The Pharmaceutical Journal
Vol 280 No 7490 p207
23 February 2008

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Glucosamine not effective for hip osteoarthritis but use still debated

Glucosamine sulphate does not have clinically important effects on pain, function and stiffness when used by patients with hip osteoarthritis, a new study suggests (Annals of Internal Medicine 2008;148:268).

Researchers from the Netherlands conducted a two-year randomised placebo controlled trial to examine the effects of glucosamine on the symptoms and structural progression of the disease.

A total of 222 patients were enrolled and assigned to either 1,500mg glucosamine sulphate or placebo.

Using WOMAC pain and function subscales (developed by Western Ontario and McMaster Universities), the researchers did not observe clinically important differences in scores for glucosamine compared with placebo after 24 months. Neither did they observe a clinically important difference in joint space narrowing.

The authors of an accompanying editorial, however, suggest that glucosamine may still have a place in the management of osteoarthritis (ibid, p315). They highlight a previously published subgroup analysis from the same trial that had shown a trend towards reduction of pain and improvement of function in patients with generalised osteoarthritis compared with those who only had osteoarthritis of the hip.

“The results suggest that glucosamine sulphate might marginally affect osteoarthritis in joints other than the hips,” they say.

To support this view, the authors point out that clinical experience suggests that inflammation of synovial tissue is much more common in knee osteoarthritis. “Some have suggested that glucosamine sulphate targets synovitis, which might partially explain why glucosamine is more effective in knee osteoarthritis than in hip osteoarthritis.”

The authors of the editorial also suggest that a larger and longer study involving patients with more severe osteoarthritis (making it easier to see the effects of glucosamine) is necessary to conclude definitively that glucosamine does not impact on hip osteoarthritis.