Dr. Erika Kancler
Objective: To determine if over the counter supplements, chondroitin sulfate and glucosamine, in combination or alone, are effective in the treatment of joint space narrowing (JSN) in knee osteoarthritis.
Design: Systematic Literature Review
Methods: Database search of PubMed and MEDLINE using the search terms “glucosamine”, “chondroitin sulfate”, “osteoarthritis”, and joint space narrowing. Filters were implemented to include articles that only dealt with human subjects, that were published in 2000 or later, and were full-text. Articles were excluded if they were cohort studies, reviews, non-English papers, or had pain as the only outcome.
Results: Sawitzke et al.primary outcomes revealed no overall significant difference between mean JSW loss over a two-year period between treatment and placebo groups. Secondary outcomes showed no significant likelihood of radiographic progression with treatment groups versus placebo. Fransen et al.observed a significant decrease in JSN in 2 years with glucosamine and chondroitin sulfate combined but there was no statistical significant in JSN with glucosamine or chondroitin sulfate alone as compared to placebo. There was also a small reduction in knee pain observed versus placebo. The meta-analysis by Lee et. alobserved those studies in which there was a small protective effect on minimum JSN with glucosamine and chondroitin individually after two years but there was no statistical significance seen at one year.
Conclusion: Overall, studies showed that chondroitin sulfate, glucosamine, and especially the combination of the two, do have a small protective effect depending on the severity of knee osteoarthritis, the number of years the supplement is utilized, and the drug dosage.
Andrews, AS, Horton CR. Effects of glucosamine versus chondroitin sulfate in reducing joint space narrowing in knee osteoarthritis. JMU Scholarly Commons Physician Assistant Capstones. http://commons.lib.jmu.edu/pacapstones/27. Published May 16, 2017.