Study: Glucosamine and Chondrotin Should Be Considered First for Knee Osteoarthritis

Doctors should consider glucosamine and chondroitin as first-line treatment to reduce the symptoms of knee osteoarthritis, according to a report in the December issue of the Journal of Family Practice.

In a synopsis of a recently conducted study, researchers from St. John's Mercy Medical Center in St. Louis said these two supplements to be particularly useful for patients who do not fare well on non-steroidal anti-inflammatory drugs.

However, the researchers noted that glucosamine and chondroitin should not be used for the sole purpose of slowing the progression of knee osteoarthritis since it is uncertain whether they actually do so.

The study looked at the safety and effectiveness of glucosamine or chondroitin on joint space narrowing, pain and function in 1,775 patients with knee osteoarthritis. Patients taking daily doses of glucosamine for three years demonstrated less joint space narrowing than those taking a placebo.

The study also found that those taking daily doses of either glucosamine or chondroitin for four weeks experienced less pain and greater mobility than those taking a placebo. Participants taking glucosamine or chondroitin did not experience more adverse reactions compared with a placebo.

Dr. Terry Seaton, a board-certified pharmacotherapy specialist who helped prepare the synopsis, told Medical Week that taking either glucosamine or chondroitin appears to be beneficial.

"The two are often sold as a combination product, but we do not yet know if the combination is more effective or not," he said. "Because they are supplements, there is no standardization and therefore it is possible that the products might differ in efficacy."

Given the wide range in price of such products, Seaton recommended that patients begin with a less-expensive product to see if it works. "If after a few weeks there is little to no benefit, then it may be worth trying a more expensive product," he added.

In general, Seaton said patients may try these products on their own first without the advice of their physician. However, he noted that they should seek medical advice if any of the following occurs:

• An injury has caused the symptoms;
  
• Signs of infection (swelling, redness, warmth, fever and limited mobility/range of motion) occur;
  
• The patient is under 30 years of age. It is less likely that their problem is osteoarthritis, but could be something more serious such as cancer;
• If other joints are involved or if they have a rash (could be rheumatoid arthritis or lupus).
  
  

Other sources: Journal of Family Practice