Glucosamine sulfate might have no effect on pain or structural changes associated with osteoarthritis

Abstract

Clinical trials of glucosamine for the treatment of patients with osteoarthritis have produced conflicting results that seem to correlate with the form of glucosamine used. Trials of glucosamine hydrochloride have produced data indicating that this form of glucosamine is no more efficacious than placebo. Trials that have demonstrated a good efficacy of glucosamine are those that tested glucosamine sulfate, and are limited almost exclusively to those carried out by Rottapharm, a producer of one brand of glucosamine sulfate. Rozendaal et al. recently performed a well-designed, 2-year, randomized, double-blind clinical trial that tested glucosamine sulfate (compared with matched placebo) in patients with hip osteoarthritis. Although the authors did not use the Rottapharm product, they did use a regimen suggested by Rottapharm as being efficacious. The Rozendaal et al. trial found no effect of glucosamine sulfate on either pain or X-ray-detected structural changes associated with hip osteoarthritis. This study persuasively challenges claims that glucosamine acts as a disease modifier and that it alleviates pain. More publicly funded trials are needed, especially those of the Rottapharm glucosamine sulfate compound.