PMID 16495392 Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis Randomized controlled trial (GAIT) · N Engl J Med, 2006 1,583 people - glucosamine/chondroitin did not beat placeboAn inert dummy treatment used as the comparison baseline. for overall knee pain (glucosamine +3.9pp, P=0.30); only the severe subgroup showed a combination effect.
Key summary
A US NIH-funded multicenter double-blind, placeboAn inert dummy treatment used as the comparison baseline.- and celecoxibA non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation.-controlled trial (GAIT). It assigned 1,583 people with symptomatic knee osteoarthritisThe most common degenerative joint disease, in which cartilage wears down causing pain and stiffness (OA). to glucosamine 1,500 mg, chondroitin 1,200 mg, the combination, celecoxib 200 mg, or placebo for 24 weeks. On the primary outcome (20% pain-response rate), glucosamine was only 3.9 points above placebo (60.1%) and not significant (P=0.30), and chondroitin and the combination were not significant either. Only celecoxib was 10.0 points higher (P=0.008). In the moderate-to-severe subgroup the combination beat placebo (79.2% vs 54.3%), but this was exploratory. Adverse events were mild and evenly distributed.
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BACKGROUND: Glucosamine and chondroitin sulfate are used to treat osteoarthritis. The multicenter, double-blind, placebo- and celecoxib-controlled Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) evaluated their efficacy and safety as a treatment for knee pain from osteoarthritis. METHODS: We randomly assigned 1583 patients with symptomatic knee osteoarthritis to receive 1500 mg of glucosamine daily, 1200 mg of chondroitin sulfate daily, both glucosamine and chondroitin sulfate, 200 mg of celecoxib daily, or placebo for 24 weeks. The primary outcome measure was a 20 percent decrease in knee pain from baseline to week 24. RESULTS: Overall, glucosamine and chondroitin sulfate were not significantly better than placebo in reducing knee pain by 20 percent. As compared with the rate of response to placebo (60.1 percent), the rate of response to glucosamine was 3.9 percentage points higher (P=0.30), the rate of response to chondroitin sulfate was 5.3 percentage points higher (P=0.17), and the rate of response to combined treatment was 6.5 percentage points higher (P=0.09). The rate of response in the celecoxib control group was 10.0 percentage points higher than that in the placebo control group (P=0.008). For patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo (79.2 percent vs. 54.3 percent, P=0.002). Adverse events were mild, infrequent, and evenly distributed among the groups. CONCLUSIONS: Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 20847017 Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis Network meta-analysis · BMJ, 2010 10 trials, 3,803 people - pain difference vs placeboAn inert dummy treatment used as the comparison baseline. -0.4 cm, below the MCID (-0.9 cm); joint spaceThe gap between bones in a joint; narrowing indicates cartilage loss. changes minute; independent trials showed smaller effects.
Key summary
A Bayesian network meta-analysisA meta-analysis that ranks several treatments at once, including indirect comparisons. of glucosamine, chondroitin, and the combination in hip or knee osteoarthritisThe most common degenerative joint disease, in which cartilage wears down causing pain and stiffness (OA). (10 large RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 3,803 people). On a 10 cm pain scale the difference versus placeboAn inert dummy treatment used as the comparison baseline. was -0.4 cm for glucosamine, -0.3 cm for chondroitin, and -0.5 cm for the combination, all short of the prespecified minimal clinically important difference (-0.9 cm). Changes in minimal joint-space width were all minute, with credible intervals overlapping zero. Industry-independent trials showed smaller effects than commercially funded ones (P=0.02). The authors concluded there was no benefit over placebo for pain or joint spaceThe gap between bones in a joint; narrowing indicates cartilage loss. and advised that health authorities and insurers not cover the cost.
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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. 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. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 25589511 Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib Randomized non-inferiority trial (MOVES) · Ann Rheum Dis, 2016 606 people (severe knee pain) - glucosamine plus chondroitin matched celecoxibA non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation. for pain reduction (both about 50%); but there was no placeboAn inert dummy treatment used as the comparison baseline. arm.
Key summary
A double-blind non-inferiority trial (MOVES, four European countries) comparing chondroitin plus glucosamine against celecoxibA non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation. in 606 patients with severe knee osteoarthritisThe most common degenerative joint disease, in which cartilage wears down causing pain and stiffness (OA). pain (Kellgren-Lawrence grades 2-3). At six months the WOMACA standard index scoring pain, stiffness, and function in knee or hip osteoarthritis. pain decrease was -185.7 (50.1%) with the combination and -186.8 (50.2%) with celecoxib, essentially identical and meeting non-inferiority (difference -1.11, P=0.92). Both groups had over 50% reduction in joint swelling/effusion, and adverse events were low and similar. But with no placeboAn inert dummy treatment used as the comparison baseline. arm, one can only say it is comparable to an NSAID, not superior to placebo.
