Meta-analysis of 54 studies supports use of glucosamine and chondroitin as combination therapy for knee osteoarthritis (OA)

Nutramax Laboratories Consumer Care has announced the publication of a meta-analysis that provides evidence for the symptomatic efficacy of glucosamine and chondroitin as a combination therapy for patients with osteoarthritis (OA) of the knee.

The results of the meta-analysis, which appear in the 18 November issue of Scientific Reports, conclude that the combination of glucosamine and chondroitin is associated with significant improvement in pain relief and functional enhancement, compared with a placebo, while avoiding the high rate of gastrointestinal (GI) adverse effects (AEs) observed in patients receiving celecoxib, a selective non-steroidal anti-inflammatory drug (NSAID).

The meta-analysis comprises data from 54 studies covering 16,427 patients with knee OA. According to the authors, it is the first network meta-analysis (one that compares a set of treatments) to compare glucosamine, chondroitin, and the two in combination against celecoxib or a placebo in the treatment of knee OA.

'This comprehensive analysis provides us with a wealth of historical data supporting the safety and efficacy of glucosamine and chondroitin in the management of joint health. It is consistent with recent findings suggesting that the efficacy of this combination is comparable with celecoxib in terms of relieving pain and improving function,' said lead author Chao Zeng, MD, of the Department of Orthopaedics at Xiangya Hospital at Central South University in Changsha, China. 'This is important news for patients requiring long-term treatment, as the potential side-effects associated with profiles of NSAIDs such as celecoxib warrant consideration of alternative treatment options that are safe and effective.'

The investigators conducted an online search of electronic databases including PubMed, Embase and the Cochrane Library to select the 54 randomised clinical trials (RCTs) that comprised the meta-analysis. In the 34 RCTs reporting changes in pain scores from baseline (as measured via a 10cm visual analogue scale [VAS]), celecoxib, glucosamine alone, chondroitin alone, and the glucosamine/chondroitin combination were all significantly superior to a placebo in relieving pain. However, only glucosamine plus chondroitin showed a clinically significant functional improvement from baseline, versus the placebo.

Additionally, although no significant difference was observed among the five treatment options with respect to three 'major' AEs (withdrawal owing to AEs, serious AEs and the number of patients with AEs), a 'classical' meta-analysis (one that compares two treatments) showed that celecoxib was the only treatment option exhibiting a higher incidence of GI AEs versus a placebo.

'Our team at Nutramax Laboratories continues to support quality clinical trials of glucosamine HCl and chondroitin sulfate and we are pleased to see, once again, third party evidence that further supports our earlier research demonstrating the effectiveness and safety of this combination,' said Dr Brian Cornblatt, Medical Director of Nutramax Laboratories Consumer Care, Inc.

'The results of this meta-analysis, combined with a wealth of recent evidence from well controlled trials, further validates the benefits of glucosamine HCl and chondroitin sulfate, while also providing additional impetus for physicians to reexamine professional practice guidelines on the use of this supplement combination to manage joint health,' he added.