Supplements as Good as Prescription for OA Knee Pain
The results of a new clinical study presented at the Annual Scientific Meeting of the American College of Rheumatology (Nov. 14, 2005) suggest that the combination of glucosamine and chondroitin sulfate is at least as effective as the prescription drug celecoxib (Celebrex) in treating pain caused by moderate to severe osteoarthritis (OA) of the knee.
Glucosamine is a naturally occurring molecule that the body uses to build joint cartilage. Most studies have shown that glucosamine (usually given as glucosamine sulfate) can relieve OA pain and slow progression of the disease, presumably by helping to repair damaged joint tissue. Chondroitin, another component of joint cartilage, has also been found to slow OA progression and to have an anti-inflammatory effect.
In the new study, 1,258 people with OA of the knee were randomly assigned to receive one of the following for 24 weeks: 500 mg of glucosamine (in the form of glucosamine hydrochloride) three times a day; 400 mg of chondroitin sulfate three times a day; 500 mg of glucosamine and 400 mg of chondroitin sulfate, each three times a day; 200 mg per day of celecoxib, a prescription anti-inflammatory medication; or a placebo. The response rate was defined as the proportion of patients in each group who experienced at least a 20% improvement in pain.
Among people with moderate to severe symptoms, the response rates were 79% with combination therapy, 69% with celecoxib, 66% with glucosamine, 61% with chondroitin sulfate, and 54% with placebo. Only the response rates in the combination-therapy and celecoxib groups were statistically significant compared with the placebo group. However, in the study as a whole, and in the subset of people with mild OA, celecoxib was the only treatment found significantly more effective than the placebo. All treatments were well tolerated.
The results of this study suggest that the combination of glucosamine and chondroitin sulfate is more effective than a placebo, and at least as effective as celecoxib, for moderate to severe OA of the knee, although this combination did not appear to be effective for milder arthritis. Combination treatment was also more effective than glucosamine or chondroitin sulfate alone, but it was not clear whether these differences were statistically significant. It should be noted that previous research has suggested that glucosamine sulfate is more effective than glucosamine hydrochloride, the form of glucosamine used in the new study, so additional research is needed to determine whether combination therapy is more effective than glucosamine sulfate alone.
An expert in nutritional therapies, Chief Medical Editor Alan R. Gaby is a former professor at Bastyr University of Natural Health Sciences, where he served as the Endowed Professor of Nutrition. He is past-president of the American Holistic Medical Association and gave expert testimony to the White House Commission on Complementary and Alternative Medicine on the cost-effectiveness of nutritional supplements. Dr. Gaby has conducted nutritional seminars for physicians and has collected over 30,000 scientific papers related to the field of nutritional and natural medicine. In addition to editing and contributing to The Natural Pharmacy (Three Rivers Press, 1999), and the A–Z Guide to Drug-Herb-Vitamin Interactions (Three Rivers Press, 1999), Dr. Gaby has authored Preventing and Reversing Osteoporosis (Prima Lifestyles, 1995) and B6: The Natural Healer (Keats, 1987) and coauthored The Patient's Book of Natural Healing (Prima, 1999).
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