Dr. Roemer has received consulting fees, speaking fees, and/or honoraria from Merck Serono (less than $10,000) and owns stock or stock options in, and serves as vice-president of, Boston Imaging Core Lab (BICL), LLC.
Effect of Oral Glucosamine on Joint Structure in Individuals With Chronic Knee Pain: A Randomized, Placebo-Controlled Clinical Trial†
Version of Record online: 28 MAR 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis & Rheumatology
Volume 66, Issue 4, pages 930–939, April 2014
How to Cite
Kwoh, C. K., Roemer, F. W., Hannon, M. J., Moore, C. E., Jakicic, J. M., Guermazi, A., Green, S. M., Evans, R. W. and Boudreau, R. (2014), Effect of Oral Glucosamine on Joint Structure in Individuals With Chronic Knee Pain: A Randomized, Placebo-Controlled Clinical Trial. Arthritis & Rheumatology, 66: 930–939. doi: 10.1002/art.38314
ClinicalTrials.gov identifier: NCT00377286.
- Issue online: 28 MAR 2014
- Version of Record online: 28 MAR 2014
- Accepted manuscript online: 10 MAR 2014 11:30PM EST
- Manuscript Accepted: 5 DEC 2013
- Manuscript Received: 11 SEP 2012
- Beverage Institute for Health & Wellness
- Coca-Cola Company
- Multidisciplinary Clinical Research Center for Musculoskeletal and Skin Diseases at the university
- NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases). Grant Number: P60-AR-054731
To determine the short-term efficacy of oral glucosamine supplementation by evaluating structural lesions in the knee joints, as assessed using 3T magnetic resonance imaging (MRI).
This study was designed as a randomized, double-blind, placebo-controlled trial. Recruitment was performed via mass mailings and an arthritis registry in southwestern Pennsylvania. In total, 201 participants with mild-to-moderate pain in one or both knees, as defined by a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score ≥25 and ≤100, were enrolled. Of these subjects, 69.2% had a Kellgren/Lawrence grade ≥2 in at least 1 knee. Participants received 24 weeks of treatment with 1,500 mg glucosamine hydrochloride in beverage form or a placebo beverage. The primary outcome was decreased worsening of cartilage damage on 3T MRI of both knees, assessed according to a validated scoring system, the Whole-Organ MRI Score (WORMS). Secondary outcomes included change in bone marrow lesion (BML) scores in all knees and change in excretion of urinary C-terminal crosslinking telopeptide of type II collagen (CTX-II).
The adjusted odds ratio (OR) for the likelihood of decreased cartilage damage over 24 weeks in any WORMS-scored subregion of the knee in the glucosamine treatment group compared to the control group was 0.938 (95% confidence interval [95% CI] 0.528, 1.666). Compared to subjects treated with glucosamine, control subjects showed more improvement in BMLs (adjusted OR 0.537, 95% CI 0.291, 0.990) but no difference in worsening BMLs (adjusted OR 0.691, 95% CI 0.410, 1.166) over 24 weeks. There was no indication that treatment with glucosamine decreased the excretion of urinary CTX-II (β = −0.10, 95% CI −0.21, 0.002).
The results of this short-term study provide no evidence of structural benefits (i.e., improvements in MRI morphologic features or urinary CTX-II excretion) from glucosamine supplementation in individuals with chronic knee pain.