Glucosamine improves joint mobility for 1 in 5 patients with osteoarthritis

Question Is either glucosamine or chondroitin effective in decreasing symptoms of osteoarthritis?

Synopsis The authors of this meta-analysis searched for all randomised, placebo controlled, clinical trials of either glucosamine or chondroitin for hip or knee arthritis. They did a thorough search of several databases and citation lists of retrieved articles and contacted pharmaceutical companies. They winnowed the 500 initially identified studies to 15 that met their inclusion criteria. These studies enrolled 1775 patients. Both drugs produced a pronounced effect on symptoms as identified by a visual analogue scale (effect size 0.49; 95% confidence interval 0.31 to 0.67) and the Western Ontario McMaster University Osteoarthritis Index, a commonly used measure of pain and physical functioning (0.3; 0.11 to 0.49). Joint mobility also improved markedly (0.59; 0.25 to 0.92) with one person responding for every five patients treated (number needed to treat = 4.9). Adverse effect rates were similar for the drugs and placebo.

Bottom line Glucosamine and chondroitin produce a significant and similar effect on symptoms of osteoarthritis, will improve joint mobility for 1 in 5 patients, and also may slow narrowing of joint spaces. Onset of action is several weeks.

Level of evidence 1a (see www.infopoems.com/resources/levels.html); systematic reviews (with homogeneity) of randomised controlled trials.