Pavelka, et. al. (Arch Intern Med 162:2113, 2002) have recently published the results of a 3-year, randomized, placebo controlled clinical trial assessing the ability of glucosamine sulfate to slow structural damage in patients with knee osteoarthritis (OA).
Methods: 202 patients with mild to moderated severity primary knee OA of the medial femorotibial compartment using ACR criteria were randomized to receive either oral glucosamine sulfate (1500mg daily) or placebo. Anteriorposterior, weight-bearing radiographs were taken at baseline and 1, 2, and 3 years and assessed randomly by 2 independent readers. Symptom severity was measured using the Lequesne and WOMAC indexes. Patients who were obese (body mass index of >27), had a history of trauma or lesions to the knee joint, and had other rheumatic diseases were excluded.
Results: The intent to treat cumulative joint space narrowing at the end of 3 years [mean (95% confidence interval) was 0.19mm (-0.29 to 0.09) for the placebo group and 0.04mm (-0.06 to 0.14) for the glucosamine sulfate group, P = .001. Similarly, the Lequesne index scores significantly improved in the glucosamine sulfate group when compared to the placebo group, -1.7 (-2.2 to 1.2) and -0.82 (-1.1 to 0.51) respectively. Adverse events were similar in both groups and most frequently included gastrointestinal symptoms, musculoskeletal pain, and cardiovascular events (increased blood pressure and recurrent episodes of preexisting ischemic heart disease). Consumption of acetaminophen, the only allowed rescue medication, did not vary significantly between the two groups.
Conclusion: These data confirm the results of Reginster, et. al. (read summary) whereby long-term treatment with glucosamine sulfate can slow the progression of structural damage to the joint in patients with knee osteoarthritis.