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OBJECTIVES: To compare the efficacy and safety of chondroitin sulfate plus glucosamine hydrochloride (CS+GH) versus celecoxib in patients with knee osteoarthritis and severe pain. METHODS: Double-blind Multicentre Osteoarthritis interVEntion trial with SYSADOA (MOVES) conducted in France, Germany, Poland and Spain evaluating treatment with CS+GH versus celecoxib in 606 patients with Kellgren and Lawrence grades 2-3 knee osteoarthritis and moderate-to-severe pain (Western Ontario and McMaster osteoarthritis index (WOMAC) score >/=301; 0-500 scale). Patients were randomised to receive 400 mg CS plus 500 mg GH three times a day or 200 mg celecoxib every day for 6 months. The primary outcome was the mean decrease in WOMAC pain from baseline to 6 months. RESULTS: The adjusted mean change (95% CI) in WOMAC pain was -185.7 (-200.3 to -171.1) (50.1% decrease) with CS+GH and -186.8 (-201.7 to -171.9) (50.2% decrease) with celecoxib, meeting the non-inferiority margin of -40: -1.11 (-22.0 to 19.8; p=0.92). All sensitivity analyses were consistent with that result. At 6 months, 79.7% of patients in the combination group and 79.2% in the celecoxib group fulfilled OMERACT-OARSI criteria. Both groups elicited a reduction >50% in the presence of joint swelling; a similar reduction was seen for effusion. No differences were observed for the other secondary outcomes. Adverse events were low and similarly distributed between groups. CONCLUSIONS: CS+GH has comparable efficacy to celecoxib in reducing pain, stiffness, functional limitation and joint swelling/effusion after 6 months in patients with painful knee osteoarthritis, with a good safety profile. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 15846645 Glucosamine therapy for treating osteoarthritis Meta-analysis (Cochrane) · Cochrane Database Syst Rev, 2005 20 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 2,570 people - only the prescription Rotta preparation was significant for pain (SMD -1.31); non-Rotta preparations were not (-0.15); safety equal to placeboAn inert dummy treatment used as the comparison baseline..
Key summary
A CochraneAn international network that rigorously reviews and synthesizes evidence. review of glucosamine's effectiveness and toxicity in osteoarthritisThe most common degenerative joint disease, in which cartilage wears down causing pain and stiffness (OA). (20 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 2,570 people). Restricting to the eight trials with adequate allocation concealment showed no benefit for pain or WOMACA standard index scoring pain, stiffness, and function in knee or hip osteoarthritis. function. Preparation drove the results: the (prescription) Rotta glucosamine sulfate beat placeboAn inert dummy treatment used as the comparison baseline. for pain (SMD -1.31) and function, and two trials slowed knee joint-space narrowing over three years (SMD 0.24). Non-Rotta preparations were not significant for pain (-0.15) or function. Adverse-event reports did not differ from placebo (RR 0.97). The conclusion is that results vary greatly with the preparation and trial quality.
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BACKGROUND: Osteoarthritis (OA) is the most common form of arthritis, and it is often associated with significant disability and an impaired quality of life. OBJECTIVES: To review all randomized controlled trials (RCTs) evaluating the effectiveness and toxicity of glucosamine in OA. MAIN RESULTS: Analysis restricted to eight studies with adequate allocation concealment failed to show benefit of glucosamine for pain and WOMAC function. Collectively, the 20 analyzed RCTs found glucosamine favoured placebo with a 28% (change from baseline) improvement in pain (SMD -0.61, 95% CI -0.95, -0.28) and a 21% (change from baseline) improvement in function using the Lequesne index (SMD -0.51 95% CI -0.96, -0.05). However, the results are not uniformly positive, and the reasons for this remain unexplained. WOMAC pain, function and stiffness outcomes did not reach statistical significance. In the 10 RCTs in which the Rotta preparation of glucosamine was compared to placebo, glucosamine was found to be superior for pain (SMD -1.31, 95% CI -1.99, -0.64) and function using the Lequesne index (SMD -0.51, 95% CI -0.96, -0.05). Pooled results for pain (SMD -0.15, 95% CI -0.35, 0.05) and function using the WOMAC index (SMD 0.03, 95% CI -0.18, 0.25) in those RCTs in which a non-Rotta preparation of glucosamine was compared to placebo did not reach statistical significance. Two RCTs using the Rotta preparation showed that glucosamine was able to slow radiological progression of OA of the knee over a three year period (SMD 0.24, 95% CI 0.04, 0.43). Glucosamine was as safe as placebo in terms of the number of subjects reporting adverse reactions (RR=0.97, 95% CI, 0.88, 1.08). ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
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