No changes of cholesterol levels with a commercially available glucosamine product in patients treated with lipid lowering drugs: a controlled, randomised, open cross-over trial

Abstract

BackgroundThe widespread use of natural health products is also a problem, as they could interact with prescribed drugs in patients. One commonly used product is glucosamine for osteoarthritis and some reports have found increased values of cholesterol and other lipids in patients treated with simvastatin for hypercholesterolemia. The aim of this trial was to investigate the effects of glucosamine on s-cholesterol levels (total s-cholesterol, s-HDL, s-LDL) in primary care patients on treatment with simvastatin or atorvastatin.MethodsControlled, randomized, open, crossover pharmacodynamic study in two primary health care centres. Patients were treated with Artrox® (glucosamine) 625 mg twice daily and control (a commercially available multivitamin tablet Vitamineral®). The study started with a run-in period of four weeks followed by control or active treatment with randomization of sealed envelopes. Each treatment period was four weeks and the treatment with simvastatin or atorvastatin was unchanged during the study (12 weeks). 34 patients were treated with a stable dose of simvastatin (n=21) or atorvastatin (n=13) for at least three months. Assessments of total s-cholesterol, s-HDL, S-LDL and s-triglycerides were performed in the morning with the patients in a fasting condition. T-tests for paired samples were used for statistical analyses and a p-value <0.05 was considered significant. Endpoints were the differences in lipid values at week 8 and week 12.ResultsAll patients completed the study. No significant changes were seen on any of lipid levels in the simvastatin group.ConclusionThe actual glucosamine product did not change lipid levels of patients treated with simvastatin. Atorvastatin group was too small for safe calculations but was also without changes.Trial registrationEUDRACT2006-001458-28

Therapeutic effects of statins on osteoarthritis: A review

“…There were no significant alterations in lipid profile in the simvastatin group, and glucosamine did not alter the lipid concentrations of simvastatin‐treated individuals. However, the atorvastatin sample was too small to make conclusive findings 93 …”

“…The physical function similar to patients with knee OA was seen in the second month following therapy but not subsequent months 92 . Among primary care patients using simvastatin or atorvastatin, Eggertsen et al 93 examined the impact of glucosamine on serum cholesterol levels, including total cholesterol, high‐density lipoprotein, or low‐density lipoprotein. There were no significant alterations in lipid profile in the simvastatin group, and glucosamine did not alter the lipid concentrations of simvastatin‐treated individuals.…”

“…However, the atorvastatin sample was too small to make conclusive findings. 93 The therapeutic relevance of research findings indicates that atorvastatin may have a preventive impact on joint cartilage experiencing OA deterioration. 94 In addition, the STAT1-caspase-3 signaling pathway was shown to be responsible for atorvastatin's anti-inflammatory effects on the knee joint.…”