|The mainstream media overlooked the
fact that for patients with moderate to severe knee osteoarthritis pain
significantly improved with glucosamine and chondrontin. Also, the
threshold for improvement (20%) was set too low. This artificially
made placebo look better. I still recommend the combination of
supplements for my patients.
This is the
abstract of the recent article on the use of supplements for Knee
Osteoarthritis. To submit a comment about this study, please use this contact form.
New England Journal of Medicine
Glucosamine, chondroitin sulfate, and the two in
combination for painful knee osteoarthritis.
Bingham CO 3rd,
Schumacher HR Jr,
Division of Rheumatology, University of Utah School of Medicine, Salt
Lake City, UT 84132, USA. firstname.lastname@example.org
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. Up to 4000
mg of acetaminophen daily was allowed as rescue analgesia. Assignment
was stratified according to the severity of knee pain (mild [N=1229] vs.
moderate to severe [N=354]). The primary outcome measure was a 20
percent decrease in knee pain from baseline to week 24. RESULTS: The
mean age of the patients was 59 years, and 64 percent were women.
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.
(ClinicalTrials.gov number, NCT00032890.). Copyright 2006 Massachusetts