Re: Glucosamine and knee cartilage

[Guest guest]

(http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html)

>

> Jacque

---------------------------

Yes, in addition to the trial that I cited, the Lancet study was the

one I had been most impressed with because it was a randomized

controlled trial, and because it showed an effect on joint space. I'm

not too worried that there was no correlation between symptoms and

joint space maintenance and that these drugs were or were not

effective against symptoms. I actually have few symptoms, but, for

example, when I had to have an arthroscopy, my doc told me that I had

changes of osteoarthritis in my knees. So I'm taking it primarily in

an effort to maintain healthy cartilage, not to treat any symptoms.

From quackwatch (link above) - this is what they say about the Lancet

study, which is what I remember about it, also:

" In 2001, the Lancet published the results of a three-year

double-blind clinical trial involving 212 people with osteoarthritis

who took either glucosamine or a placebo. The researchers found that

symptoms improved 20% to 25% in the glucosamine group but worsened

slightly in the placebo group. The x-ray examinations showed that

serious narrowing of the knee-joint space -- a sign of progression of

the disease -- occurred in only half as many patients taking

glucosamine as in those receiving the placebo [3].However, the Medical

Letter has reported that the x-rays were questionably standardized;

there was little correlation between the joint-space changes and the

symptoms; and there was no difference between the glucosamine and

placebo groups in the use of standard medication to " rescue " patients

[4]. "

I had not been aware of the preliminary report of the NIH GAIT trial

at the Rheumatology meeting 3 months ago (see Jeff's post). I don't

think these results have been published. Trials often post

preliminary results at a national meeting, and then it often takes

another 6 months to a year for the results to be published. This

preliminary announcement had to do with symptoms of arthritis only -

it didn't mention anything either pro or con regarding maintenance of

joint space. It may be that they are still looking at that part of

the data, although you would think that if they found something very

strong, they would have reported this as well - but sometimes abstract

deadlines come, and the data from one part a study have been analyzed

completely, while other analyses are still ongoing.

In any case, these NIH trials are top notch, and this GAIT trial

should give everyone a good answer about whether

glucosamine/chondroitin do help maintain the joint space in people

with osteoarthritis.

There are some interesting back and forth discussions with the FDA on

this that you can find in Google. This one letter, apparently from

people who make glucosamine sulfate, suggest that the GAIT trial is

using glucosamine hydochloride - not the right compound, and they

defend the use of X-rays to look at cartilage space.

http://www.fda.gov/ohrms/dockets/dockets/04p0060/04p-0060-let0011-vol3.pdf

Like anything else in medical research, the closer you look at things,

the more controversy you find. But the point is, that there are a

number of randomized trials out there that suggest that this stuff may

work, and there appears to be no down side in taking it, other than

the expense.

Anyway, the GAIT study certainly did look at joint space widening:

http://www.clinicaltrials.gov/show/NCT00032890

So if any one knows of any reports of this trial that had to do with

the joint space results, it would be nice if you could provide a link.

Again, as far as I know, these results have not been reported yet.

[Guest guest]

(http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html)

>

> Jacque

---------------------------

Yes, in addition to the trial that I cited, the Lancet study was the

one I had been most impressed with because it was a randomized

controlled trial, and because it showed an effect on joint space. I'm

not too worried that there was no correlation between symptoms and

joint space maintenance and that these drugs were or were not

effective against symptoms. I actually have few symptoms, but, for

example, when I had to have an arthroscopy, my doc told me that I had

changes of osteoarthritis in my knees. So I'm taking it primarily in

an effort to maintain healthy cartilage, not to treat any symptoms.

From quackwatch (link above) - this is what they say about the Lancet

study, which is what I remember about it, also:

" In 2001, the Lancet published the results of a three-year

double-blind clinical trial involving 212 people with osteoarthritis

who took either glucosamine or a placebo. The researchers found that

symptoms improved 20% to 25% in the glucosamine group but worsened

slightly in the placebo group. The x-ray examinations showed that

serious narrowing of the knee-joint space -- a sign of progression of

the disease -- occurred in only half as many patients taking

glucosamine as in those receiving the placebo [3].However, the Medical

Letter has reported that the x-rays were questionably standardized;

there was little correlation between the joint-space changes and the

symptoms; and there was no difference between the glucosamine and

placebo groups in the use of standard medication to " rescue " patients

[4]. "

I had not been aware of the preliminary report of the NIH GAIT trial

at the Rheumatology meeting 3 months ago (see Jeff's post). I don't

think these results have been published. Trials often post

preliminary results at a national meeting, and then it often takes

another 6 months to a year for the results to be published. This

preliminary announcement had to do with symptoms of arthritis only -

it didn't mention anything either pro or con regarding maintenance of

joint space. It may be that they are still looking at that part of

the data, although you would think that if they found something very

strong, they would have reported this as well - but sometimes abstract

deadlines come, and the data from one part a study have been analyzed

completely, while other analyses are still ongoing.

In any case, these NIH trials are top notch, and this GAIT trial

should give everyone a good answer about whether

glucosamine/chondroitin do help maintain the joint space in people

with osteoarthritis.

There are some interesting back and forth discussions with the FDA on

this that you can find in Google. This one letter, apparently from

people who make glucosamine sulfate, suggest that the GAIT trial is

using glucosamine hydochloride - not the right compound, and they

defend the use of X-rays to look at cartilage space.

http://www.fda.gov/ohrms/dockets/dockets/04p0060/04p-0060-let0011-vol3.pdf

Like anything else in medical research, the closer you look at things,

the more controversy you find. But the point is, that there are a

number of randomized trials out there that suggest that this stuff may

work, and there appears to be no down side in taking it, other than

the expense.

Anyway, the GAIT study certainly did look at joint space widening:

http://www.clinicaltrials.gov/show/NCT00032890

So if any one knows of any reports of this trial that had to do with

the joint space results, it would be nice if you could provide a link.

Again, as far as I know, these results have not been reported yet.