Article

Effect of glucosamine sulphate on joint space narrowing, pain and function in patients with hip osteoarthritis; subgroup analyses of a randomized controlled trial

Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Osteoarthritis and Cartilage (Impact Factor: 4.66). 10/2008; 17(4):427-32. DOI: 10.1016/j.joca.2008.05.022
Source: PubMed

ABSTRACT Recently we reported that glucosamine sulphate (GS) did not have an effect on the symptoms and progression of primary care patients with hip osteoarthritis (OA). The aim of this present study was to investigate whether there are subgroups of patients with hip OA for whom GS might be an effective therapy.
We randomized 222 patients with hip OA that met one of the American College of Rheumatology criteria to either 1500 mg of oral GS or placebo once daily for 2 years. Subgroup analyses were predefined for radiographic severity (Kellgren & Lawrence (KL)=1 vs >or=2) and for type of OA (localised vs generalised). Additional exploratory subgroup analyses focused on groups based on pain level, pain medication use, baseline joint space width (JSW), and concomitant knee OA at baseline. Primary outcome measures were Western Ontario MacMaster Universities (WOMAC) pain and function scores over 24 months, and joint space narrowing (JSN) after 24 months.
In the predefined subgroups based on radiographic severity and type of OA, the outcomes WOMAC pain, function and JSN were similar for the GS and placebo group.
GS was not significantly better than placebo in reducing symptoms and progression of hip OA in subgroups of patients.

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Available from: Sten P Willemsen, Aug 31, 2015
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    • "When considering only high quality trials, the ES for glucosamine sulfate decreased to 0.29 (0.003 to 0.57), with no publication bias but still heterogeneity outcomes of trials. The same analysis revealed a small but significant ES (0.24 (0.04 to 0.43)) for glucosamine sulfate for reduction of joint space loss in the medial compartment of knee OA patients, as reported by two sponsored RCTs [55,56], but a non-significant effect on joint space narrowing in hip OA patients after a 24-month treatment either when considering the whole study group [66] or when analyzing predefined subgroups for OA severity [64]. The same conclusion was reached by the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), with a ES of 0.15 (-0.07 to 0.38) [61]. "
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    • "This showed they had a mean VAS score of 56.4 with an SD of 19.3, a mean WOMAC pain score of 51.2 with a SD of 16.4; these data are very similar to the SDs in the study of Qvistgaard et al. Therefore, in the planned trial, we will include 135 patients, anticipating only 5% loss to follow-up based on the relatively short follow-up and earlier experience with loss to follow-up [22,23]. "
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