nach oben

Erschienen in:

11.06.2018 | Systematic Review

Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials

verfasst von: Mario Simental-Mendía, Adriana Sánchez-García, Félix Vilchez-Cavazos, Carlos A. Acosta-Olivo, Víctor M. Peña-Martínez, Luis E. Simental-Mendía

Erschienen in: Rheumatology International | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Although glucosamine and chondroitin sulfate have showed beneficial effects on joint tissues in osteoarthritis (OA), their therapeutic use in the clinical setting is still debatable. Hence, a systematic review and meta-analysis of randomized placebo-controlled trials was conducted to investigate the efficacy of glucosamine and chondroitin sulfate on knee OA symptoms. Medline, SCOPUS, Web of Science, and Google Scholar databases were searched for randomized placebo-controlled trials evaluating the effect of orally administered glucosamine and/or chondroitin sulfate on OA symptoms using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and/or the Visual Analog Scale (VAS). Meta-analysis was conducted using a random-effects model and generic inverse-variance method. Heterogeneity was tested using the I² statistic index. Treatments with glucosamine and chondroitin were found to significantly reduce pain in VAS [weighted mean difference (WMD) − 7.41 mm, 95% CI − 14.31, − 0.51, p = 0.04 and WMD − 8.35 mm, 95% CI − 11.84, − 4.85, p < 0.00001, respectively]. Their combination did not show this behavior (WMD − 0.28 mm, 95% CI − 8.87, 8.32, p = 0.95). None of the glucosamine, chondroitin or their combination had a significant positive effect on the total WOMAC index and its subscores. Oral supplementation with glucosamine or chondroitin sulfate reduces pain in knee OA. However, there is no additional effect using both therapeutic agents in combination for the management of symptomatic knee OA.

Nelson AE (2018) Osteoarthritis year in review 2017: clinical. Osteoarthr Cartil 26:319–325. https://doi.org/10.1016/j.joca.2017.11.014 CrossRefPubMed

Yan M, Zhang J, Yang H, Sun Y (2018) The role of leptin in osteoarthritis. Medicine (Baltimore) 97:e0257. https://doi.org/10.1097/MD.0000000000010257 CrossRef

Frasca D, Blomberg BB, Paganelli R (2017) Aging, obesity, and inflammatory age-related diseases. Front Immunol 8:1745. https://doi.org/10.3389/fimmu.2017.01745 CrossRefPubMedPubMedCentral

Zhang W, Nuki G, Moskowitz RW et al (2010) OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil 18:476–499. https://doi.org/10.1016/j.joca.2010.01.013 CrossRefPubMed

Kalunian KC (2016) Current advances in therapies for osteoarthritis. Curr Opin Rheumatol 28:246–250. https://doi.org/10.1097/BOR.0000000000000273 CrossRefPubMed

Sherman AL, Ojeda-Correal G, Mena J (2012) Use of glucosamine and chondroitin in persons with osteoarthritis. PM&R 4:S110–S116. https://doi.org/10.1016/j.pmrj.2012.02.021 CrossRef

Largo R, Alvarez-Soria MA, Diez-Ortego I et al (2003) Glucosamine inhibits IL-1beta-induced NFκB activation in human osteoarthritic chondrocytes. Osteoarthr Cartil 11:290–298CrossRef

Towheed T, Maxwell L, Anastassiades TP et al (2009) Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD002946.pub2 CrossRef

Imagawa K, de Andrés MC, Hashimoto K et al (2011) The epigenetic effect of glucosamine and a nuclear factor-kappa B (NF-kB) inhibitor on primary human chondrocytes—implications for osteoarthritis. Biochem Biophys Res Commun 405:362–367. https://doi.org/10.1016/j.bbrc.2011.01.007 CrossRefPubMedPubMedCentral

10.

Chan PS, Caron JP, Orth MW (2006) Short-term gene expression changes in cartilage explants stimulated with interleukin beta plus glucosamine and chondroitin sulfate. J Rheumatol 33:1329–1340. https://doi.org/10.2460/ajvr.68.7.709 CrossRefPubMed

11.

Dalirfardouei R, Karimi G, Jamialahmadi K (2016) Molecular mechanisms and biomedical applications of glucosamine as a potential multifunctional therapeutic agent. Life Sci 152:21–29. https://doi.org/10.1016/j.lfs.2016.03.028 CrossRefPubMed

12.

