Evidence-based practice: review of clinical evidence on the efficacy of glucosamine and chondroitin in the treatment of osteoarthritis.
OBJECTIVE
To evaluate past and current evidence from randomized controlled trials on the efficacy of glucosamine sulfate (GS), glucosamine hydrochloride (GH), and chondroitin sulfate (CS) for the treatment of osteoarthritis (OA).


METHODS
An extensive review of four meta-analyses and a review of the findings of the recently published Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) funded by the National Institutes of Health.


RESULTS
Review of previous studies on the efficacy of GS, GH, and CS in the treatment of OA showed inconclusive results because of weak research design. The GAIT attempted to provide clarity on the use of GH and CS in treating knee pain from OA by using a rigorous research design to elicit cause and effect. The GAIT results showed that GH and CS were not effective in reducing knee pain in the study group overall; however, these may be effective in combination for patients with moderate-to-severe knee pain.


CONCLUSIONS
There is now clinical evidence indicating that recommending GS, GH, and CS for the treatment of mild knee pain from OA is ineffective. Further research needs to be done to identify specific characteristics in patients that results in a positive response. Until the findings of the GAIT undergo further peer review, the results of the research needs to be interpreted with caution.
Distler
John
J
Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, USA. distler@son.umaryland.edu
Anguelouch
Amanda
A
D002807:Chondroitin / Q000627:therapeutic use*; D004338:Drug Combinations; D019317:Evidence-Based Medicine; D005944:Glucosamine / Q000627:therapeutic use*; D006301:Health Services Needs and Demand; D006801:Humans; D015201:Meta-Analysis as Topic; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012720:Severity of Illness Index; D016896:Treatment Outcome
D004338:Drug Combinations; D004366:Nonprescription Drugs; D002807:Chondroitin; D005944:Glucosamine