Johns Hopkins Health Alert
Evidence Mounts Against Glucosamine Use for Osteoarthritis Pain
Do glucosamine chondroitin supplements actually work for osteoarthritis pain, or are their “effects” really just wishful thinking by people desperate to find some relief?Over 20 million Americans suffer from osteoarthritis -- which means that 20 million Americans are looking for relief from osteoarthritis pain. That’s no small task, especially after the recall of the two COX-2 inhibitors, Vioxx and Bextra.
One popular treatment for osteoarthritis is the supplement glucosamine. Glucosamine, usually made from crustacean shells, contains an amino sugar compound found in cartilage. Supplement manufacturers claim that taking glucosamine supplements will help preserve and repair cartilage in arthritic joints, although it is unknown exactly how the body processes this extra glucosamine -- or even whether it is delivered to the joints. Some glucosamine supplements also contain chondroitin, another natural component of cartilage. Chondroitin is believed to promote cartilage elasticity and prevent cartilage breakdown, but again it’s unknown how or if the chondroitin reaches the joint tissue.
How effective are glucosamine chondroitin supplements? A large-scale study conducted by the National Institutes of Health hopes to answer this question. The Glucosamine Chondroitin Arthritis Intervention Trial (GAIT) involved almost 1,600 patients with knee osteoarthritis. Participants were assigned to six months of treatment with one of five regimens: 1,500 mg of glucosamine hydrochloride daily, 1,200 mg of chondroitin sulfate daily, a full-dosage combination of both glucosamine and chondroitin sulfate daily, 200 mg of celecoxib daily, or placebo. All study participants were allowed up to 4,000 mg of acetaminophen per day if needed for pain relief, though on average they took less than 1,000 mg per day. Patients reported the intensity of their pain symptoms on a scale from 1 to 5. Effective treatment was defined as a 20 percent improvement in pain.
Overall, glucosamine and chondroitin supplements were no more effective than placebo: Both groups reported similar improvements. As was expected, people taking celecoxib had the greatest improvement. Glucosamine chondroitin supplements did appear to work better for participants suffering from moderate to-severe pain: 79 percent of the glucosamine chondroitin supplement group reported an effective reduction in pain, compared with just 54 percent of the placebo group.
Posted in Arthritis on February 17, 2007
Reviewed June 2011
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