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Overall, the physician rating at 4 weeks identified 45% of subjects as symptom-free and 39% as improved in the glucosamine group, compared to 32% of subjects symptom-free and 45% as improved in the ibuprofen group. narcotic pain medication Gold shots for rheumatoid arthritis. At the end of the 2-week wash-out period, however, the glucosamine group had a significantly better improvement rating than did the ibuprofen group, with 55% of the glucosamine-treated subjects being symptom-free compared with 36% in the ibuprofen group. Reginster et alref 6 conducted a randomized, double-blind placebo controlled trial examining the effects of glucosamine on the long-term progression of osteoarthritis. Two-hundred twelve patients with knee osteoarthritis were randomized to receive either 1500 mg glucosamine sulfate or placebo once-a-day for three years. narcotic pain medication Fungal arthritis. Radiographs of each knee were taken at enrollment and after one and three years. The patients on placebo had a mean joint-space loss of -. 31 mm. narcotic pain medication Lower left abdomen pain. Patients who had received glucosamine sulfate had a mean joint-space loss of -. 06 mm, a statistically significant finding. This indicates glucosamine sulfate may be able to slow the natural progression of osteoarthritis of the knee. Of note, there were no differences in safety or early withdrawal between the placebo and treatment groups. All of the published reports on clinical trials of glucosamine in OA have resulted in favorable outcomes. Unfortunately, many of these studies have significant flaws in experimental design. Nevertheless, the data from a few quality studies discussed above are suggestive that glucosamine is effective in the control of pain symptoms and is potentially a disease-modifying agent in the treatment of knee OA. When taken orally, it is safe but there are few long-term data. Glucosamine may thus be effective in decreasing the symptoms of OA; however it should be recommended to patients with the attitude that additional long-term efficacy studies need to be performed. (top of section)(top of page) Chondroitin SulfateFrequently sold in combination with glucosamine, chondroitin sulfate is a proteoglycan and a major component of articular cartilage. It is hypothesized to work by increasing levels of chondroitin sulfate in the blood and subsequent incorporation into the cartilage. Additionally, in vitro studies have demonstrated that chondroitin sulfate can stimulate production of other important cartilage proteoglycans. ref 4 & 7 A number of clinical studies have now demonstrated that chondroitin sulfate therapy does indeed produce clinical benefits. Bourgeois et alref 8 conducted a multicenter, randomized, double-blind, controlled study which compared 1200 mg/day chondroitin sulfate to placebo. One hundred twenty-seven patients were randomized to receive either placebo, chondroitin sulfate 1200 mg/day, or chondroitin sulfate 3x400 mg/day. In the chondroitin sulfate groups, the Lequesne's Index, and the patient and physician overall assessments were significantly improved compared to baseline (P<0. 01 for both assessments). In contrast, there was only a slight improvement observed in the placebo group. Both the physician's and patient's overall efficacy assessments were significantly better in the chondroitin sulfate group than in the placebo group (P<0. 01).
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