Effects of Oral Glucosamine Sulfate on Osteoarthritis-Related Pain and Joint-Space Changes: Systematic Review and Meta-Analysis

Joseph Knapik, Rodney R Pope, Sally Hoedebecke, Ben Schram, Rob Marc Orr, Harris Lieberman

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Osteoarthritis (OA) is a disorder involving deterioration
of articular cartilage and underlying bone and is associated
with symptoms of pain and disability. Glucosamine is
a component of articular cartilage naturally synthesized in the
body from glucose and incorporated into substances contained
in the cartilage. It has been suggested that consumption of glucosamine
may reduce the pain of OA and may have favorable
effects on structural changes in the cartilage. This article presents
a systematic review and meta-analysis of the effectiveness
of orally consumed glucosamine sulfate (GS) on OA-related
pain and joint structural changes. Methods: PubMed and
Ovid Embase were searched using specific search terms to
find randomized, double-blinded, placebo-controlled trials
on the effects of GS on pain and/or joint-space narrowing.
The outcome measure was the standardized mean difference
(SMD), which was the improvement in the placebo groups minus
the improvement in the GS groups divided by the pooled
standard deviation. Results: There were 17 studies meeting the
review criteria for pain, and the summary SMD was –0.35,
with a 95% confidence interval (95% CI) = –0.54 to –0.16
(negative SMD is in favor of GS). Of the 17 studies, 7 showed
a statistically significant reduction in pain from GS use. Four
studies met the review criteria for joint space narrowing with
a summary SMD = –0.10 (95% CI = –0.23 to +0.04). Studies
without involvement of the commercial glucosamine industry
had a lower (but still significant) pain reduction efficacy (summary
SMD = –0.19, 95% CI = –0.39 to –0.02) than those with
industry involvement. Several smaller dosages throughout the
day had larger pain reduction effects than a single daily large
dose (1500 mg). Conclusion: These data indicate that GS may
have a small to moderate effect in reducing OA-related pain
but little effect on joint-space narrowing. Until there is more
definitive evidence, healthcare providers should be cautious in
recommending use of GS to their patients. Because GS dosages
used in studies to date resulted in mild and transient adverse
effects, and these were similar to that experienced by patients
receiving placebos, larger GS doses possibly could be investigated
in future studies.
Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalJournal of special operations medicine : a peer reviewed journal for SOF medical professionals
Volume18
Issue number4
Publication statusPublished - Dec 2018

Fingerprint

Glucosamine
Arthralgia
Osteoarthritis
Meta-Analysis
Pain
Joints
Placebos
Articular Cartilage
Confidence Intervals
Cartilage
PubMed
Health Personnel
Outcome Assessment (Health Care)
Bone and Bones
Glucose

Cite this

@article{7ce261bd63ff40a68f4bb3ba43d1067a,
title = "Effects of Oral Glucosamine Sulfate on Osteoarthritis-Related Pain and Joint-Space Changes: Systematic Review and Meta-Analysis",
abstract = "Background: Osteoarthritis (OA) is a disorder involving deteriorationof articular cartilage and underlying bone and is associatedwith symptoms of pain and disability. Glucosamine isa component of articular cartilage naturally synthesized in thebody from glucose and incorporated into substances containedin the cartilage. It has been suggested that consumption of glucosaminemay reduce the pain of OA and may have favorableeffects on structural changes in the cartilage. This article presentsa systematic review and meta-analysis of the effectivenessof orally consumed glucosamine sulfate (GS) on OA-relatedpain and joint structural changes. Methods: PubMed andOvid Embase were searched using specific search terms tofind randomized, double-blinded, placebo-controlled trialson the effects of GS on pain and/or joint-space narrowing.The outcome measure was the standardized mean difference(SMD), which was the improvement in the placebo groups minusthe improvement in the GS groups divided by the pooledstandard deviation. Results: There were 17 studies meeting thereview criteria for pain, and the summary SMD was –0.35,with a 95{\%} confidence interval (95{\%} CI) = –0.54 to –0.16(negative SMD is in favor of GS). Of the 17 studies, 7 showeda statistically significant reduction in pain from GS use. Fourstudies met the review criteria for joint space narrowing witha summary SMD = –0.10 (95{\%} CI = –0.23 to +0.04). Studieswithout involvement of the commercial glucosamine industryhad a lower (but still significant) pain reduction efficacy (summarySMD = –0.19, 95{\%} CI = –0.39 to –0.02) than those withindustry involvement. Several smaller dosages throughout theday had larger pain reduction effects than a single daily largedose (1500 mg). Conclusion: These data indicate that GS mayhave a small to moderate effect in reducing OA-related painbut little effect on joint-space narrowing. Until there is moredefinitive evidence, healthcare providers should be cautious inrecommending use of GS to their patients. Because GS dosagesused in studies to date resulted in mild and transient adverseeffects, and these were similar to that experienced by patientsreceiving placebos, larger GS doses possibly could be investigatedin future studies.",
author = "Joseph Knapik and Pope, {Rodney R} and Sally Hoedebecke and Ben Schram and Orr, {Rob Marc} and Harris Lieberman",
year = "2018",
month = "12",
language = "English",
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pages = "139--147",
journal = "Journal of special operations medicine : a peer reviewed journal for SOF medical professionals",
issn = "1553-9768",
publisher = "U.S. Special Operations Command",
number = "4",

}

Effects of Oral Glucosamine Sulfate on Osteoarthritis-Related Pain and Joint-Space Changes : Systematic Review and Meta-Analysis. / Knapik, Joseph; Pope, Rodney R; Hoedebecke, Sally; Schram, Ben; Orr, Rob Marc; Lieberman, Harris.

