Medical Literature References on Treatment of Osteoarthritis with Glucosamine Sulfate
Lopes Vaz A
Double-blind clinical evaluation of the relative efficacy of
ibuprofen and glucosamine sulphate in the management of
osteoarthrosis of the knee in out-patients.
In: Curr Med Res Opin (1982) 8(3):145-9
ISSN: 0300-7995
A double-blind trial was carried out in 40 out-patients with
unilateral osteoarthrosis of the knee to compare the efficacy and
tolerance of oral treatment with 1.5 g glucosamine sulphate or 1.2 g
ibuprofen daily over a period of 8 weeks. Pain scores decreased
faster during the first 2 weeks in the ibuprofen than in the
glucosamine treatment group. Although the rate of decrease was
slower, the reduction in pain scores was continued throughout the
trial period in patients an glucosamine and the difference between
the two groups turned significantly in favour of glucosamine at Week
8. No significant differences were observed in swelling or any of the
other parameters monitored. Tolerance was satisfactory with both
treatments, with only minor complaints being reported by 2 patients
on glucosamine compared with 5 patients on ibuprofen.
Registry Numbers: 15687-27-1 (Ibuprofen)
3416-24-8 (Glucosamine)
81065906
Pujalte JM Llavore EP Ylescupidez FR
Double-blind clinical evaluation of oral glucosamine sulphate in the
basic treatment of osteoarthrosis.
In: Curr Med Res Opin (1980) 7(2):110-14
ISSN: 0300-7995
The efficacy and tolerance of oral glucosamine sulphate were tested
against placebo in a prospective double-blind trial in 20 out-
patients with established osteoarthrosis. Two capsules of either
glucosaminene sulphate (250 mg) or placebo were administered 3-times
daily over a period of 6 to 8 weeks. Articular pain, joint tenderness
and restricted movement were semi-quantitatively scored 1 to 4 every
3 days, and individually averaged over the treatment period (overall
composite score). Possible side-reactions were similarly scored upon
positive questioning of the patients. Haematology, erythrocyte
sedimentation rate, urine analysis and X-rays were recorded before
and after treatment. Significant alleviation of symptoms was
associated with the use of the active drug at the prescribed dose.
Similarly, patients given glucosamine sulphate experienced earlier
alleviation of symptoms compared with those who had placebo. The use
of glucosamine sulphate also resulted in a significantly larger
proportion of patients who experienced lessening or disappearance of
symptoms within the trial period. No adverse reactions were reported
by the patients treated with glucosamine, and no variation in
laboratory tests was recorded.
Registry Numbers: 3416-24-8 (Glucosamine)
JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS
(REFERENCE 4 OF 7)
97418499
Gottlieb MS
Conservative management of spinal osteoarthritis with glucosamine
sulfate and chiropractic treatment.
In: J Manipulative Physiol Ther (1997 Jul-Aug) 20(6):400-14
ISSN: 0161-4754
OBJECTIVE: To evaluate the rationale behind the most commonly used
treatments of osteoarthritis, including nonsteroidal anti-
inflammatory drugs (NSAIDs), and to assess more effective
conservative treatment options. SUMMARY OF BACKGROUND DATA: This
review includes a description of the pathophysiology and prevalence
of osteoarthritis, joint physiology and NSAID treatment of
osteoarthritis, as well as side effects on joints, the
gastrointestinal tract, kidneys and livers. Several studies of
conservative treatment, consisting of supplementation of glucosamine
sulfate (which occurs naturally in the human body), exercise, and the
use of chiropractic treatment for maintaining joint function and
preventing further destruction, are reviewed. DATA SOURCES: A
computerized search of Medline using the key indexing terms
osteoarthritis, degenerative joint disease, nonsteroidal anti-
inflammatory drugs, glucosamine sulfate, chiropractic and
manipulation. RESULTS: Numerous studies wee obtained under each
subheading and reviewed by category. Human and animal-model studies
are described. CONCLUSION: The rationales for using NSAIDs in the
treatment of osteoarthritis is controversial and openly contested.
Given the detrimental effects of NSAIDs on joints and other organs,
their use should be discouraged and their classification as a first
choice conservative treatment should be abolished. A truly effective
and conservative approach to the treatment of osteoarthritis should
include chiropractic manipulation, essential nutrient
supplementation, exogenous administration of glucosamine sulfate and
rehabilitative stretches and exercises to maintain joint function.
Because there is no correlation between pain levels and the extent of
degeneration detected by radiographic or physical examination,
conservative treatment should be initiated and sustained based on
functional, objective findings and not strictly on how the patient
feels. The use of NSAIDs should be limited to the treatment of gross
inflammation and analgesics should only be used in the short-term
when absolutely necessary for pain palliation. The present
conservative approach could lead not only to a better quality of life
but also to the saving of health care dollars by reducing the
iatrogenic morbidity and mortality associated with NSAID use.
