Objective. To assess the effects of the prescription formulation of glucosamine sulfate (1,500 mg administered once daily) on the symptoms of knee osteoarthritis (OA) during a 6-month treatment course.Methods. Three hundred eighteen patients were enrolled in this randomized, placebo-controlled, doubleblind trial in which acetaminophen, the currently preferred medication for symptomatic treatment of OA, was used as a side comparator. Patients were randomly assigned to receive oral glucosamine sulfate 1,500 mg once daily (n ‫؍‬ 106), acetaminophen 3 gm/day ( n ‫؍‬ 108), or placebo (n ‫؍‬ 104). The primary efficacy outcome measure was the change in the Lequesne index after 6 months. Secondary parameters included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and response according to the Osteoarthritis Research Society International criteria. These outcome measures were assessed using an intentto-treat analysis.Results. At baseline, the study patients had moderately severe OA symptoms (mean Lequesne index ϳ11 points). Glucosamine sulfate was more effective than placebo in improving the Lequesne score, with a final decrease of 3.1 points, versus 1.9 with placebo (difference between glucosamine sulfate and placebo ؊1.2 [95% confidence interval ؊2.3, ؊0.8]) (P ‫؍‬ 0.032). The 2.7-point decrease with acetaminophen was not significantly different from that with placebo (difference ؊0.8 [95% confidence interval ؊1.9, 0.3]) (P ‫؍‬ 0.18). Similar results were observed for the WOMAC. There were more responders to glucosamine sulfate (39.6%) and acetaminophen (33.3%) than to placebo (21.2%) (P ‫؍‬ 0.004 and P ‫؍‬ 0.047, respectively, versus placebo). Safety was good, and was comparable among groups.Conclusion. The findings of this study indicate that glucosamine sulfate at the oral once-daily dosage of 1,500 mg is more effective than placebo in treating knee OA symptoms. Although acetaminophen also had a higher responder rate compared with placebo, it failed to show significant effects on the algofunctional indexes.ClinicalTrials.gov identifier: NCT00110474.

Over 1 year, we found no difference in effectiveness between adalimumab, etanercept and infliximab.

Objective We aimed to characterize severity and occurrence of knee osteoarthritis (OA), and effects of age, sex, body weight, and reproductive status on population-level normal variation in this condition in the baboon, a natural model of human knee OA. Methods We visually inspected articular cartilage of distal right femora of 464 baboons (309 females, 155 males) and assigned an OA severity score (comparable to a modified Outerbridge score) from 1 = unaffected to 4 = advanced OA (eburnation). Presence/absence of osteophytes was recorded. We tested for significant effects of age, sex, weight, and, in females, reproductive status (pre-, peri-, or post-menopausal) on OA. When appropriate, analyses were repeated on an age-matched subset (153 of each sex). Results Knee OA was more frequent and severe in older animals (p < 0.0001), but significant age variation was apparent in each severity grade. Sex differences within the younger and older age groups suggest that males develop knee OA earlier, but females progress more quickly to advanced disease. There is a strong relationship between reproductive status and OA severity grade in females (p = 0.0005) with more severe OA in peri- and post-menopausal female baboons, as in humans. Conclusions Idiopathic knee OA is common in adult baboons. Occurrence and severity are influenced strongly by reproductive status in females, and by sex with regard to patterns of disease progression – providing an animal model to investigate sex-specific variation in OA susceptibility in which the environmental heterogeneity inherent in human populations is vastly reduced.