In: Journal of special operations medicine : a peer reviewed journal for SOF medical professionals, Vol. 18, No. 4, 12.2018, p. 139-147.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effects of Oral Glucosamine Sulfate on Osteoarthritis-Related Pain and Joint-Space Changes

T2 - Systematic Review and Meta-Analysis

AU - Knapik, Joseph

AU - Pope, Rodney R

AU - Hoedebecke, Sally

AU - Schram, Ben

AU - Orr, Rob Marc

AU - Lieberman, Harris

PY - 2018/12

Y1 - 2018/12

N2 - Background: Osteoarthritis (OA) is a disorder involving deteriorationof articular cartilage and underlying bone and is associatedwith symptoms of pain and disability. Glucosamine isa component of articular cartilage naturally synthesized in thebody from glucose and incorporated into substances containedin the cartilage. It has been suggested that consumption of glucosaminemay reduce the pain of OA and may have favorableeffects on structural changes in the cartilage. This article presentsa systematic review and meta-analysis of the effectivenessof orally consumed glucosamine sulfate (GS) on OA-relatedpain and joint structural changes. Methods: PubMed andOvid Embase were searched using specific search terms tofind randomized, double-blinded, placebo-controlled trialson the effects of GS on pain and/or joint-space narrowing.The outcome measure was the standardized mean difference(SMD), which was the improvement in the placebo groups minusthe improvement in the GS groups divided by the pooledstandard deviation. Results: There were 17 studies meeting thereview criteria for pain, and the summary SMD was –0.35,with a 95% confidence interval (95% CI) = –0.54 to –0.16(negative SMD is in favor of GS). Of the 17 studies, 7 showeda statistically significant reduction in pain from GS use. Fourstudies met the review criteria for joint space narrowing witha summary SMD = –0.10 (95% CI = –0.23 to +0.04). Studieswithout involvement of the commercial glucosamine industryhad a lower (but still significant) pain reduction efficacy (summarySMD = –0.19, 95% CI = –0.39 to –0.02) than those withindustry involvement. Several smaller dosages throughout theday had larger pain reduction effects than a single daily largedose (1500 mg). Conclusion: These data indicate that GS mayhave a small to moderate effect in reducing OA-related painbut little effect on joint-space narrowing. Until there is moredefinitive evidence, healthcare providers should be cautious inrecommending use of GS to their patients. Because GS dosagesused in studies to date resulted in mild and transient adverseeffects, and these were similar to that experienced by patientsreceiving placebos, larger GS doses possibly could be investigatedin future studies.

AB - Background: Osteoarthritis (OA) is a disorder involving deteriorationof articular cartilage and underlying bone and is associatedwith symptoms of pain and disability. Glucosamine isa component of articular cartilage naturally synthesized in thebody from glucose and incorporated into substances containedin the cartilage. It has been suggested that consumption of glucosaminemay reduce the pain of OA and may have favorableeffects on structural changes in the cartilage. This article presentsa systematic review and meta-analysis of the effectivenessof orally consumed glucosamine sulfate (GS) on OA-relatedpain and joint structural changes. Methods: PubMed andOvid Embase were searched using specific search terms tofind randomized, double-blinded, placebo-controlled trialson the effects of GS on pain and/or joint-space narrowing.The outcome measure was the standardized mean difference(SMD), which was the improvement in the placebo groups minusthe improvement in the GS groups divided by the pooledstandard deviation. Results: There were 17 studies meeting thereview criteria for pain, and the summary SMD was –0.35,with a 95% confidence interval (95% CI) = –0.54 to –0.16(negative SMD is in favor of GS). Of the 17 studies, 7 showeda statistically significant reduction in pain from GS use. Fourstudies met the review criteria for joint space narrowing witha summary SMD = –0.10 (95% CI = –0.23 to +0.04). Studieswithout involvement of the commercial glucosamine industryhad a lower (but still significant) pain reduction efficacy (summarySMD = –0.19, 95% CI = –0.39 to –0.02) than those withindustry involvement. Several smaller dosages throughout theday had larger pain reduction effects than a single daily largedose (1500 mg). Conclusion: These data indicate that GS mayhave a small to moderate effect in reducing OA-related painbut little effect on joint-space narrowing. Until there is moredefinitive evidence, healthcare providers should be cautious inrecommending use of GS to their patients. Because GS dosagesused in studies to date resulted in mild and transient adverseeffects, and these were similar to that experienced by patientsreceiving placebos, larger GS doses possibly could be investigatedin future studies.

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JO - Journal of special operations medicine : a peer reviewed journal for SOF medical professionals

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