The analysis of randomized controlled trials from which data have
been made public found that at both three-month and 24-month
follow-up points, the supplement had no effect on either hip or knee
pain from arthritis.
Even analyses of the results for sub-groups of study participants,
such as overweight people or those with high inflammation, found no
benefit with the supplements.
“Most recent guidelines conclude there is an overall lack of
efficacy of glucosamine, however, we knew that osteoarthritis could
affect subgroups differently,” said senior study author Sita
Bierma-Zeinstra of Erasmus University Medical Center in Rotterdam,
the Netherlands.
The most recent report from the U.S. National Center for Health
Statistics found that Americans spent nearly $13 billion in 2012 on
natural product supplements, and glucosamine was one of the most
popular.
The Osteoarthritis Research Society International and the U.S.
National Institute for Health and Care Excellence recently issued
guidance about the lack of evidence for glucosamine as a cure for
joint pain.
“Before we threw the baby out with the bathwater, however, it was
important to know whether different subgroups could have some
effect,” Bierma-Zeinstra told Reuters Health by email.
The researchers analyzed data from randomized, controlled trials
conducted between 1994 and 2014. Of the 21 studies they found on the
subject, only six shared data through the OA Trial Bank, an
international collection of data from trials conducted worldwide.
None of the trials included in the analysis was funded by industry,
the authors note.
Five of the trials, which altogether included more than 1,600
patients, compared glucosamine with a placebo. Five of the six
studies investigated knee osteoarthritis, and one looked at hip
osteoarthritis.
Overall, the effects of glucosamine and the placebo on pain and
physical functioning didn’t differ, either in the short-term or one
or two years later. The supplement was also no better than placebo
among subgroups based on pain severity, severity of osteoarthritis,
age, body mass index, gender or signs of inflammation.
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“Of course, the most striking thing in this study is that when a
commercial party funded the source, data sharing became difficult,”
Bierma-Zeinstra said. “Open access to data from clinical studies,
although propagated by many research organizations worldwide, is
still far from common practice.”
In addition, the researchers found that data for a study published
in 2006 was no longer available. Although data from older studies
may disappear, that doesn’t often happen with recent ones, she
added.
The research team plans to update subgroup data in the OA Trial Bank
every five years. They’ll continue to contact clinical trial
researchers to encourage them to contribute data to the project.
Future studies should look more closely at knee versus hip
osteoarthritis and specific supplement types such as glucosamine
sulfate versus glucosamine hydrochloride, the Bierma-Zeinstra’s team
writes in the Annals of the Rheumatic Diseases.
“Consumers should be cautious about spending money on unproven
treatments,” said Dr. C. Kent Kwoh, director of the University of
Arizona Arthritis Center in Tucson.
For instance, side effects of glucosamine include heartburn,
drowsiness, headaches, allergic reactions, weight gain, diarrhea and
abdominal pain, said Kwoh, who wasn’t involved in the study.
“Most consumers believe that, as a ‘natural product,’ glucosamine is
safe, but there are potential side effects,” he told Reuters Health
by email. “There is very little evidence that oral glucosamine is
beneficial for pain.”
SOURCE: http://bit.ly/2vTqE5h Annals of the Rheumatic Diseases,
online July 28, 2017.
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