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Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis

  1. Jolanda Cibere1,*,
  2. Jacek A. Kopec1,
  3. Anona Thorne2,
  4. Joel Singer3,
  5. Janice Canvin4,
  6. David B. Robinson5,
  7. Janet Pope6,
  8. Paul Hong7,
  9. Eric Grant8,
  10. John M. Esdaile1

Article first published online: 11 OCT 2004

DOI: 10.1002/art.20697

Issue

Arthritis Care & Research

Arthritis Care & Research

Volume 51, Issue 5, pages 738–745, 15 October 2004

Additional Information

How to Cite

Cibere, J., Kopec, J. A., Thorne, A., Singer, J., Canvin, J., Robinson, D. B., Pope, J., Hong, P., Grant, E. and Esdaile, J. M. (2004), Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Care & Research, 51: 738–745. doi: 10.1002/art.20697

Author Information

  1. 1

    Arthritis Research Centre of Canada and University of British Columbia, Vancouver, British Columbia, Canada

  2. 2

    University of British Columbia, Vancouver, British Columbia, Canada

  3. 3

    University of British Columbia and Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

  4. 4

    University of Manitoba, Winnipeg, Manitoba, Canada, and GlaxoSmithKline, Stevenage, United Kingdom

  5. 5

    University of Manitoba, Winnipeg, Manitoba, Canada

  6. 6

    University of Western Ontario, St. Joseph's Health Care London, London, Ontario, Canada

  7. 7

    University of Ottawa, Ottawa, Ontario, Canada

  8. 8

    Dalhousie University, Saint John, New Brunswick, Canada

*Arthritis Research Centre of Canada, 895 West 10th Avenue, Vancouver, BC, Canada, V5Z 1L7

Publication History

  1. Issue published online: 11 OCT 2004
  2. Article first published online: 11 OCT 2004
  3. Manuscript Accepted: 9 FEB 2004
  4. Manuscript Received: 22 OCT 2003

Funded by

  • Mary Pack Research Fund, Vancouver, British Columbia, Canada
  • Doris Alma Mary Anderson Fund for Geriatric Research, London, ON, Canada
  • Canadian Institutes of Health Research Clinician Scientist Award
  • Michael Smith Foundation for Health Research Postdoctoral Fellowship Award

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Keywords:

  • Glucosamine;
  • Knee osteoarthritis;
  • Randomized discontinuation trial

Abstract

Objective

To assess the efficacy of glucosamine sulfate in knee osteoarthritis (OA).

Methods

A 4-center, 6-month, randomized, double-blind, placebo-controlled glucosamine discontinuation trial was conducted in 137 current users of glucosamine with knee OA who had experienced at least moderate improvement in knee pain after starting glucosamine. Study medication dosage was equivalent to the dosage of glucosamine taken prior to the study (maximum 1,500 mg/day). Followup continued for 6 months or until disease flare, whichever occurred first. The primary outcome was the proportion of disease flares in the glucosamine and placebo groups using an intent-to-treat analysis. Secondary outcomes included time to disease flare; analgesic medication use; severity of disease flare; and change in pain, stiffness, function and quality of life in the glucosamine and placebo groups.

Results

Disease flare was seen in 28 (42%) of 66 placebo patients and 32 (45%) of 71 glucosamine patients (difference −3%; 95% confidence interval [95% CI] −19, 14; P = 0.76). In the Cox regression analysis, after adjustment for sex, study site, and OA radiographic severity, time to disease flare was not significantly different in the glucosamine compared with placebo group (hazard ratio of flare = 0.8; 95% CI 0.5, 1.4; P = 0.45). At final study visit, acetaminophen was used in 27% and 21% of placebo and glucosamine patients, respectively (P = 0.40), nonsteroidal antiinflammatory drugs were used in 29% and 30% (P = 0.92), and both were used in 20% and 21% (P = 0.84). No differences were found in severity of disease flare or other secondary outcomes between placebo and glucosamine patients.

Conclusion

In patients with knee OA with at least moderate subjective improvement with prior glucosamine use, this study provides no evidence of symptomatic benefit from continued use of glucosamine sulfate.

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