and function. The improvements in these final three measures lasted for 20 weeks. In the treatment group, reported side-effects were heartburn and an all-over itch.

Review article

This review article summarised results of four trials:

  • Two trials out of three found that glucosamine sulphate was significantly more effective than NSAIDs in reducing pain, while the third found that both treatments had similar effects.
  • One trial out of two found that glucosamine sulphate was significantly better than NSAIDs in improving physical function, while the second trial found that both medications had similar effects.
  • Three trials out of four found that the number and severity of side-effects reported by participants taking glucosamine sulphate were significantly less than those reported by participants who were given NSAIDs.

‡ A trial of low quality. Results of this trial were given a lower weighting when we came to our conclusion about the compound.

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