Glucosamine vs placebo: no difference for hip or knee OA in any subgroup

Takeaway

  • This meta-analysis found no evidence for a glucosamine effect on pain or function in osteoarthritis (OA), including in any prespecified patient subgroups.
  • Open access to trial data remains a largely unmet goal.

Why this matters

  • Evidence for glucosamine’s benefits in OA is weakening as better quality studies emerge.
  • Whether a greater or lesser effect might appear in patient subgroups is unknown.

Key results

  • 6 trials agreed to share data (5 using placebo control were analyzed).
  • 4 trials were of knee OA and 1 of hip OA (n=1625).
  • All studies had low risk for bias.
  • No outcome measure revealed a statistically significant difference between glucosamine and placebo in any subgroup.
  • Results were unchanged when analyzed for 4 knee OA trials (n=1403).

Study design

  • Meta-analysis of individual patient data on efficacy of oral glucosamine for knee, hip OA in predefined subgroups.
  • Subgroups based on pain, BMI, inflammation.
  • Researchers requested shared trial data from 21 randomized controlled trials from 1994 to 2014 in the OA Trial Bank.
  • Primary outcome: Pain severity during 3-6 mo and at ≥1 y follow-up.
  • Funding: Dutch Arthritis Foundation.

Limitations

  • Few trials' data available.
  • Many missing data in outcome measures of analyzed trials.

Runhaar J, Rozendaal RM, Middelkoop MV, Bijlsma HJW, Doherty M, Dziedzic KS, Lohmander LS, McAlindon T, Zhang W, Bierma Zeinstra S. Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank. Ann Rheum Dis. 2017 Jul 28 [Epub ahead of print]. doi: 10.1136/annrheumdis-2017-211149. PMID: 28754801

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