Glucosamine chondroitin benefit in knee arthritis comparable to popular arthritis drug

Glucosamine/chondroitin benefit in knee arthritis comparable to popular arthritis drug

Tuesday, February 10, 2015. A clinical trial reported online on January 14, 2015 in the Annals of the Rheumatic Diseases reveals that glucosamine and chondroitin sulfate—an over-the-counter combination that has been used for decades as a natural alternative to arthritis drugs—is as effective as the nonsteroidal anti-inflammatory (NSAID) drug celecoxib at relieving the symptoms of knee osteoarthritis. While NSAIDs such as celecoxib offer symptomatic relief, they have been associated with adverse cardiovascular and gastrointestinal effects which have led to concerns regarding their long-term use.

In the randomized, double-blinded MOVES trial, 606 men and women with knee osteoarthritis resulting in moderate to severe pain received 500 milligrams (mg) glucosamine hydrochloride plus 400 mg chondroitin sulfate three times daily or 200 mg celecoxib daily for six months. Participants' pain, function, stiffness, swelling, effusion (build-up of fluid), and need for analgesic medication (acetaminophen) were scored before and after the treatment period.

At the end of the trial, the reduction in pain scores was similar between the glucosamine/chondroitin group and those who received celecoxib. Stiffness decreased by 46.9% in the glucosamine/chondroitin group and by 49.2% in the celecoxib group. Additionally, both groups experienced a 50% or greater reduction in joint swelling and effusion.

"These results confirm that the combination of chondroitin sulfate plus glucosamine hydrochloride has proven non-inferior to celecoxib in reducing pain," authors Marc C. Hochberg of the University of Maryland and colleagues conclude. "No differences were found for stiffness, functional limitations, joint swelling and effusion after 6 months of treatment in patients with severe pain from osteoarthritis of the knee, and the combination has a similar good safety profile and tolerability."

They conclude that glucosamine/chondroitin "should offer a safe and effective alternative for those patients with cardiovascular or gastrointestinal conditions."

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Glucosamine extends life span in mice

In May 2010, Life Extension Update reported findings from a study of supplement users which found a reduced risk of dying in association with the use of glucosamine and chondroitin over a five year period. Now, in this month's issue of Nature Communications, Michael Ristow and colleagues at the University of Jena offer a reason why.

In an earlier study, Dr Ristow found a reduction in life span among roundworms given a diet high in sugar, whereas impairment of carbohydrate metabolism resulted in improved survival. In the current research, the team found that the administration of glucosamine resulted in an increase in roundworm lifespan of 5% in comparison with no treatment. When glucosamine was given to 100 week old mice, those receiving the compound experienced an increase in life span of nearly 10%. Further investigation revealed that glucosamine increased the breakdown of amino acids, which is what occurs in the absence of dietary carbohydrates. "This reflects the metabolic state of a low-carb diet due to glucosamine supplementation alone – while these mice ingested the same amount of carbohydrates as their unsupplemented counterparts," Dr Ristow explained.

In regard to supplementation, Dr Ristow stated that "This may be considered a valid option, and yes, I have started taking glucosamine myself." Due to glucosamine's inhibitory effect on carbohydrate metabolism, he recommended that "diabetics should perform tight blood glucose control, especially during the first weeks."

"Interestingly, two recent epidemiological studies on more than 77,000 individuals suggest that intake of glucosamine supplements is associated with reduced mortality in humans," he observed. "Unlike with our longer living mice, such an association is no definite proof of the effectiveness of glucosamine in humans. But the chances are good, and since unlike with most other potentially lifespan-extending drugs there are no known relevant side effects of glucosamine supplementation, I would tend to recommend this supplement."

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Health Concern

Arthritis – Osteoarthritis

Glucosamine is a component of larger compounds called glycosaminoglycans and proteoglycans, which help trap water in the matrix of cartilage, providing it with the flexibility and resilience it needs to function properly (Sanders 2011). In laboratory models, glucosamine has been shown to possess both anti-inflammatory and disease modifying effects in OA (Aghazadeh-Habashi 2011). In addition, researchers believe that glucosamine may repair cartilage by stimulating synthesis of chondrocytes (Fouladbakhsh 2012). Glucosamine also plays a crucial role in maintaining joint lubrication (Sanders 2011).

Commercial glucosamine preparations consist of either glucosamine hydrochloride or glucosamine sulfate (Miller 2011a). When compared to placebo, high-quality clinical data indicate that glucosamine sulfate is superior for relieving the severity of OA symptoms (Herrero-Beaumont 2007).

Although there remains some controversy in the conventional medical community over the effectiveness of glucosamine for osteoarthritis, most published studies show that glucosamine sulfate is effective and studies that have found otherwise have been limited by methodological flaws and dosing/formulation inconsistencies (Bijlsma 2011; Aghazadeh-Habashi 2011). Since glucosamine offers promise as structural support in osteoarthritis, additional research is planned (Seed 2011).

Because cartilage takes time to synthesize, and glucosamine is only one of its structural components, experts recommend up to 8 weeks of initial therapy before making an assessment concerning efficacy (Sanders 2011).

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