Jawed H, Anjum S, Awan SI, Simjee SU (2011) Anti-arthritic effect of GN1, a novel synthetic analog of glucosamine, in the collagen-induced arthritis model in rats. Inflamm Res 60:1113–1120. https://doi.org/10.1007/s00011-011-0375-9 CrossRefPubMed

13.

Pearle AD, Warren RF, Rodeo SA (2005) Basic science of articular cartilage and osteoarthritis. Clin Sports Med 24:1–12. https://doi.org/10.1016/j.csm.2004.08.007 CrossRefPubMed

14.

Hui JH, Chan SW, Li J et al (2007) Intra-articular delivery of chondroitin sulfate for the treatment of joint defects in rabbit model. J Mol Histol 38:483–489. https://doi.org/10.1007/s10735-007-9120-7 CrossRefPubMed

15.

Monfort J, Pelletier J-P, Garcia-Giralt N, Martel-Pelletier J (2008) Biochemical basis of the effect of chondroitin sulphate on osteoarthritis articular tissues. Ann Rheum Dis 67:735–740. https://doi.org/10.1136/ard.2006.068882 CrossRefPubMed

16.

Ronca F, Palmieri L, Panicucci P, Ronca G (1998) Anti-inflammatory activity of chondroitin sulfate. Osteoarthr Cartil 6(Suppl A):14–21CrossRef

17.

Uitterlinden EJ, Jahr H, Koevoet JLM et al (2006) Glucosamine decreases expression of anabolic and catabolic genes in human osteoarthritic cartilage explants. Osteoarthr Cartil 14:250–257. https://doi.org/10.1016/j.joca.2005.10.001 CrossRefPubMed

18.

Henrotin Y, Marty M, Mobasheri A (2014) What is the current status of chondroitin sulfate and glucosamine for the treatment of knee osteoarthritis? Maturitas 78:184–187. https://doi.org/10.1016/j.maturitas.2014.04.015 CrossRefPubMed

19.

Bruyère O, Cooper C, Pelletier JP et al (2014) An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 44:253–263. https://doi.org/10.1016/j.semarthrit.2014.05.014 CrossRefPubMed

20.

Mazie B, Hucher M, Zaı M et al (2004) Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthr Cartil 6:2113–2123. https://doi.org/10.1056/NEJMoa1208410 CrossRef

21.

Roman-Blas JA, Castañeda S, Sánchez-Pernaute O et al. (2016) Chondroitin sulfate plus glucosamine sulfate shows no superiority over placebo in a randomized, double-blind, placebo-controlled clinical trial in patients with knee osteoarthritis. Arthritis Rheumatol (Hoboken, NJ). https://doi.org/10.1002/art.39819 CrossRef

22.

Fransen M, Agaliotis M, Nairn L et al (2015) Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Ann Rheum Dis 74:851–858. https://doi.org/10.1136/annrheumdis-2013-203954 CrossRefPubMed

23.

Lugo JP, Saiyed ZM, Lane NE (2016) Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J 15:14. https://doi.org/10.1186/s12937-016-0130-8 CrossRefPubMedPubMedCentral

24.

Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535. https://doi.org/10.1136/bmj.b2535 CrossRefPubMedPubMedCentral

25.

Higgins J, Green S (eds) (2009) Cochrane handbook for systematic reviews of interventions, Version 5.0.2. The Cochrane Collaboration, London

26.

Sutton AJ, Abrams KR, Jones DR et al (2000) Methods for meta-analysis in medical research. West Sussex, Wiley

27.

Cibere J, Kopec JA, Thorne A et al (2004) Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Care Res 51:738–745. https://doi.org/10.1002/art.20697 CrossRef

28.

Frestedt JL, Walsh M, Kuskowski MA, Zenk JL (2008) A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Nutr J 7:9. https://doi.org/10.1186/1475-2891-7-9 CrossRefPubMedPubMedCentral

29.

Giordano N, Fioravanti A, Papakostas P et al (2009) The efficacy and tolerability of glucosamine sulfate in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled trial. Curr Ther Res Clin Exp 70:185–196. https://doi.org/10.1016/j.curtheres.2009.05.004 CrossRefPubMedPubMedCentral

30.

