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30-04-2018 | Osteoarthritis | Article

Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis

Journal: Clinical Rheumatology

Authors: Toru Ogata, Yuki Ideno, Masami Akai, Atsushi Seichi, Hiroshi Hagino, Tsutomu Iwaya, Toru Doi, Keiko Yamada, Ai-Zhen Chen, Yingzi Li, Kunihiko Hayashi

Publisher: Springer London

Abstract

Osteoarthritis (OA) of the knee is one of the main causes of mobility decline in the elderly. Non-surgical treatments such as administration of supplements to strengthen the joint cartilage matrix have become popular not only for pain relief but also for joint preservation. Glucosamine has been used in many countries based on the increasing evidence of its effectiveness for OA. Although there are many previous studies and systematic reviews, the findings vary and different conclusions have been drawn. We aimed to review recent randomized controlled trials on glucosamine for knee OA to reveal up-to-date findings about this supplement. We also performed a meta-analysis of some of the outcomes to overcome the unsolved bias in each study. Eighteen articles written between 2003 and 2016 were analyzed. Many used visual analogue scale (VAS) pain scores and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which were assessed in our meta-analysis. We found a marginally favorable effect of glucosamine on VAS pain scores. The effect on knee function, as measured by the WOMAC, was small and not significant. A newly established knee OA scale, the Japanese Knee Osteoarthritis Measure (JKOM), is commonly used in Japan. Although the number of subjects was small, the JKOM meta-analysis indicated that glucosamine is superior to a placebo in alleviating knee OA symptoms. Given this, we concluded that glucosamine has the potential to alleviate knee OA pain. Further studies are needed to evaluate the effect of glucosamine on knee function and joint preservation, as well as to evaluate the combined effect with other components, such as chondroitin.

Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 41(5):778–799. https://doi.org/10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V CrossRefPubMed

Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27(5):620–628. https://doi.org/10.1007/s00774-009-0080-8 CrossRefPubMed

Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N (2010) Association of radiographic and symptomatic knee osteoarthritis with health-related quality of life in a population-based cohort study in Japan: the ROAD study. Osteoarthr Cartil 18(9):1227–1234. https://doi.org/10.1016/j.joca.2010.06.001 CrossRefPubMed

Wang SY, Olson-Kellogg B, Shamliyan TA, Choi JY, Ramakrishnan R, Kane RL (2012) Physical therapy interventions for knee pain secondary to osteoarthritis: a systematic review. Ann Intern Med 157(9):632–644. https://doi.org/10.7326/0003-4819-157-9-201211060-00007 CrossRefPubMed

McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, Hawker GA, Henrotin Y, Hunter DJ, Kawaguchi H, Kwoh K, Lohmander S, Rannou F, Roos EM, Underwood M (2014) OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil 22(3):363–388. https://doi.org/10.1016/j.joca.2014.01.003 CrossRefPubMed

Jevsevar DS (2013) Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg 21(9):571–576. https://doi.org/10.5435/JAAOS-21-09-571 PubMedCrossRef

Molloy IB, Martin BI, Moschetti WE, Jevsevar DS (2017) Effects of the length of stay on the cost of total knee and total hip arthroplasty from 2002 to 2013. J Bone Joint Surg Am 99(5):402–407. https://doi.org/10.2106/JBJS.16.00019 CrossRefPubMedPubMedCentral

Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, Hochberg MC, Wells G (2005) Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2:CD002946. https://doi.org/10.1002/14651858.CD002946.pub2 CrossRef

Wandel S, Juni P, Tendal B, Nuesch E, Villiger PM, Welton NJ, Reichenbach S, Trelle S (2010) Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ 341:c4675. https://doi.org/10.1136/bmj.c4675 CrossRefPubMedPubMedCentral

10.

McAlindon TE, LaValley MP, Gulin JP, Felson DT (2000) Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 283(11):1469–1475CrossRefPubMed

11.

Snijders GF, den Broeder AA, van Riel PL, Straten VH, de Man FH, van den Hoogen FH, van den Ende CH, Group NS (2011) Evidence-based tailored conservative treatment of knee and hip osteoarthritis: between knowing and doing. Scand J Rheumatol 40 (3):225–231. doi:https://doi.org/10.3109/03009742.2010.530611

12.

Gallagher B, Tjoumakaris FP, Harwood MI, Good RP, Ciccotti MG, Freedman KB (2015) Chondroprotection and the prevention of osteoarthritis progression of the knee: a systematic review of treatment agents. Am J Sports Med 43(3):734–744. https://doi.org/10.1177/0363546514533777 CrossRefPubMed

13.

