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Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank.

Runhaar, J; Rozendaal, RM; van Middelkoop, M; Bijlsma, HJW; Doherty, M; Dziedzic, KS; Lohmander, LS; McAlindon, T; Zhang, W; Bierma Zeinstra, S


J Runhaar

RM Rozendaal

M van Middelkoop

HJW Bijlsma

M Doherty

LS Lohmander

T McAlindon

W Zhang

S Bierma Zeinstra


OBJECTIVE: To evaluate the effectiveness of oral glucosamine in subgroups of people with hip or knee osteoarthritis (OA) based on baseline pain severity, body mass index (BMI), sex, structural abnormalities and presence of inflammation using individual patient data. METHODS: After a systematic search of the literature and clinical trial registries, all randomised controlled trials (RCTs) evaluating the effect of any oral glucosamine substance in patients with clinically or radiographically defined hip or knee OA were contacted. As a minimum, pain, age, sex and BMI at baseline and pain as an outcome measure needed to be assessed. RESULTS: Of 21 eligible studies, six (n=1663) shared their trial data with the OA Trial Bank. Five trials (all independent of industry, n=1625) compared glucosamine with placebo, representing 55% of the total number of participants in all published placebo-controlled RCTs. Glucosamine was no better than placebo for pain or function at short (3 months) and long-term (24 months) follow-up. Glucosamine was also no better than placebo among the predefined subgroups. Stratification for knee OA and type of glucosamine did not alter these results. CONCLUSIONS: Although proposed and debated for several years, open trial data are not widely made available for studies of glucosamine for OA, especially those sponsored by industry. Currently, there is no good evidence to support the use of glucosamine for hip or knee OA and an absence of evidence to support specific consideration of glucosamine for any clinically relevant OA subgroup according to baseline pain severity, BMI, sex, structural abnormalities or presence of inflammation.

Journal Article Type Article
Acceptance Date Jun 26, 2017
Publication Date Oct 9, 2017
Journal Annals of the Rheumatic Diseases
Print ISSN 0003-4967
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 76
Issue 11
Pages 1862 - 1869
Publisher URL