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Glucosamine Chondroitin
1. Glucosamine Chondroitin
Product Description
There have been multiple clinical trials of glucosamine as a medical therapy for osteoarthritis, but
results have been conflicting. The evidence both for and against glucosamine's efficacy has led to debate
among physicians about whether to recommend glucosamine treatment to their patients.
Multiple clinical trials in the 1980s and 1990s, all sponsored by the European patent-holder,
Rottapharm, demonstrated a benefit for glucosamine. However, these studies were of poor quality due
to shortcomings in their methods, including small size, short duration, poor analysis of drop-outs, and
unclear procedures for blinding.
Rottapharm then sponsored two large (at least 100 patients per group), three-year-long, placebo-
controlled clinical trials of the Rottapharm brand of glucosamine sulfate. These studies both
demonstrated a clear benefit for glucosamine treatment. There was not only an improvement in
symptoms but also an improvement in joint space narrowing on radiographs. This suggested that
glucosamine, unlike pain relievers such as NSAIDs, can actually help prevent the destruction of cartilage
that is the hallmark of osteoarthritis. On the other hand, several subsequent studies, independent of
Rottapharm, but smaller and shorter, did not detect any benefit of glucosamine.
Due to these controversial results, some reviews and meta-analyses have evaluated the efficacy of
glucosamine. Richie et al. performed a meta-analysis of randomized clinical trials in 2003 and found
efficacy for glucosamine on VAS and WOMAC pain, Lequesne index and VAS mobility and good
tolerability.
2. Recently, a review by Bruyere et al. about glucosamine and chondroitin sulfate for the treatment of
knee and hip osteoarthritis concludes that both products act as valuable symptomatic therapies for
osteoarthritis disease with some potential structure-modifying effects.
This situation led the National Institutes of Health to fund a large, multicenter clinical trial (the GAIT
trial) studying reported pain in osteoarthritis of the knee, comparing groups treated with chondroitin
sulfate, glucosamine, and the combination, as well as both placebo and celecoxib.The results of this 6-
month trial found that patients taking glucosamine HCl, chondroitin sulfate, or a combination of the two
had no statistically significant improvement in their symptoms compared to patients taking a placebo.
The group of patients who took celecoxib did have a statistically significant improvement in their
symptoms. These results suggest that glucosamine and chondroitin did not effectively relieve pain in the
overall group of osteoarthritis patients, but it should be interpreted with caution because most patients
presented only mild pain (thus a narrow margin to appraise pain improvement) and because of an
unusual response to placebo in the trial (60%). However, exploratory analysis of a subgroup of patients
suggested that the supplements taken together (glucosamine and chondroitin sulfate) may be
significantly more effective than placebo (79.2% versus 54%; p = 0.002) and a 10% higher than the
positive control, in patients with pain classified as moderate to severe (see testing hypotheses suggested
by the data).
In an accompanying editorial, Dr. Marc Hochberg also noted that "It is disappointing that the GAIT
investigators did not use glucosamine sulfate ... since the results would then have provided important
information that might have explained in part the heterogeneity in the studies reviewed by Towheed
and colleagues" But this concern is not shared by pharmacologists at the PDR who state, "The counter
anion of the glucosamine salt (i.e. chloride or sulfate) is unlikely to play any role in the action or
pharmacokinetics of glucosamine". Thus the question of glucosamine's efficacy will not be resolved
without further updates or trials. Visit : http://www.goldcrownnaturalproducts.com/