title: Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee.
abstract: This study aimed to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA). PubMed, Embase and Cochrane Library were searched through from inception to February 2015. A total of 54 studies covering 16427 patients were included. Glucosamine plus chondroitin, glucosamine alone, and celecoxib were all more effective than placebo in pain relief and function improvement. Specifically, celecoxib is most likely to be the best treatment option, followed by the combination group. All treatment options showed clinically significant improvement from baseline pain, but only glucosamine plus chondroitin showed clinically significant improvement from baseline function. In terms of the structure-modifying effect, both glucosamine alone and chondroitin alone achieved a statistically significant reduction in joint space narrowing. Although no significant difference was observed among the five options with respect to the three major adverse effects (withdrawal due to adverse events, serious adverse events and the number of patients with adverse events), the additional classical meta-analysis showed that celecoxib exhibited a higher rate of gastrointestinal adverse effect comparing with the placebo group. The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Chao
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.|Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Jie
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Yi-lun
authors.initials: YL
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Dong-xing
authors.initials: DX
authors.lastname: Xie
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Tuo
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Shu-guang
authors.initials: SG
authors.lastname: Gao
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Yu-sheng
authors.initials: YS
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China, 410008.
authors.forename: Guang-hua
authors.initials: GH
authors.lastname: Lei
mesh_terms: D018771:Arthralgia / Q000188:drug therapy / Q000209:etiology; D000068579:Celecoxib / Q000009:adverse effects / Q000627:therapeutic use*; D002807:Chondroitin / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005944:Glucosamine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D059408:Pain Management; D016896:Treatment Outcome
chemical_list: D002807:Chondroitin; D000068579:Celecoxib; D005944:Glucosamine