Long-term effects of glucosamine sulphate on osteoarthritis progression
Not that these results are Earth-shattering, but it’s nice to see them published in one of the major medical journals. Glucosamine and chondrotin sulfate have been used for a long time now with natural practioners. It is very effective, very inexpensive (when compared with almost any NSAID and especially the new COX-2 inhibitors) and has little incidence of side effects. There has been some concern with GS affecting insulin sensitivity, but the evidence is not strong to date. Combine GS or CS with manipulative therapy, an exercise routine, an anti-inflammatory diet and avoidance of food allergies to round out a natural approach to osteoarthritis.
Lancet 2001; 357: 251-56 Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms. We did a randomised, double-blind placebo controlled trial, in which 212 patients with knee osteoarthritis were randomly assigned 1500 mg sulphate oral glucosamine or placebo once daily for 3 years. Weightbearing, anteroposterior radiographs of each knee in full extension were taken at enrolment and after 1 and 3 years. Mean joint-space width of the medial compartment of the tibiofemoral joint was assessed by digital image analysis, whereas minimum joint-space width–ie, at the narrowest point–was measured by visual inspection with a magnifying lens. Symptoms were scored by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. The 106 patients on placebo had a progressive joint-space narrowing, with a mean joint-space loss after 3 years of -0·31 mm (95% CI -0·48 to -0·13). There was no significant joint-space loss in the 106 patients on glucosamine sulphate: -0·06 mm (-0·22 to 0·09). Similar results were reported with minimum joint-space narrowing. As assessed by WOMAC scores, symptoms worsened slightly in patients on placebo compared with the improvement observed after treatment with glucosamine sulphate. There were no differences in safety or reasons for early withdrawal between the treatment and placebo groups. The long-term combined structure-modifying and symptom-modifying effects of gluosamine sulphate suggest that it could be a disease modifying agent in osteoarthritis.