Prescribing Advice for GPs

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Glucosamine meta-analysis finds no benefit

The British Medical Journal has published the results of a meta-analysis that reviews 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.

The review aimed to identify large randomised controlled trials (more than 200 participants) that assessed the effect of glucosamine, chondroitin or their combination with placebo or head to head in patients with osteoarthritis of the knee or hip. 10 such studies were identified involving 3,803 patients. The studies were reviewed for a primary outcome of pain relief with a secondary outcome of minimal width of joint space.

When comparing the pain efficacy for any active treatment with placebo all of the effect lines crossed the boundary from minimal clinically important difference. When comparing joint space the effect lines crossed the line of no effect. The review also identified that sponsored studies were more likely to report a larger effect compared to studies operated independently.

The authors conclude that active treatment does "not reduce joint pain or have an impact on narrowing of joint space". They further advise that the cost of these treatments should not be covered by health organisations and that new treatment initiations should be avoided.

Action: The National Institute for Health and Clinical Excellence (NICE) guideline on osteoarthritis advises against prescribing glucosamine or chondroitin products. This analysis indicates that this advice is justified.

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2 Comments to “Glucosamine meta-analysis finds no benefit”

  1. Is there any adverse effect when taken by type 2 diabetics?

    Comment by Crick — March 21, 2011 #
    Reply

    1. @Crick,

      There are some theoretical concerns that glucosamine might affect blood glucose levels however practical use has not confirmed an appreciable effect.

      Some of the supporting data for an interaction are based on intravenous administration in animals that results in much higher blood levels when compared to swallowing tablets.

      The bottom line is we cannot say for sure either way so a period or more careful monitoring would be wise if a diabetic patient were to start taking glucosamine.

      Comment by Matthew Robinson — March 21, 2011 #
      Reply

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