Dietary supplements of little use for arthritis
In general, the use of glucosamine and chondroitin has little effect on symptoms of knee arthritis, according to results of a study funded by the National Institutes of Health. Still, these dietary supplements seem safe and patients with moderate to severe pain may experience some relief with them.
“Among alternative caregivers or nutritional supplement providers, (glucosamine and chondroitin) are widely believed to be beneficial,” lead researcher Dr. Daniel O. Clegg told Reuters Health, “and many patients consider that it’s a possibility.”
To determine if the agents are of benefit, Clegg, from the University of Utah in Salt Lake City, and other members of the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) group enrolled 1,583 patients with knee pain during the previous 6 months.
As reported in The New England Journal of Medicine, patients were randomly assigned to 500 mg glucosamine three times daily, 400 mg chondroitin three times daily, the combination of both products three times daily, Celebrex (celecoxib) 200 mg daily, or inactive “placebo.”
“In the overall group, the supplements, either alone or combined, were not distinguished from placebo in any regard,” Clegg said, including pain, stiffness or swelling. Only Celebrex was associated with significant pain relief.
Among the 22 percent of patients with moderate to severe pain, glucosamine and chondroitin provided greater pain relief than placebo. However, the authors write, “the relatively small numbers of patients in this subgroup may have limited the study’s power to demonstrate significant benefits.”
But if patients do want to try the supplements, Clegg pointed out that “the agents did appear to be safe.”
In a related editorial, Dr. Marc C. Hochberg, from the University of Maryland School of Medicine in Baltimore, comments that previous research suggests that the supplements may modify the rate of structural deterioration in knee arthritis, data that the GAIT investigators will report later this year.
For patients choosing to take dietary supplements to control their symptoms, he advises that they should be told that glucosamine sulfate in combination with chondroitin sulfate may have an additive effect.
Three months is a sufficient period to evaluation the benefits of these agents, he adds. “If there is no clinically significant decrease in symptoms by this time, the supplements should be discontinued.”
SOURCE: The New England Journal of Medicine, February 23, 2006.
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