Glucosamine sulfate resulted in modest improvement and was marginally better than acetaminophen.
In a recent U.S. study, glucosamine hydrochloride was no better than placebo for treatment of painful knee osteoarthritis. Now, investigators in Spain and Portugal present results of a manufacturer-supported study of the more widely used glucosamine preparation — glucosamine sulfate.
In this double-blind, randomized trial, 318 patients with knee osteoarthritis received glucosamine sulfate (1500 mg once daily), acetaminophen (1 g three times daily), or placebo. At baseline, the mean score on the 24-point Lequesne index was 11, indicating moderate pain and limitation of function. At 6 months, mean scores decreased by 3.1, 2.7, and 1.9 points in the glucosamine, acetaminophen, and placebo groups, respectively. The difference between glucosamine and placebo was significant (P=0.03), but the difference between acetaminophen and placebo was not (P=0.18).
Comment: In this study, treatment with glucosamine sulfate resulted in statistically significant (though modest) improvement in pain and function in patients with knee osteoarthritis, compared with placebo; this drug performed marginally better than acetaminophen. Differences between the U.S. study noted above and this study include the different glucosamine preparations (hydrochloride vs. sulfate), a much higher average body-mass index among U.S. subjects (32 vs. 28), and slightly more baseline pain in the U.S. study. An important endpoint in the U.S. study — the effects of glucosamine and chondroitin on radiographic progression of osteoarthritis — has not yet been published.
— Allan S. Brett, MD
Published in Journal Watch General Medicine February 27, 2007
Herrero-Beaumont G et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: A randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 2007 Feb; 56:555-67.