Vangsness CT Jr, Spiker W, Erickson J (2009) A review of evidence-based medicine for glucosamine and chondroitin sulfate use in knee osteoarthritis. Arthroscopy 25(1):86–94. https://doi.org/10.1016/j.arthro.2008.07.020 CrossRefPubMed

14.

Eriksen P, Bartels EM, Altman RD, Bliddal H, Juhl C, Christensen R (2014) Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken) 66(12):1844–1855. https://doi.org/10.1002/acr.22376 CrossRef

15.

Bruyere O, Cooper C, Pelletier JP, Maheu E, Rannou F, Branco J, Luisa Brandi M, Kanis JA, Altman RD, Hochberg MC, Martel-Pelletier J, Reginster JY (2016) A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis—from evidence-based medicine to the real-life setting. Semin Arthritis Rheum 45(4 Suppl):S3–S11. https://doi.org/10.1016/j.semarthrit.2015.11.010

16.

Hayami Y, Shichikawa K (2003) Effect of glucosamine, shark cartilage extract, and roots extract on knee osteoarthritis. Rinsho-to-Kenkyu 80(7):201–209

17.

Usha PR, Naidu MU (2004) Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clin Drug Investig 24(6):353–363CrossRefPubMed

18.

Cibere J, Kopec JA, Thorne A, Singer J, Canvin J, Robinson DB, Pope J, Hong P, Grant E, Esdaile JM (2004) Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 51(5):738–745. https://doi.org/10.1002/art.20697 CrossRefPubMed

19.

McAlindon T, Formica M, LaValley M, Lehmer M, Kabbara K (2004) Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial. Am J Med 117(9):643–649. https://doi.org/10.1016/j.amjmed.2004.06.023 CrossRefPubMed

20.

Kajimoto O, Miyabayashi N, Nakagawa S, Kajimoto Y (2005) A efficacy of tablet containing glucosamine hydrochloride on knee osteoarthritis. J New Rem & Clin 54(2):53–65

21.

Clegg DO, Reda DJ, Harris CL, Klein MA, O'Dell JR, Hooper MM, Bradley JD, Bingham CO 3rd, Weisman MH, Jackson CG, Lane NE, Cush JJ, Moreland LW, Schumacher HR Jr, Oddis CV, Wolfe F, Molitor JA, Yocum DE, Schnitzer TJ, Furst DE, Sawitzke AD, Shi H, Brandt KD, Moskowitz RW, Williams HJ (2006) Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 354(8):795–808. https://doi.org/10.1056/NEJMoa052771 CrossRefPubMed

22.

Hatano K, Hayashida K, Nakagawa S, Miyakuni Y (2006) Effects and safety of soymilk beverage containing N-acetyl glucosamine on osteoarthritis. Jpn Pharmacol Ther 34(1):149–165

23.

Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martin-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araujo D, Figueroa M, Branco J (2007) Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 56(2):555–567. https://doi.org/10.1002/art.22371 CrossRefPubMed

24.

Frestedt JL, Walsh M, Kuskowski MA, Zenk JL (2008) A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Nutr J 7:9. https://doi.org/10.1186/1475-2891-7-9 CrossRefPubMedPubMedCentral

25.

Inuzuka M, Hosono N, Ninomiya C, Itanami E, Sugano T (2010) The clinical safety and efficacy of oral MSM tablet administration was evaluated by the randomized controlled trial against arthralgia. Clin Pharmacol Therapy 20(4):15–20

26.

Nakasone Y, Watabe K, Watanabe K, Tomonaga A, Nagaoka I, Yamamoto T, Yamaguchi H (2011) Effect of a glucosamine-based combination supplement containing chondroitin sulfate and antioxidant micronutrients in subjects with symptomatic knee osteoarthritis: a pilot study. Exp Ther Med 2(5):893–899. https://doi.org/10.3892/etm.2011.298 CrossRefPubMedPubMedCentral

27.

Kanzaki N, Saito K, Maeda A, Kitagawa Y, Kiso Y, Watanabe K, Tomonaga A, Nagaoka I, Yamaguchi H (2012) Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study. J Sci Food Agric 92(4):862–869. https://doi.org/10.1002/jsfa.4660 CrossRefPubMed

28.

Gokan N, Suzuki N, Shiizuka K, Yamamoto K, Takara T (2011) The effect of the dietary supplement containing with both glucosamine and chondroitin sulfate on knee joint pain. J New Rem Clin 60(7):186–192

29.

