CHONDROITIN, GLUCOSAMINE & PREVENTION OF JOINT SPACE LOSSES – MIXED RESULTS FROM NEW RESEARCH

In the fall of 2008, a paper was published that was an extension of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT)¹, which I summarized in Dynamic Chiropractic ². 572 of the 1583 subjects continued to take one of five treatments for an additional 2 years: 1) Glucosamine 1500 mg/day, 2) Chondroitin 1200 mg/day, 3) Glucosamine (1500 mg) and chondroitin (1200 mg), 4) Celebrex 200 mg/day or 5) placebo for 24 months. Knee joint space was measured radiographically at baseline, 12 and 24 months. The mean two-year loss in joint space (with adjustment for diseases and other risk factors) was as follows:

A few months later another two-year study was published. 622 patients with knee arthritis randomly received either 800 mg of chondroitin sulfate or a placebo for two years. Radiographic analysis at baseline, 12 and 24 months was done. After 2 years the mean joint space losses were as follows :

The authors concluded that the radiographic progression of joint space loss was reduced in the patients who took chondroitin sulfate compared to placebo. The authors noted pain was also noticeably reduced in the chondroitin group. This conflicted with the conclusion of the GAIT extension, which, according to the authors, were statistically insignificant .

Conclusion

For some people, glucosamine and chondroitin will have varying degrees of benefit. Research has yet to determine who will be a responder, nor can we say if chondroitin, glucosamine or the combination deliver the best results. Until that happens, the best advice we can give to our patients is to take a trial and error approach and stick to what works best .

1. Sawitzke, A.D., Shi, H., Finco, M.F., el al. The Effect of Glucosamine and/or Chondroitin Sulfate on the Progression of Knee Osteoarthritis: A Report From the Glucosamine/Chondroitin Arthritis Intervention Trial. Arthritis and Rheum 2008;58(10): 3183-3191.

2. Andersen, G.D. The Glucosamine/Chondroitin Arthritis Intervention Trial.

Dynamic Chiropractic 2006;24(13) p18

3. Kahan, A, Uebelhart, D., DeVathaire, F. et al. Long-Term Effects of Chondroitin (4 and 6 Sulfate) on Knee Osteoarthritis: The Study on Osteoarthritis Progression Prevention, A TwoYear, Randomized, Double- Blind, Placebo-controlled Trial. Arthritis and Rheum 2009; 60(2):524-533.