Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee
- October 17, 2013
- URAH Singapore
Objective To determine the effect of glucosamine,
chondroitin, or the two in combination on joint pain and
on radiological progression of disease in osteoarthritis of
the hip or knee.
DesignNetwork meta-analysis. Direct comparisons within
trials were combined with indirect evidence from other
trials by using a Bayesian model that allowed the
synthesis of multiple time points.
Main outcome measure Pain intensity. Secondary
outcome was change in minimal width of joint space. The
minimal clinically important difference between
preparations and placebo was prespecified at-0.9 cm on
a 10 cm visual analogue scale.
Data sources Electronic databases and conference
proceedings from inception to June 2009, expert contact,
Eligibility criteria for selecting studies Large scale
randomised controlled trials in more than 200 patients
with osteoarthritis of the knee or hip that compared
glucosamine, chondroitin, or their combination with
placebo or head to head.
Results 10 trials in 3803 patients were included. On a 10
cm visual analogue scale the overall difference in pain
intensity compared with placebo was -0.4 cm (95%
credible interval-0.7 to-0.1 cm) for glucosamine,-0.3 cm
(-0.7 to 0.0 cm) for chondroitin, and -0.5 cm (-0.9 to 0.0
cm) for the combination. For none of the estimates did the
95% credible intervals cross the boundary of the minimal
clinically important difference. Industry independent trials
showed smaller effects than commercially funded trials
(P=0.02 for interaction). The differences in changes in
minimal width of joint space were all minute, with 95%
credible intervals overlapping zero.
Conclusions Compared with placebo, glucosamine,
chondroitin, and their combination do not reduce joint
pain or have an impact on narrowing of joint space. Health
authorities and health insurers should not cover the costs
of these preparations, and new prescriptions to patients
who have not received treatment should be discouraged.
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