Summary of findings for the main comparison. Summary of findings (adequate allocation concealment).
| Glucosamine versus placebo for treating osteoarthritis | ||||||
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Patient or population: patients with treating osteoarthritis Settings: Intervention: Glucosamine versus placebo (adequate allocation concealment) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Glucosamine versus placebo (adequate allocation concealment) | |||||
| Pain based on WOMAC pain scale Scale from: 0 (no pain) to 20 (worst pain). (follow‐up: mean 6 months) | The mean pain based on womac pain scale in the control groups was 6.6 points | The mean Pain based on WOMAC pain scale in the intervention groups was 0.7 lower (1.5 lower to 0.17 higher) | 2173 (11) | ⊕⊕⊕⊝ moderate1 | SMD ‐0.16 (95% CI ‐0.36 to 0.04, see outcome 3.1). Relative per cent change from baseline is ‐7% (95% CI ‐17%, 1.8%). Note that when all studies are pooled together, the result is statistically significant: SMD=‐0.47 (95% CI ‐0.72, ‐0.23, see outcome 1.1). This corresponds to a 10 point improvement on a 0 to 100 scale. When studies using the Rotta preparation are pooled together, the result is statistically significant: SMD=‐1.11 ( 95% CI ‐1.66, ‐0.57, see outcome 4.1 and Summary of Findings Table 2). | |
| WOMAC Function Subscale Scale from: 0 to 68. (follow‐up: median 6 months) | The mean womac function subscale in the control groups was 31.6 points | The mean WOMAC Function Subscale in the intervention groups was 1.02 lower (2.04 lower to 0 higher) | 2017 (9) | ⊕⊕⊕⊕ high | SMD ‐0.08 (95% CI ‐0.17 to 0.00, see outcome 3.6). Relative per cent change from baseline is ‐3% (95% CI ‐6%, 0%). Note that when studies using the Rotta preparation are pooled together, the SMD is ‐0.19 (95% CI ‐0.35, ‐0.03, see outcome 4.6) which is statistically significant. See Summary of Findings Table 2. | |
| Physician Global Assessment 100 mm visual analogue scale. Scale from: 0 to 100. (follow‐up: 6 months) | The mean physician global assessment in the control groups was 37.1 mm | The mean Physician Global Assessment in the intervention groups was 0.80 higher (2.78 lower to 4.38 higher) | 630 (1) | ⊕⊕⊕⊝ moderate1,2 | MD 0.80 (95% CI ‐2.78, 4.38). Relative per cent change from baseline is ‐1.5% (95% CI ‐5.4%, 8.5%)See Results section, #10. | |
| Patient Global Assessment (patients rated whether they were better at the end of trial than at the start of the trial) (follow‐up: mean 6 months) | Medium risk population | RR 1.21 (0.8 to 1.82) | 118 (1) | ⊕⊕⊕⊝ moderate3 | ||
| 40 per 100 | 48 per 100 (32 to 73) | |||||
| Minimum Joint Space Width mm (follow‐up: mean 3 years) | The mean minimum joint space width in the control groups was 3.55 mm | The mean Minimum Joint Space Width in the intervention groups was 0.32 higher (0.05 to 0.58 higher) | 414 (2) | ⊕⊕⊕⊕ high | MD 0.32 (95% CI 0.05 to 0.58, see outcome 3.8). | |
| Toxicity (Number of Patients Reporting Adverse Events) | Medium risk population | RR 0.99 (0.91 to 1.07) | 1640 (9) | ⊕⊕⊕⊕ high | ||
| 53 per 100 | 53 per 100 (48 to 57) | |||||
| Toxicity (Number of Withdrawals due to Adverse Events) | Medium risk population | RR 0.76 (0.54 to 1.07) | 2435 (12) | ⊕⊕⊕⊝ moderate4 | ||
| 4 per 100 | 3 per 100 (2 to 5) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidance High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Heterogeneity fairly high; I‐squared=79%
2 Only 1 study and wide confidence interval
3 Few events; only 1 study
4 Confidence interval crosses threshold for appreciable benefit or harm of a RRR or RRI of 25%. Also, number of events is less than 300.