Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials

Abstract

ObjectiveTo assess the symptomatic effectiveness and safety of oral symptomatic slow-acting drugs (SYSADOAs) on the treatment of knee and/or hip osteoarthritis, such as chondroitin, glucosamine, and combination treatment with chondroitin plus glucosamine.MethodsWe searched electronic database including PubMed, Embase, Cochrane Library, and the reference lists of relevant articles published from inception to May 22, 2018. An updated meta-analysis was performed to assess the effectiveness of these slow-acting drugs for osteoarthritis.ResultsTwenty-six articles describing 30 trials met our inclusion criteria and were included in the meta-analysis. The estimates between chondroitin and placebo showed that chondroitin could alleviate pain symptoms and improve function. Compared with placebo, glucosamine proved significant effect only on stiffness improvement. However, the combination therapy did not have enough evidence to be superior to placebo. Additionally, there was no significant difference in the incidence of AEs and discontinuations of AEs when compared with placebo.ConclusionsGiven the effectiveness of these symptomatic slow-acting drugs, oral chondroitin is more effective than placebo on relieving pain and improving physical function. Glucosamine showed effect on stiffness outcome. Regarding on the limited number of combination therapy, further studies need to investigate the accurate effectiveness. This information accompanied with the tolerability and economic costs of included treatments would be conducive to making decisions for clinicians.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0871-5) contains supplementary material, which is available to authorized users.

Short-Term Effect of a New Oral Sodium Hyaluronate Formulation on Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

“…These results are in line with those observed with large doses of some well-studied cartilage-protecting agents, such as glucosamine and chondroitin, both exerting a certain degree of anti-inflammatory and anti-pain effect in OA patients [46].…”

<p>Analysis of the Health and Budgetary Impact of Chondroitin Sulfate Prescription in the Treatment of Knee Osteoarthritis Compared to NSAIDs and COXIBs</p>

“…The most recent literature suggests that chondroitin sulfate, alone or associated with glucosamine (CS), is an effective treatment for osteoarthritis, according to most of the available studies published in the period 2008–2018. 1 – 8 Although doubts were raised in a meta-analysis published in 2010, 9 the reliability of the results of this study was highly questioned due to possible methodological deficiencies. 10 – 12 On the other hand, the efficacy of CS has been confirmed more recently in three randomised, double-blind clinical trials in patients with knee osteoarthritis: the MOVES 4 study, in which it was found that the combination of CS with glucosamine would have similar efficacy to that of celecoxib; in the MOSAIC 5 study, in which the superiority of CS over celecoxib in reducing cartilage volume loss was demonstrated through a 2-year follow-up; and finally, in the CONCEPT 6 study, in which CS was superior to placebo and similar to celecoxib in reducing pain and improving joint function for 6 months in symptomatic patients.…”

“…These results were also confirmed in a meta-analysis published in 2018. 8 CS is currently recommended for the treatment of knee osteoarthritis by, among others, the guidelines of the Spanish Society of Rheumatology, 13 , 14 the European League Against Rheumatism 15 and those published by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). 16 …”

Nutritional and Botanical Approaches for Osteoarthritis

“…Although these trials each varied somewhat in terms of outcomes, each showed an effect from either glucosamine or chondroitin on pain and/or function. [38][39][40] Of the two metaanalyses that looked at the combination of glucosamine plus chondroitin, no significant benefit was demonstrated for the two together. An additional 2019 meta-analyses specifically looked at safety (rather than efficacy), and demonstrated that both glucosamine and chondroitin are considered safe, with neither being associated with increased adverse events compared with placebo.…”