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Ann Rheum Dis. 2017 Nov;76(11):1862-1869. doi: 10.1136/annrheumdis-2017-211149. Epub 2017 Jul 28.

Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank.

Author information

1
Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
2
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
3
Department of Rheumatology, The University of Nottingham, Nottingham, UK.
4
Department of Primary Care & Health Services, Keele University, Staffordshire, UK.
5
Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden.
6
Department of Rheumatology, Tufts Medical Center, Boston, Massachusetts, USA.
7
Department of General Practice and Orthopaedics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.

Abstract

OBJECTIVE:

To evaluate the effectiveness of oral glucosamine in subgroups of people with hip or knee osteoarthritis (OA) based on baseline pain severity, body mass index (BMI), sex, structural abnormalities and presence of inflammation using individual patient data.

METHODS:

After a systematic search of the literature and clinical trial registries, all randomised controlled trials (RCTs) evaluating the effect of any oral glucosamine substance in patients with clinically or radiographically defined hip or knee OA were contacted. As a minimum, pain, age, sex and BMI at baseline and pain as an outcome measure needed to be assessed.

RESULTS:

Of 21 eligible studies, six (n=1663) shared their trial data with the OA Trial Bank. Five trials (all independent of industry, n=1625) compared glucosamine with placebo, representing 55% of the total number of participants in all published placebo-controlled RCTs. Glucosamine was no better than placebo for pain or function at short (3 months) and long-term (24 months) follow-up. Glucosamine was also no better than placebo among the predefined subgroups. Stratification for knee OA and type of glucosamine did not alter these results.

CONCLUSIONS:

Although proposed and debated for several years, open trial data are not widely made available for studies of glucosamine for OA, especially those sponsored by industry. Currently, there is no good evidence to support the use of glucosamine for hip or knee OA and an absence of evidence to support specific consideration of glucosamine for any clinically relevant OA subgroup according to baseline pain severity, BMI, sex, structural abnormalities or presence of inflammation.

KEYWORDS:

glucosamine; individual patient data; meta-analysis; osteoarthritis; subgroups

PMID:
28754801
DOI:
10.1136/annrheumdis-2017-211149
[Indexed for MEDLINE]

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