title: Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial.
abstract: BACKGROUND
  The effectiveness of glucosamine sulfate as a symptom and disease modifier for osteoarthritis is still under debate.
  
  
  OBJECTIVE
  To assess whether glucosamine sulfate has an effect on the symptoms and structural progression of hip osteoarthritis during 2 years of treatment.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Primary care in the Netherlands.
  
  
  METHODS
  222 patients with hip osteoarthritis who were recruited by their general practitioner. Patients were eligible if they met the American College of Rheumatology clinical criteria for hip osteoarthritis.
  
  
  METHODS
  2 years of treatment with 1500 mg of oral glucosamine sulfate or placebo once daily.
  
  
  METHODS
  Primary outcome measures were Western Ontario and McMaster Universities (WOMAC) pain and function subscales over 24 months and joint space narrowing after 24 months. The main secondary outcome measures were WOMAC pain, function, and stiffness after 3, 12, and 24 months.
  
  
  RESULTS
  At baseline, both groups were similar in demographic and clinical variables. Overall, WOMAC pain did not differ (mean difference [glucosamine sulfate minus placebo], -1.54 [95% CI, -5.43 to 2.36]), nor did WOMAC function (mean difference, -2.01 [CI, -5.38 to 1.36]). Joint space narrowing also did not differ after 24 months (mean difference, -0.029 [CI, -0.122 to 0.064]). Only 1 of the sensitivity analyses, based on extreme assumptions regarding missing assessments due to total hip replacement, provided results consistent with a glucosamine effect.
  
  
  CONCLUSIONS
  Twenty patients had total hip replacement during the trial. Half of the patients had a Kellgren and Lawrence score of 1.
  
  
  CONCLUSIONS
  Glucosamine sulfate was no better than placebo in reducing symptoms and progression of hip osteoarthritis. International Standard Randomised Controlled Trial Number: ISRCTN54513166.
authors.affiliation: Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands. r.rozendaal@erasmusmc.nl
authors.forename: Rianne M
authors.initials: RM
authors.lastname: Rozendaal
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Gerjo J V M
authors.initials: GJ
authors.lastname: van Osch
authors.forename: Elian J
authors.initials: EJ
authors.lastname: Uitterlinden
authors.forename: Eric H
authors.initials: EH
authors.lastname: Garling
authors.forename: Sten P
authors.initials: SP
authors.lastname: Willemsen
authors.forename: Abida Z
authors.initials: AZ
authors.lastname: Ginai
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
authors.forename: Harrie
authors.initials: H
authors.lastname: Weinans
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000284:Administration, Oral; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D018450:Disease Progression; D004311:Double-Blind Method; D005944:Glucosamine / Q000009:adverse effects / Q000627:therapeutic use*; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000517:prevention & control; D012680:Sensitivity and Specificity
chemical_list: D005944:Glucosamine