Efficacy of glucosamine, chondroitin sulfate may depend on level of osteoarthritis pain

The popular dietary supplements glucosamine and chondroitin sulfate proved no better than a placebo in relieving osteoarthritis knee pain in most participants of a major national trial. But the study, published in the Feb. 23 issue of the New England Journal of Medicine, also showed a smaller subgroup of trial patients with moderate to severe osteoarthritis knee pain taking the combination of the two supplements experienced significant pain relief.

"For the study population as a whole, supplements were found to be ineffective," said rheumatologist Daniel O. Clegg, M.D., professor of medicine at the University of Utah School of Medicine, chief of rheumatology at the George E. Wahlen Veterans Affairs Medical Center in Salt Lake City, and principal investigator for the national trial. "An exploratory analysis suggested, however, that the combination of glucosamine and chondroitin sulfate might be effective in patients who suffer from moderate to severe osteoarthritis knee pain."

Glucosamine, an amino sugar the body produces and distributes in cartilage and other connective tissue, and chondroitin sulfate, a complex carbohydrate that helps cartilage retain water, have become popular remedies among osteoarthritis sufferers in recent decades. But evidence of the supplements' ability to control pain had been anecdotal.

The five-year, $12.5 million Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) was designed to rigorously assess the efficacy and safety of glucosamine and chondroitin sulfate, taken either separately or in combination. Nearly 1,600 patients with painful knee osteoarthritis were enrolled in the trial and randomly assigned to take placebo, celecoxib (a widely prescribed arthritis pain drug), glucosamine, chondroitin sulfate, or a combination of the two supplements for 24 weeks. Of the 1,583 study patients, 78 percent were in the mild knee pain subgroup and the remaining 22 percent were in the moderate to severe subgroup.

Contact: Phil Sahm
University of Utah Health Sciences Center

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