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Glucosamine and chondroitin sulphate ‘delays cartilage loss’ in osteoarthritis

Glucosamine and chondroitin sulphate slows cartilage loss in the knee joints of patients with knee osteoarthritis, report researchers.

They found that the combination was effective irrespective of the severity of the disease and whether patients also took analgesics or NSAIDs.

The team from Canada looked at knee joint MRI scans of 600 patients with knee osteoarthritis, which were done over a two-year period between 2004 and 2006, to study the impact of treatment with conventional pharmacological treatments and glucosamine/chondroitin sulphate.

Half the patients were taking analgesics/NSAIDs and 113 of these were also taking glucosamine/chondroitin sulphate, while 90 patients were taking glucosamine/chondroitin sulphate alone.

Patients on analgesics/NSAIDs had more severe symptoms and joint structural damage at baseline and worse disease progression over time, than those not taking these drugs. The patients taking both analgesics/NSAIDs and glucosamine sulphate had milder disease than those taking analgesics/NSAIDs alone.

Over the two years, patients taking analgesics/NSAIDs and glucosamine/chondroitin sulphate lost less of their cartilage volume in the global joint compartment than those on analgesics alone.

Similarly patients taking glucosamine/chondroitin sulphate only had significantly less cartilage loss in the medial central plateau than patients taking neither conventional drugs nor glucosamine/chondroitin sulphate.

The researchers concluded: ‘Participants with symptomatic radiographic osteoarthritis of the knee who received conventional pharmacological treatment had more severe disease symptoms and structural changes at the onset of the study, and tended to have more rapid structural progression over time.

‘Despite this, there was evidence of a beneficial effect of the glucosamine/chondroitin sulphate at delaying knee osteoarthritis structural progression (cartilage loss), whether they took osteoarthritis pharmacological treatment or not.’

NICE previously advised against using glucosamine or chondroitin formulations for osteoarthritis, in 2008 guidance. Since then prescribed forms of glucosamine have been made available, however a draft update of the NICE guidance still recommends GPs ‘not offer glucosamine or chondroitin products for the management of osteoarthritis’.

Ann Rheum Dis; available online 13 December 2013

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