Herrero-Beaumont G, Román Ivorra JA, Trabado MDC et al (2007) Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 56:555–567. https://doi.org/10.1002/art.22371 CrossRefPubMed

31.

Madhu K, Chanda K, Saji MJ (2013) Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial. Inflammopharmacology 21:129–136. https://doi.org/10.1007/s10787-012-0163-3 CrossRefPubMed

32.

Pavelka K, MD P, Gatterova J et al (2002) Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 162:2113–2123. https://doi.org/10.1001/archinte.162.18.2113 CrossRefPubMed

33.

Rindone JP, Hiller D, Collacott E et al (2000) Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med 172:91–94. https://doi.org/10.1136/ewjm.172.2.91 CrossRefPubMedPubMedCentral

34.

Petersen SG, Beyer N, Hansen M et al (2011) Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Arch Phys Med Rehabil 92:1185–1193. https://doi.org/10.1016/j.apmr.2011.03.009 CrossRefPubMed

35.

Reginster JY, Deroisy R, Rovati LC et al (2001) Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 357:251–256. https://doi.org/10.1016/S0140-6736(00)03610-2 CrossRefPubMed

36.

Clegg DO, Reda DJ, Harris CL et al (2006) Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 354:795–808. https://doi.org/10.1056/NEJMoa052771 CrossRefPubMed

37.

Kwoh CK, Roemer FW, Hannon MJ et al (2014) Effect of oral glucosamine on joint structure in individuals with chronic knee pain: a randomized, placebo-controlled clinical trial. Arthritis Rheumatol 66:930–939. https://doi.org/10.1002/art.38314 CrossRefPubMedPubMedCentral

38.

McAlindon T, Formica M, LaValley M et al (2004) Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial. Am J Med 117:643–649. https://doi.org/10.1016/j.amjmed.2004.06.023 CrossRefPubMed

39.

Bourgeois P, Chales G, Dehais J et al (1998) Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3 × 400 mg/day vs placebo. Osteoarthr Cartil 6:25–30. https://doi.org/10.1016/S1063-4584(98)80008-3 CrossRefPubMed

40.

Zegels B, Crozes P, Uebelhart D et al (2013) Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4 & 6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study. Osteoarthr Cartil 21:22–27. https://doi.org/10.1016/j.joca.2012.09.017 CrossRefPubMed

41.

Bucsi L, Poór G (1998) Efficacy and tolerability of oral chondroitin sulfate as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) in the treatment of knee osteoarthritis. Osteoarthr Cartil 6:31–36. https://doi.org/10.1016/S1063-4584(98)80009-5 CrossRefPubMed

42.

Möller I, Pérez M, Monfort J et al (2010) Effectiveness of chondroitin sulphate in patients with concomitant knee osteoarthritis and psoriasis: a randomized, double-blind, placebo-controlled study. Osteoarthr Cartil 18:S32–S40. https://doi.org/10.1016/j.joca.2010.01.018 CrossRefPubMed

43.

Reginster J-Y, Dudler J, Blicharski T, Pavelka K (2017) Pharmaceutical-grade chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo trial (CONCEPT). Ann Rheum Dis 76:1537–1543. https://doi.org/10.1136/annrheumdis-2016-210860 CrossRefPubMedPubMedCentral

44.

Uebelhart D (1998) Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthr Cartil 6:35–42. https://doi.org/10.1016/S1063-4584(98)80011-3 CrossRef

45.

Uebelhart D, Malaise M, Marcolongo R et al (2004) Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a 1-year, randomized, double-blind, multicenter study versus placebo. Osteoarthr Cartil 12:269–276. https://doi.org/10.1016/j.joca.2004.01.004 CrossRefPubMed

46.

Wildi LM, Raynauld J, Martel-pelletier J et al (2011) Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI. Ann Rheum Dis 70:982–989. https://doi.org/10.1136/ard.2010.140848 CrossRefPubMedPubMedCentral

47.

Kahan A, Uebelhart D, De Vathaire F et al (2009) Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a 2-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 60:524–533. https://doi.org/10.1002/art.24255 CrossRefPubMed

48.

Mazières B, Combe B, Phan Van A et al (2001) Chondroitin sulfate in osteoarthritis of the knee: a prospective, double blind, placebo controlled multicenter clinical study. J Rheumatol 28:173–181PubMed

49.