Nieman DC, Shanely RA, Luo B, Dew D, Meaney MP, Sha W (2013) A commercialized dietary supplement alleviates joint pain in community adults: a double-blind, placebo-controlled community trial. Nutr J 12(1):154. https://doi.org/10.1186/1475-2891-12-154 CrossRefPubMedPubMedCentral

30.

Yokoi K, Fujimoto Y (2013) [Effect of the dietary containing N-acetyl glucosamine on knee pain and cartilage matabolism]. J New Rem Clin 62 (9):256–266

31.

Fransen M, Agaliotis M, Nairn L, Votrubec M, Bridgett L, Su S, Jan S, March L, Edmonds J, Norton R, Woodward M, Day R, group Lsc (2015) Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Ann Rheum Dis 74(5):851–858. https://doi.org/10.1136/annrheumdis-2013-203954 CrossRefPubMed

32.

Tsuji T, Yoon J, Kitano N, Okura T, Tanaka K (2016) Effects of N-acetyl glucosamine and chondroitin sulfate supplementation on knee pain and self-reported knee function in middle-aged and older Japanese adults: a randomized, double-blind, placebo-controlled trial. Aging Clin Exp Res 28(2):197–205. https://doi.org/10.1007/s40520-015-0412-6 CrossRefPubMed

33.

Sterzi S, Giordani L, Morrone M, Lena E, Magrone G, Scarpini C, Milighetti S, Pellicciari L, Bravi M, Panni I, Ljoka C, Bressi F, Foti C (2016) The efficacy and safety of a combination of glucosamine hydrochloride, chondroitin sulfate and bio-curcumin with exercise in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled study. Eur J Phys Rehabil Med 52(3):321–330PubMed

34.

Qiu G, Weng X, Zhang K, Zhou Y, Lou S, Wang Y, Li W, Zhang H, Liu Y (2005) A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis. Natl Med J China 85:3067–3070

35.

Bruyere O, Pavelka K, Rovati LC, Deroisy R, Olejarova M, Gatterova J, Giacovelli G, Reginster JY (2004) Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Menopause 11(2):138–143CrossRefPubMed

36.

Bruyere O, Pavelka K, Rovati LC, Gatterova J, Giacovelli G, Olejarova M, Deroisy R, Reginster JY (2008) Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthr Cartil 16(2):254–260. https://doi.org/10.1016/j.joca.2007.06.011 CrossRefPubMed

37.

Sawitzke AD, Shi H, Finco MF, Dunlop DD, Harris CL, Singer NG, Bradley JD, Silver D, Jackson CG, Lane NE, Oddis CV, Wolfe F, Lisse J, Furst DE, Bingham CO, Reda DJ, Moskowitz RW, Williams HJ, Clegg DO (2010) Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis 69(8):1459–1464. https://doi.org/10.1136/ard.2009.120469 CrossRefPubMedPubMedCentral

38.

Akai M, Doi T, Fujino K, Iwaya T, Kurosawa H, Nasu T (2005) An outcome measure for Japanese people with knee osteoarthritis. J Rheumatol 32(8):1524–1532PubMed

39.

Doi T, Akai M, Fujino K, Iwaya T, Kurosawa H, Hayashi K, Marui E (2008) Effect of home exercise of quadriceps on knee osteoarthritis compared with nonsteroidal antiinflammatory drugs: a randomized controlled trial. Am J Phys Med Rehabil 87(4):258–269. https://doi.org/10.1097/PHM.0b013e318168c02d CrossRefPubMed

40.

Raynauld JP, Pelletier JP, Abram F, Dodin P, Delorme P, Martel-Pelletier J (2016) Long-term effects of glucosamine and chondroitin sulfate on the progression of structural changes in knee osteoarthritis: six-year follow-up data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 68(10):1560–1566. https://doi.org/10.1002/acr.22866 CrossRef

41.

Eckstein F, Guermazi A, Gold G, Duryea J, Hellio Le Graverand MP, Wirth W, Miller CG (2014) Imaging of cartilage and bone: promises and pitfalls in clinical trials of osteoarthritis. Osteoarthr Cartil 22(10):1516–1532. https://doi.org/10.1016/j.joca.2014.06.023 CrossRefPubMedPubMedCentral

42.

Mobasheri A, Bay-Jensen AC, van Spil WE, Larkin J, Levesque MC (2017) Osteoarthritis year in review 2016: biomarkers (biochemical markers). Osteoarthr Cartil 25(2):199–208. https://doi.org/10.1016/j.joca.2016.12.016 CrossRefPubMed

Medicine Matters Rheumatology

Abstract