The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation

Black, Corri; Clar, Christine; Henderson, Robyn J.; MacEachern, Campbell F.; McNamee, Paul; Quayyum, Zahidul; Royle, P. L.; Thomas, Siân

doi:10.3310/hta13520

Cited by 152 publications

(105 citation statements)

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“…This is significant in the two individual 3-year trials [Reginster et al 2001;Pavelka et al 2002], and when they are pooled in the Cochrane Review [Towheed et al 2009], or in a recent UK Health Technology Assessment (HTA) [Black et al 2009]. Both trials indicated that in mild disease with an initial joint space width of approximately 4 mm, the placebo group loses around 0.1 mm/year and this is prevented by crystalline glucosamine sulfate 1500 mg once daily.…”

Section: Efficacymentioning

confidence: 97%

“…This was actually the 2-year extension of the GAIT study [Sawitzke et al 2008], the poor quality of which is explained in the HTA report by the fact that it included only a subset of patients from the original 6-month study [Clegg et al 2006], several patients (over 40%) were excluded from the analysis, there was no intention-to-treat (ITT) analysis with failure to describe appropriately withdrawn patients and, finally, baseline characteristics were unbalanced between groups [Black et al 2009]. This extension of GAIT was indeed a small study in which, despite use of the wrong salt (glucosamine hydrochloride instead of sulfate), at the wrong dose (500 mg three times daily versus 1500 mg once daily), the only results close to a statistically significant difference with placebo were indeed the JSN sparing effect in the glucosamine group, while celecoxib, chondroitin, or a combination of the latter with glucosamine, were completely inactive [Sawitzke et al 2008].…”

Section: Efficacymentioning

confidence: 99%

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Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties

Rovati¹,

Girolami²,

Persiani³

2012

Therapeutic Advances in Musculoskeletal

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Abstract:Glucosamine is an amino monosaccharide and a natural constituent of glycosaminoglycans in articular cartilage. When administered exogenously, it is used for the treatment of osteoarthritis as a prescription drug or a dietary supplement. The latter use is mainly supported by its perception as a cartilage building block, but it actually exerts specific pharmacologic effects, mainly decreasing interleukin 1-induced gene expression by inhibiting the cytokine intracellular signaling cascade in general and nuclear factor-kappa B (NF-kB) activation in particular. As a whole, the use of glucosamine in the management of osteoarthritis is supported by the clinical trials performed with the original prescription product, that is, crystalline glucosamine sulfate. This is the stabilized form of glucosamine sulfate, while other formulations or different glucosamine salts (e.g. hydrochloride) have never been shown to be effective. In particular, long-term pivotal trials of crystalline glucosamine sulfate 1500 mg once daily have shown significant and clinically relevant improvement of pain and function limitation (symptom-modifying effect) in knee osteoarthritis. Continuous administration for up to 3 years resulted in significant reduction in the progression of joint structure changes compared with placebo as assessed by measuring radiologic joint space narrowing (structure-modifying effect). The two effects combined may suggest a disease-modifying effect that was postulated based on an observed decrease in the risk of undergoing total joint replacement in the follow up of patients receiving the product for at least 12 months in the pivotal trials. The safety of the drug was good in clinical trials and in the postmarketing surveillance. Crystalline glucosamine sulfate 1500 mg once daily is therefore recommended in the majority of clinical practice guidelines and was found to be cost effective in pharmacoeconomic analyses. Compared with other glucosamine formulations, salts, or dosage forms, the prescription product achieves higher plasma and synovial fluid concentrations that are above the threshold for a pharmacologically relevant effect, and may therefore justify its distinct therapeutic characteristics.

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Section: Efficacymentioning

confidence: 97%

Section: Efficacymentioning

confidence: 99%

Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties

Rovati¹,

Girolami²,

Persiani³

2012

Therapeutic Advances in Musculoskeletal

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“…287 A burden-of-illness study with a broad utility decrement for cancer was identified and used to define utility decrements for breast and colon cancer. 304 A utility decrement for osteoarthritis was taken from a HTA, 305 and a utility decrement for depression was calculated from a trial that had used the EQ-5D. 306 The multiplicative utility factors that are used in the model to describe health utility decrements from comorbid complications are shown in Table 46.…”

Section: Utility Decrementsmentioning

confidence: 99%

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.

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“…Methylation patterns, although generally stable throughout the genome, are responsive to pharmacologic intervention. One common medication that appears to act through epigenetic mechanisms is glucosamine [169]. In arthritis models, it has been demonstrated that glucosamine prevents demethylation of the IL-1b gene promoter, thereby decreasing expression of this cytokine.…”

Section: Intervention: Dna Methylationmentioning

confidence: 99%

Molecular Signatures of Chronic Pain Subtypes

Shaw¹

2013

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR'S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 SPONSOR/MONITOR'S REPORT NUMBER(S) DISTRIBUTION / AVAILABILITY STATEMENTApproved for Public Release; Distribution Unlimited SUPPLEMENTARY NOTES ABSTRACTThis project continues to be a biomarker discovery program focusing on the causes of persistent pain after traumatic amputation in the combat setting. In the second year we have: 1) maintained the necessary regulatory approval at WRMC and Duke University. We have obtained and maintained documents for approval by MRMC; 2) maintained our interactive, secure web based data collection system; 3) populated our biorepository at Duke with bioresource collected from 71 patients enrolled at WRNMMC; 4) conducted further on-site visits and investigator meetings at WRNMMC; 5) submitted samples to the Duke Core Lab facilities for proteomic, metabolomic, genomic, genetic and epigenetic assays. We have received our initial pilot results and presented these in Washington DC at ASA. We have published two more papers and are now collecting our validation cohort of patients. Our overall progress is slightly ahead of target, given the lengthy administrative delays during year one. Lastly, we have been funded by DOD to conduct an intervention trial at WRNMMC and the Durham VAMC of valproate for the prevention of amputation induced chronic pain.

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The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation

Abstract: This monograph may be freely reproduced for the purposes of private research and study and may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising.

Cited by 152 publications

References 18 publications

Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties

Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Molecular Signatures of Chronic Pain Subtypes

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