Mazières B, Hucher M, Zaïm M, Garnero P (2007) Effect of chondroitin sulphate in symptomatic knee osteoarthritis: a multicentre, randomised, double-blind, placebo-controlled study. Ann Rheum Dis 66:639–645. https://doi.org/10.1136/ard.2006.059899 CrossRefPubMedPubMedCentral

50.

Railhac J-J, Zaim M, Saurel A-S et al (2012) Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI. Clin Rheumatol 31:1347–1357. https://doi.org/10.1007/s10067-012-2022-4 CrossRefPubMed

51.

Lubis AMT, Siagian C, Wonggokusuma E et al (2017) Comparison of glucosamine–chondroitin sulfate with and without methylsulfonylmethane in grade I–II knee osteoarthritis: a double blind randomized controlled trial. Acta Med Indones 49:105–111PubMed

52.

Messier SP, Mihalko S, Loeser RF et al (2007) Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study. Osteoarthr Cartil 15:1256–1266. https://doi.org/10.1016/j.joca.2007.04.016 CrossRefPubMed

53.

Liu X, Machado GC, Eyles JP et al (2018) Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Br J Sports Med 52:167–175. https://doi.org/10.1136/bjsports-2016-097333 CrossRefPubMed

54.

Singh JA, Noorbaloochi S, MacDonald R, Maxwell LJ (2015) Chondroitin for osteoarthritis. Cochrane database Syst Rev 1:CD005614. https://doi.org/10.1002/14651858.CD005614.pub2 CrossRefPubMedPubMedCentral

55.

Henrotin Y, Lambert C (2013) Chondroitin and glucosamine in the management of osteoarthritis: an update. Curr Rheumatol Rep 15:361. https://doi.org/10.1007/s11926-013-0361-z CrossRefPubMed

56.

Hochberg MC, Martel-Pelletier J, Monfort J et al (2016) Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis 75:37–44. https://doi.org/10.1136/annrheumdis-2014-206792 CrossRefPubMed

57.

Zeng C, Wei J, Lei G (2015) Is chondroitin sulfate plus glucosamine superior to placebo in the treatment of knee osteoarthritis? Ann Rheum Dis 74:e37–e37. https://doi.org/10.1136/annrheumdis-2015-207476 CrossRefPubMed

58.

Zhang W, Robertson J, Jones AC, Dieppe PA, Doherty M (2008) The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials. Ann Rheum Dis 67(12):1716–1723. https://doi.org/10.1136/ard.2008.092015 CrossRefPubMed

59.

Henrotin Y, Mobasheri A, Marty M (2012) Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis? Arthritis Res Ther 14:201. https://doi.org/10.1186/ar3657 CrossRefPubMedPubMedCentral

60.

Du Souich P (2014) Absorption, distribution and mechanism of action of SYSADOAS. Pharmacol Ther 142:362–374. https://doi.org/10.1016/j.pharmthera.2014.01.002 CrossRefPubMed

Titel: Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials
verfasst von: Mario Simental-Mendía
Adriana Sánchez-García
Félix Vilchez-Cavazos
Carlos A. Acosta-Olivo
Víctor M. Peña-Martínez
Luis E. Simental-Mendía
Publikationsdatum: 11.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Rheumatology International / Ausgabe 8/2018
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-018-4077-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

11.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Im Battle of Experts traten zwei Experten auf dem Diabeteskongress gegeneinander an: Die eine vertrat die Auffassung „Sport statt Spritze“ bei Adipositas und Typ-2-Diabetes, der andere forderte „Spritze statt Sport!“ Am Ende waren sie sich aber einig: Die Kombination aus beidem erzielt die besten Ergebnisse.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

Vorsicht, erhöhte Blutungsgefahr nach PCI!

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

Update Innere Medizin

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2018

Recognition and control of hypertension, diabetes, and dyslipidemia in patients with rheumatoid arthritis

Rheumatoid factor isotype and Ro epitope distribution in primary Sjögren syndrome and rheumatoid arthritis with keratoconjunctivitis sicca

The many faces of IgG4-related disease: report of a case with inaugural recurrent aortic aneurism ruptures and literature review

Cardiopulmonary factors affecting 6-min walk distance in patients with idiopathic inflammatory myopathies

Novel insights into the role of inflammasomes in autoimmune and metabolic rheumatic diseases

2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

Vorsicht, erhöhte Blutungsgefahr nach PCI!

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

Update Innere Medizin