title: Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens.
abstract: OBJECTIVE
  To determine if the dietary supplements, glucosamine and/or chondroitin, result in reduced joint space narrowing (JSN) and pain among people with symptomatic knee osteoarthritis.
  
  
  METHODS
  A double-blind randomised placebo-controlled clinical trial with 2-year follow-up. 605 participants, aged 45-75 years, reporting chronic knee pain and with evidence of medial tibio-femoral compartment narrowing (but retaining >2 mm medial joint space width) were randomised to once daily: glucosamine sulfate 1500 mg (n=152), chondroitin sulfate 800 mg (n=151), both dietary supplements (n=151) or matching placebo capsules (n=151). JSN (mm) over 2 years was measured from digitised knee radiographs. Maximum knee pain (0-10) was self-reported in a participant diary for 7 days every 2 months over 1 year.
  
  
  RESULTS
  After adjusting for factors associated with structural disease progression (gender, body mass index (BMI), baseline structural disease severity and Heberden's nodes), allocation to the dietary supplement combination (glucosamine-chondroitin) resulted in a statistically significant (p=0.046) reduction of 2-year JSN compared to placebo: mean difference 0.10 mm (95% CI 0.002 mm to 0.20 mm); no significant structural effect for the single treatment allocations was detected. All four allocation groups demonstrated reduced knee pain over the first year, but no significant between-group differences (p=0.93) were detected. 34 (6%) participants reported possibly-related adverse medical events over the 2-year follow-up period.
  
  
  CONCLUSIONS
  Allocation to the glucosamine-chondroitin combination resulted in a statistically significant reduction in JSN at 2 years. While all allocation groups demonstrated reduced knee pain over the study period, none of the treatment allocation groups demonstrated significant symptomatic benefit above placebo.
  NCT00513422; http://www.clinicaltrials.gov.
authors.affiliation: Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Marlene
authors.initials: M
authors.lastname: Fransen
authors.affiliation: Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0001-5180-6360
authors.initials: M
authors.lastname: Agaliotis
authors.affiliation: Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Lillias
authors.initials: L
authors.lastname: Nairn
authors.affiliation: Graduate School of Medicine, Notre Dame University, Darlinghurst, New South Wales, Australia.
authors.forename: Milana
authors.initials: M
authors.lastname: Votrubec
authors.affiliation: Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bridgett
authors.affiliation: Covance Pty Ltd, Sydney, New South Wales, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Su
authors.affiliation: The George Institute for Global Health, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.affiliation: Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
authors.forename: Lyn
authors.initials: L
authors.lastname: March
authors.affiliation: St George Hospital Clinical School, University of New South Wales, Kogarah, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Edmonds
authors.affiliation: The George Institute for Global Health, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Norton
authors.affiliation: The George Institute for Global Health, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.affiliation: Department of Clinical Pharmacology, St Vincent's Hospital and University of New South Wales, Darlinghurst, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Day
mesh_terms: D000368:Aged; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D019587:Dietary Supplements; D018450:Disease Progression; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; 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*; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D002809:Chondroitin Sulfates; D005944:Glucosamine
keywords: chondroitin; disease progression; glucosamine; osteoarthritis knee; pain