title: Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial.
abstract: BACKGROUND
  Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms.
  
  
  METHODS
  We did a randomised, double-blind placebo controlled trial, in which 212 patients with knee osteoarthritis were randomly assigned 1500 mg sulphate oral glucosamine or placebo once daily for 3 years. Weightbearing, anteroposterior radiographs of each knee in full extension were taken at enrolment and after 1 and 3 years. Mean joint-space width of the medial compartment of the tibiofemoral joint was assessed by digital image analysis, whereas minimum joint-space width--ie, at the narrowest point--was measured by visual inspection with a magnifying lens. Symptoms were scored by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index.
  
  
  RESULTS
  The 106 patients on placebo had a progressive joint-space narrowing, with a mean joint-space loss after 3 years of -0.31 mm (95% CI -0.48 to -0.13). There was no significant joint-space loss in the 106 patients on glucosamine sulphate: -0.06 mm (-0.22 to 0.09). Similar results were reported with minimum joint-space narrowing. As assessed by WOMAC scores, symptoms worsened slightly in patients on placebo compared with the improvement observed after treatment with glucosamine sulphate. There were no differences in safety or reasons for early withdrawal between the treatment and placebo groups.
  
  
  CONCLUSIONS
  The long-term combined structure-modifying and symptom-modifying effects of gluosamine sulphate suggest that it could be a disease modifying agent in osteoarthritis.
authors.affiliation: Bone and Cartilage Metabolism Research Unit (WHO Collaborating Center for Public Aspects of Osteoarticular Disorders), University of Liege, Belgium. jyreginster@ulg.ac.be
authors.forename: J Y
authors.initials: JY
authors.lastname: Reginster
authors.forename: R
authors.initials: R
authors.lastname: Deroisy
authors.forename: L C
authors.initials: LC
authors.lastname: Rovati
authors.forename: R L
authors.initials: RL
authors.lastname: Lee
authors.forename: E
authors.initials: E
authors.lastname: Lejeune
authors.forename: O
authors.initials: O
authors.lastname: Bruyere
authors.forename: G
authors.initials: G
authors.lastname: Giacovelli
authors.forename: Y
authors.initials: Y
authors.lastname: Henrotin
authors.forename: J E
authors.initials: JE
authors.lastname: Dacre
authors.forename: C
authors.initials: C
authors.lastname: Gossett
mesh_terms: D000284:Administration, Oral; D000368:Aged; D019587:Dietary Supplements; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D005944:Glucosamine / Q000627:therapeutic use*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010919:Placebos; D011859:Radiography; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D010919:Placebos; D005944:Glucosamine