Open AccessThe effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: A report from the glucosamine/chondroitin arthritis intervention trial
Author(s) -
Sawitzke Allen D.,
Shi Helen,
Finco Martha F.,
Dunlop Dorothy D.,
Bingham Clifton O.,
Harris Crystal L.,
Singer Nora G.,
Bradley John D.,
Silver David,
Jackson Christopher G.,
Lane Nancy E.,
Oddis Chester V.,
Wolfe Fred,
Lisse Jeffrey,
Furst Daniel E.,
Reda Domenic J.,
Moskowitz Roland W.,
Williams H. James,
Clegg Daniel O.
Publication year - 2008
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.23973
Subject(s) - medicine , osteoarthritis , placebo , chondroitin sulfate , glucosamine , chondroitin , celecoxib , womac , arthritis , randomized controlled trial , arthropathy , surgery , pathology , glycosaminoglycan , chemistry , alternative medicine , organic chemistry , anatomy
Objective Osteoarthritis (OA) of the knee causes significant morbidity and current medical treatment is limited to symptom relief, while therapies able to slow structural damage remain elusive. This study was undertaken to evaluate the effect of glucosamine and chondroitin sulfate (CS), alone or in combination, as well as celecoxib and placebo on progressive loss of joint space width (JSW) in patients with knee OA. Methods A 24‐month, double‐blind, placebo‐controlled study, conducted at 9 sites in the United States as part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), enrolled 572 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence [K/L] grade 2 or grade 3 changes and JSW of at least 2 mm at baseline). Patients with primarily lateral compartment narrowing at any time point were excluded. Patients who had been randomized to 1 of the 5 groups in the GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The minimum medial tibiofemoral JSW was measured at baseline, 12 months, and 24 months. The primary outcome measure was the mean change in JSW from baseline. Results The mean JSW loss at 2 years in knees with OA in the placebo group, adjusted for design and clinical factors, was 0.166 mm. No statistically significant difference in mean JSW loss was observed in any treatment group compared with the placebo group. Treatment effects on K/L grade 2 knees, but not on K/L grade 3 knees, showed a trend toward improvement relative to the placebo group. The power of the study was diminished by the limited sample size, variance of JSW measurement, and a smaller than expected loss in JSW. Conclusion At 2 years, no treatment achieved a predefined threshold of clinically important difference in JSW loss as compared with placebo. However, knees with K/L grade 2 radiographic OA appeared to have the greatest potential for modification by these treatments.