Registry Numbers: 3416-24-8 (Glucosamine)
MEDICAL HYPOTHESES
(REFERENCE 5 OF 7)
95020811
McCarty MF
The neglect of glucosamine as a treatment for osteoarthritis--a
personal perspective.
In: Med Hypotheses (1994 May) 42(5):323-7
ISSN: 0306-9877
Osteoarthritis results from progressive catabolic loss of cartilage
proteoglycans, owing to an imbalance between synthesis and
degradation. Standard drug therapy is only of palliative benefit and
may exacerbate loss of cartilage. Glucosamine is an intermediate in
mucopolysaccharide synthesis, and its availability in cartilage
tissue culture can be rate-limiting for proteoglycan production. A
number of double-blind studies dating from the early 1980s
demonstrate that oral glucosamine decreases pain and improves
mobility in osteoarthritis, without side effects. Nevertheless,
medical researchers and physicians in the US have totally ignored
this rational and safe therapeutic strategy. By mechanisms that are
still unclear, the natural methyl donor S-adenosylmethionine also
promotes production of cartilage proteoglycans, and is
therapeutically beneficial in osteoarthritis in well-tolerated oral
doses. These and other safe nutritional measures supporting
proteoglycan synthesis, may offer a practical means of preventing or
postponing the onset of osteoarthritis in older people or athletes.
Registry Numbers: 29908-03-0 (S-Adenosylmethionine)
3416-24-8 (Glucosamine)
PHARMATHERAPEUTICA
(REFERENCE 6 OF 7)
83039552
Tapadinhas MJ Rivera IC Bignamini AA
Oral glucosamine sulphate in the management of arthrosis: report on a
multi-centre open investigation in Portugal.
In: Pharmatherapeutica (1982) 3(3):157-68
ISSN: 0308-051X
An open study was carried out by 252 doctors throughout Portugal to
assess the effectiveness and tolerability of oral glucosamine
sulphate in the treatment of arthrosis. Patients received 1.5 g daily
in 3 divided doses over a mean period of 50 +/- 14 days. The results
from 1208 patients were analyzed and showed that the symptoms of pain
at rest, on standing and on exercise and limited active and passive
movements improved steadily through the treatment period. The
improvement obtained lasted for a period of 6 to 12 weeks after the
end of treatment. Objective therapeutic efficacy was rated by the
doctors as 'good' in 59% of patients, and 'sufficient' in a further
36%. These results were significantly better than those obtained with
previous treatments (except for injectable glucosamine) in the same
patients. Sex, age, localization of arthrosis, concomitant illnesses
or concomitant treatments did not influence the frequency of
responders to treatment. Oral glucosamine was fully tolerated by 86%
of patients, a significantly larger proportion than that reported
with other previous treatments and approached only by injectable
glucosamine. The onset of possible side-effects was significantly
related to pre-existing gastro-intestinal disorders and related
treatments, and to concomitant diuretic treatment.
Registry Numbers: 3416-24-8 (Glucosamine)
(REFERENCE 7 OF 7)
81247600
D'Ambrosio E Casa B Bompani R Scali G Scali M
Glucosamine sulphate: a controlled clinical investigation in
arthrosis.
In: Pharmatherapeutica (1981) 2(8):504-8
ISSN: 0308-051X
Efficacy and tolerance of a new preparation of pure glucosamine
sulphate, in injectable and oral form, were investigated in 30
patients with osteoarthrosis. Two groups of in-patients with chronic
degenerative articular disorders received daily for 7 days either 400
mg glucosamine sulphate or a piperazine/chlorbutanol combination by
intravenous or intramuscular injection. During the 2 following weeks,
the patients receiving glucosamine had oral glucosamine capsules (6 x
250 mg daily); the other group had placebo. Efficacy was tested by
semi-quantitative scoring of pain at rest and during active and
passive movements, as well as limitation of articular function,
before and after 7 and 21 days of treatment. Patients were positively
questioned daily for possible intolerance symptoms. Haematology,
circulatory data and urine analysis were tested before and after
treatment. During both initial parenteral treatments, each symptom
significantly improved, but to a faster and greater extent in the
group treated with glucosamine. During the maintenance period, a
further improvement was recorded in the patients treated with
glucosamine, whereas in those on placebo the symptom scores increased
almost to the pre-treatment level. This was considered the major
difference between basic therapy, such as with glucosamine, as purely
symptomatic treatment. Clinical and biological tolerance were
excellent with both treatments, and no definitely drug-related
complaints were recorded. It is suggested that parenteral and/or oral
treatment with pure glucosamine sulphate should be considered as
basic therapy for the management of primary or secondary degenerative
osteoarthrosis disorders.
Registry Numbers: 3416-24-8 (Glucosamine)
