Glucosamine Sulfate in Osteoarthritis: The Jury Is Still Out
Authors: Johannes W.J. Bijlsma, Floris P.J.G. Lafeber
Journal: Annals of Internal Medicine (2008)

Editorials19 February 2008Glucosamine Sulfate in Osteoarthritis: The Jury Is Still OutJohannes W.J. Bijlsma and Floris P.J.G. LafeberJohannes W.J. BijlsmaFrom the University Medical Center Utrecht, 3508 GA Utrecht, the Netherlands. and Floris P.J.G. LafeberFrom the University Medical Center Utrecht, 3508 GA Utrecht, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-4-200802190-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Treatment in osteoarthritis has 3 goals: relief of symptoms (pain), preservation of function (daily activities in life), and delay of joint damage (cartilage and bone) (1). Millions of patients with osteoarthritis use glucosamine. However, despite more than 4 decades of use and many controlled and uncontrolled trials, the effects of glucosamine on these outcomes are still unproven (2). One possible explanation is the lack of a standard preparation. The U.S. Food and Drug Administration classifies glucosamine as a dietary supplement and does not require standardization of its content and purity. An Italian company, Rottapharm, produces a standardized preparation that is ...References1. Bijlsma JW, Knahr K. Strategies for the prevention and management of osteoarthritis of the hip and knee. Best Pract Res Clin Rheumatol. 2007;21:59-76. [PMID: 17350544] CrossrefMedlineGoogle Scholar2. Wollheim FA. Prescription of glucosamine for osteoarthritis: does it work and is it safe? Nat Clin Pract Rheumatol. 2007;3:364-5. [PMID: 17534290] CrossrefMedlineGoogle Scholar3. Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;:CD002946. [PMID: 15846645] MedlineGoogle Scholar4. Vlad SC, LaValley MP, McAlindon TE, Felson DT. Glucosamine for pain in osteoarthritis: why do trial results differ? Arthritis Rheum. 2007;56:2267-77. [PMID: 17599746] CrossrefMedlineGoogle Scholar5. Reginster JY. The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest [Editorial]. Arthritis Rheum. 2007;56:2105-10. [PMID: 17599727] CrossrefMedlineGoogle Scholar6. Clegg DO, Reda DJ, Harris CL, Klein MA, O'Dell JR, Hooper MM, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354:795-808. [PMID: 16495392] CrossrefMedlineGoogle Scholar7. Rozendaal RM, Koes BW, van Osch GJ, Uitterlinden EJ, Garling EH, Willemsen SP, et al. Effect of glucosamine sulfate on hip osteoarthritis. A randomized trial. Ann Intern Med. 2008;148:268-77. LinkGoogle Scholar8. Rozendaal RM, Koes BW, van Osch GJ, Uitterlinden EJ, Garling EH, Ginai AZ, et al. Glucosamine sulphate in hip OA, the GOAL study: subgroup analyses. Osteoarthritis Cartilage. 2007;15:C217. CrossrefGoogle Scholar9. Thacker MA, Clark AK, Marchand F, McMahon SB. Pathophysiology of peripheral neuropathic pain: immune cells and molecules. Anesth Analg. 2007;105:838-47. [PMID: 17717248] CrossrefMedlineGoogle Scholar10. Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP, et al; EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005;64:669-81. [PMID: 15471891] CrossrefMedlineGoogle Scholar11. Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, et al; Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003;62:1145-55. [PMID: 14644851] CrossrefMedlineGoogle Scholar12. Pham T, van der Heijde D, Altman RD, Anderson JJ, Bellamy N, Hochberg M, et al. OMERACT-OARSI initiative: Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials revisited. Osteoarthritis Cartilage. 2004;12:389-99. [PMID: 15094138] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University Medical Center Utrecht, 3508 GA Utrecht, the Netherlands.Disclosures: None disclosed.Corresponding Author: Johannes W.J. Bijlsma, Department of Rheumatology-Clinical Immunology, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, the Netherlands; e-mail, j.w.j.[email protected]nl.Current Author Addresses: Drs. Bijlsma and Lafeber: Department of Rheumatology-Clinical Immunology, Unversity Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, the Netherlands. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Glucosamine Sulfate on Hip Osteoarthritis Rianne M. Rozendaal , Bart W. Koes , Gerjo J.V.M. van Osch , Elian J. Uitterlinden , Eric H. Garling , Sten P. Willemsen , Abida Z. Ginai , Jan A.N. Verhaar , Harrie Weinans , and Sita M.A. Bierma-Zeinstra Metrics Cited byEffect of Oral Glucosamine on Joint Structure in Individuals With Chronic Knee Pain: A Randomized, Placebo-Controlled Clinical TrialNew drugs in clinical trials for osteoarthritisOsteoarthritis: an update with relevance for clinical practiceGlucosamine sulfate might have no effect on pain or structural changes associated with osteoarthritis 19 February 2008Volume 148, Issue 4Page: 315-316KeywordsArthralgiaCartilageClinical trialsHipKneesNeuropathic painOsteoarthritisSigns and symptomsSulfates ePublished: 19 February 2008 Issue Published: 19 February 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...