Glucosamine and Chondroitin Sulfate: Is There Any Scientific Evidence for Their Effectiveness as Disease-Modifying Drugs in Knee Osteoarthritis Preclinical Studies?—A Systematic Review from 2000 to 2021

Abstract

Glucosamine and chondroitin sulfate have been proposed due to their physiological and functional benefits in the management of osteoarthritis in companion animals. However, the scientific evidence for their use is still controversial. The purpose of this review was to critically elucidate the efficacy of these nutraceutical therapies in delaying the progression of osteoarthritis, evaluating their impact on the synovial knee joint tissues and biochemical markers in preclinical studies by systematically reviewing the last two decades of peer-reviewed publications on experimental osteoarthritis. Three databases (PubMed, Scopus and, Web of Science) were screened for eligible studies. Twenty-two articles were included in the review. Preclinical studies showed a great heterogeneity among the experimental designs and their outcomes. Generally, the evaluated nutraceuticals, alone or in combination, did not seem to prevent the subchondral bone changes, the synovial inflammation or the osteophyte formation. However, further experimental studies may be needed to evaluate their effect at those levels. Regarding the cartilage status and biomarkers, positive responses were identified in approximately half of the evaluated articles. Furthermore, beneficial effects were associated with the pre-emptive administrations, higher doses and, multimodality approaches with some combined therapies. However, additional studies in the long term and with good quality and systematic design are required.

Clinical Efficacy and Safety of Chondroitin Combined with Glucosamine in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis

“…Western medicine treatment can be divided into two categories: medicine and operation [ 9 , 10 ]. Nonsteroidal anti-inflammatory drugs (NSAID) [ 11 ] are the most commonly used drugs in the treatment of KOA, such as Celebrex, Tylenin, and diclofenac sodium. However, there are still a few limitations of NASIDs, so it is imperative to find alternative drug treatment.…”

Evaluation of unsulfated biotechnological chondroitin in a knee osteoarthritis mouse model as a potential novel functional ingredient in nutraceuticals and pharmaceuticals

“…Chondroitin sulfate and biotechnological chondroitin at the doses of 200 and 400 mg/kg or vehicle (saline) were administered via gavage starting from day 7 post induction for three weeks. The doses used were chosen according to previous studies ( Fernández-Martin et al, 2021 ).…”

Acupotomy combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis

“…Current KOA modalities often comprise nonsteroidal anti-inflammatory drugs, glucosamine, chondroitin sulfate, hyaluronic acid, and other medication. [12–17] Pharmacological treatment benefits patients with KOA in the short-term, and its long-term efficacy is still unsatisfactory. [18] In addition, it is often accompanied by a variety of adverse events, such as gastrointestinal ulcers.…”