Glucosamine sulphate: an umbrella review of health outcomes

Abstract

Background and Aims: Glucosamine sulphate (GS) can be used as background therapy in people affected by knee osteoarthritis (OA). Knowledge regarding the efficacy and safety of GS is of importance since its use worldwide is increasing. Therefore, the present study aimed to map and grade the diverse health outcomes associated with GS using an umbrella review approach. Methods: Medline, Cinahl and Embase databases were searched until 1 April 2020. An umbrella review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) was carried out. The evidence from the RCTs was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Results: From 140 articles returned, 11 systematic reviews, for a total of 21 outcomes (37 RCTs; 3949 participants; almost all using 1500 mg/day), were included. No systematic reviews/meta-analyses of observational studies were included. Regarding the findings of the meta-analyses, 9/17 outcomes were statistically significant, indicating that GS is more effective than placebo. A high certainty of evidence, as assessed by GRADE, supported the use of GS ( versus placebo) in improving the Lequesne Index, joint space width change, joint space width change after 3 years of follow up, joint space narrowing and OA progression. No difference in terms of adverse effects was found between GS and placebo. In systematic reviews, GS was associated with a better glucose profile and a better physical function performance than placebo. Conclusion: GS, when used as a prescription drug (i.e. crystalline glucosamine sulphate) at 1500 mg daily dosage, can positively affect the cartilage structure, reduce pain, improve function and glucose metabolism in people with knee OA, without having a greater incidence of adverse effects than placebo.

Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New‐User Cohort Design

“…The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes 5–9 . Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat 10–12 .…”

“…[2][3][4] The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes. [5][6][7][8][9] Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat. [10][11][12] It is unclear whether and to what extent the observational studies that report significant reductions in cancer incidence and other major outcomes with glucosamine have affected their widespread prescription.…”

Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New‐User Cohort Design

“…The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes 5–9 . Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat 10–12 .…”

“…[2][3][4] The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes. [5][6][7][8][9] Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat. [10][11][12] It is unclear whether and to what extent the observational studies that report significant reductions in cancer incidence and other major outcomes with glucosamine have affected their widespread prescription.…”

Sericin promotes chondrogenic proliferation and differentiation via glycolysis and Smad2/3 TGF-β signaling inductions and alleviates inflammation in three-dimensional models

“…GS is an amino-monosaccharide and a natural composition of long-chain glycosaminoglycans in the human cartilage matrix 76 . It is extensively utilized in the treatment of OA 77 . In the present study, GS treatment decreased the expressions of IL-1β, TNF-α, and MMP-1 (Fig.…”

Vegan Glucosamine versus Crustacean Glucosamine in Osteoarthritis: Choosing the Correct One During Clinical Practice

“…Considerable research has been conducted to assess the efficacy of glucosamine supplementation in managing OA. 1 , 2 A recent meta-analysis, 3 which included data from 3949 participants, confirmed that glucosamine, when administered at a dosage of 1500 mg/day, can positively impact cartilage structure, alleviate pain, enhance functionality, and improve glucose metabolism in people with knee OA. Importantly, this positive effect occurs without a higher incidence of adverse effects compared to a placebo.…”

Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New‐User Cohort Design

“…The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes 5–9 . Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat 10–12 .…”

“…[2][3][4] The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes. [5][6][7][8][9] Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat. [10][11][12] It is unclear whether and to what extent the observational studies that report significant reductions in cancer incidence and other major outcomes with glucosamine have affected their widespread prescription.…”

Sericin promotes chondrogenic proliferation and differentiation via glycolysis and Smad2/3 TGF-β signaling inductions and alleviates inflammation in three-dimensional models

“…GS is an amino-monosaccharide and a natural composition of long-chain glycosaminoglycans in the human cartilage matrix 76 . It is extensively utilized in the treatment of OA 77 . In the present study, GS treatment decreased the expressions of IL-1β, TNF-α, and MMP-1 (Fig.…”

Vegan Glucosamine versus Crustacean Glucosamine in Osteoarthritis: Choosing the Correct One During Clinical Practice

“…Considerable research has been conducted to assess the efficacy of glucosamine supplementation in managing OA. 1 , 2 A recent meta-analysis, 3 which included data from 3949 participants, confirmed that glucosamine, when administered at a dosage of 1500 mg/day, can positively impact cartilage structure, alleviate pain, enhance functionality, and improve glucose metabolism in people with knee OA. Importantly, this positive effect occurs without a higher incidence of adverse effects compared to a placebo.…”

Glucosamine and Cancer Incidence in Osteoarthritis: A Prevalent New‐User Cohort Design

“…The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes 5–9 . Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat 10–12 .…”

“…[2][3][4] The data from randomized trials of the effectiveness of glucosamine in treating osteoarthritis and joint pain are inconsistent; the results range from no effect to some beneficial effect on certain clinical outcomes. [5][6][7][8][9] Consequently, the treatment guidelines regarding recommendations of glucosamine prescription have disagreed somewhat. [10][11][12] It is unclear whether and to what extent the observational studies that report significant reductions in cancer incidence and other major outcomes with glucosamine have affected their widespread prescription.…”

Sericin promotes chondrogenic proliferation and differentiation via glycolysis and Smad2/3 TGF-β signaling inductions and alleviates inflammation in three-dimensional models

“…GS is an amino-monosaccharide and a natural composition of long-chain glycosaminoglycans in the human cartilage matrix 76 . It is extensively utilized in the treatment of OA 77 . In the present study, GS treatment decreased the expressions of IL-1β, TNF-α, and MMP-1 (Fig.…”

Vegan Glucosamine versus Crustacean Glucosamine in Osteoarthritis: Choosing the Correct One During Clinical Practice

“…Considerable research has been conducted to assess the efficacy of glucosamine supplementation in managing OA. 1 , 2 A recent meta-analysis, 3 which included data from 3949 participants, confirmed that glucosamine, when administered at a dosage of 1500 mg/day, can positively impact cartilage structure, alleviate pain, enhance functionality, and improve glucose metabolism in people with knee OA. Importantly, this positive effect occurs without a higher incidence of adverse effects compared to a placebo.…”