Glucosamine, Chondroitin Did Not Slow Knee Damage In Osteoarthritis Treatment

Glucosamine Chondroitin And Arthritis Knee Treatment

New research was reported in the journal Arthritis and Rheumatism that shows glucosamine and chondroitin for arthritis treatment are no better than placebo in slowing the loss of knee cartilage. The two-year study showed that the popular over the counter supplements did not work better than sugar pills.

The study gave patients the supplements, placebo or Celebrex and looked at the cartilage in the knees by measuring the space between the knee joints. Neither Celebrex, nor glucosamine-chondroitin worked better than placebo to slow the progression of disease. Loss of cartilage, the material that cushions the joints, is a sign of osteoarthritis and its loss is seen on an X-ray as the distance between the ends of the bones in the joint.


Daniel O. Clegg, MD and Allen D. Sawitzke, MD from the University of Utah School of Medicine led this multi-center NIH supported study. It is a continuation of the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) that first reported results in 2006. The researchers began by comparing glucosamine and chondroitin to the medication Celebrex for diminishing arthritis pain and no differences were found. When they took a smaller subgroup of study participants with moderate-to-severe pain, the combination of glucosamine/chondroitin showed some pain relief.

Patients were asked if they wished to continue the trial for an additional 18 months for a total of two years. The continuation group was randomly assigned to receive either 500 mg glucosamine HCL three times daily, sodium chondroitin sulfate 400mg three times daily, the combination of glucosamine plus chondroitin, placebo or celecoxib (Celebrex) 200mg daily. At the end of the study the doctors had gathered data on 581 knees with moderate (grade 2) or severe (grade 3) osteoarthritis. The X-rays showed no differences in the treatment groups.

Osteoarthritis affects nearly 21 million Americans and is the result of several factors including age, genetics, weight, joint injuries and gender. It is the most common form of arthritis.

The combination of glucosamine and chondroitin had annual sales of $831 million in 2007 according to the Nutrition Business Journal.



Robbed again! DOH!
The choice of using Xrays for measuring the effects of the interventions was not the best one unfortunately; the differences (improvements) on the joint cartilage thickness are on the orders of millimeters (1-3), very difficult to identify reliably with Xrays. A much better measurement woud have been plasma or intraarticular levels of colagen degradation products, and maybe inflammatory molecules (TNF, IL10 and other cytokines, etc). The fact that the supplements and Celebrex were comparable in efficacy of pain/discomfort relief is also important; and even though subjective assessment by patient of pain relief and functional improvement is not as "solid" as measurements of biomarkers, it is probably most important for patients. Finally, the persistence of remission of symptoms under treatment is probably better for supplements/Celebrex than placebo