Today's issue of The Lancet reports the
results of a clinical trial that showed administration of the nutritional
supplement, glucosamine sulfate, slows disease progression in patients with
The three-year, double-blind, placebo-controlled study (Long-term effects
of glucosamine sulfate on osteoarthritis progression: a randomized,
placebo-controlled clinical trial. Reginster J-Y, et al) was performed using
212 patients suffering from knee osteoarthritis who were randomly selected to
receive 1500 mg once-a-day of oral glucosamine sulfate or a placebo for the
three-year period. Disease progression was evaluated by measuring the joint
space width on x-rays of the knee. According to the study, patients who
received a placebo experienced progressive joint space narrowing, representing
further loss of cartilage, but patients who received glucosamine sulfate
showed no further joint space narrowing. Additionally, pain and function
limitation worsened with the placebo, but improved with glucosamine sulfate.
The study also showed that glucosamine sulfate is a safe compound.
"For the first time, we have shown that a treatment may be able to at
least reduce the progression of osteoarthritis," said principal investigator,
Professor Jean-Yves Reginster, MD PhD, University of Liege in Belgium.
"Further studies may be necessary to see if administration of glucosamine
sulfate for even longer periods may reduce substantial disability after
decades and/or the need for surgical joint replacement," added co-investigator
Lucio Rovati, MD from Milan, Italy.
The Lancet article warns against generalizing the results of this study to
glucosamine products other than the one used in this study, Dona(TM), which is
manufactured by Rotta Pharmaceuticals, Inc. Dona(TM) is sold as a
prescription drug in Europe, and is also available in the United States as a
Tim McAlindon, of the Arthritis Center at Boston University and author of
The Lancet Commentary about the glucosamine sulfate research, offers an
interesting and accurate perspective on bringing effective nutritional
supplements, such as the original glucosamine sulfate, closer to the forefront
of the health care profession. Currently, health care professionals generally
expect to be involved in medical decisions of public health importance, but
the reality is that they are not regarded as a repository of objective advice
about nutritional products and are generally kept out of the loop. Since
glucosamine sulfate as a nutritional supplement is generally self-prescribed,
there needs to be a shift in the profession to accommodate the possibility
that many nutritional products, including the original glucosamine sulfate,
may have valuable therapeutic effects and to regain the credibility of the
public at large.
Osteoarthritis, the most common form of arthritis, is the deterioration of
cartilage that cushions bones in the joints, leading to pain and function
limitation. In the United States nearly 12% of the population suffers from
osteoarthritis, accounting for 46 million physician visits, 3.7 million
hospital admissions, 185 million bed days, and 68 million workdays lost per
year. Many osteoarthritis sufferers eventually undergo surgical joint
replacement or become disabled.
The most common treatments for osteoarthritis are analgesics and non-
steroidal anti-inflammatory drugs, which can relieve symptoms for short
periods of time, but leave the progression of the disease unaltered, or may
even make it worse. Availability of nutritional supplements such as
glucosamine sulfate that give similar relief of symptoms and, in addition,
could delay the progression of osteoarthritis offer hope for the future.