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Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee Osteoarthritis
A Comprehensive Meta-analysis
Florent Richy, MSc;
Olivier Bruyere, MSc;
Olivier Ethgen, MSc;
Michel Cucherat, MSc, PhD;
Yves Henrotin, MSc, PhD;
Jean-Yves Reginster, MD, PhD
Arch Intern Med. 2003;163:1514-1522.
Objective To assess the structural and symptomatic efficacy of oral glucosamine sulfate and chondroitin sulfate in knee osteoarthritis through independent meta-analyses of their effects on joint space narrowing, Lequesne Index, Western Ontario MacMaster University Osteoarthritis Index (WOMAC), visual analog scale for pain, mobility, safety, and response to treatment.
Methods An exhaustive systematic research of randomized, placebo-controlled clinical trials published or performed between January 1980 and March 2002 that assessed the efficacy of oral glucosamine or chondroitin on gonarthrosis was performed using MEDLINE, PREMEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Current Contents, BIOSIS Previews, HealthSTAR, EBM Reviews, manual review of the literature and congressional abstracts, and direct contact with the authors and manufacturers of glucosamine and chondroitin. Inclusion, quality scoring, and data abstraction were performed systematically by 2 independent reviewers who were blinded to sources and authors. Conservative approaches were used for clear assessment of potential efficacy.
Results Our results demonstrated a highly significant efficacy of glucosamine on all outcomes, including joint space narrowing and WOMAC. Chondroitin was found to be effective on Lequesne Index, visual analog scale pain, mobility, and responding status. Safety was excellent for both compounds.
Conclusions Our study demonstrates the structural efficacy of glucosamine and indistinguishable symptomatic efficacies for both compounds. Regarding the relatively sparse data on glucosamine and joint space narrowing and the absence of data on structural effects of chondroitin, further studies are needed to investigate the relationship among time, dose, patient baseline characteristics, and structural efficacy for an accurate, disease-modifying characterization of these 2 compounds.
From the Faculty of Medicine, Department of Public Health, Public Health and Epidemiology, University of Liège, Liège, Belgium (Messrs Richy, Bruyere, and Ethgen and Dr Reginster); Bone and Cartilage Metabolism Research Unit, World Health Organization Collaborating Center for Public Health Aspects of Osteoarticular Disorders, Liège (Messrs Richy, Bruyere, and Ethgen and Drs Henrotin and Reginster); and Cochrane French Center, Lyon, France (Dr Cucherat). The authors have no relevant financial interest in this article.
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