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The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial.
Arthritis Rheum 2008; 58(10):3183-91AR

Abstract

OBJECTIVE

Osteoarthritis (OA) of the knee causes significant morbidity and current medical treatment is limited to symptom relief, while therapies able to slow structural damage remain elusive. This study was undertaken to evaluate the effect of glucosamine and chondroitin sulfate (CS), alone or in combination, as well as celecoxib and placebo on progressive loss of joint space width (JSW) in patients with knee OA.

METHODS

A 24-month, double-blind, placebo-controlled study, conducted at 9 sites in the United States as part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), enrolled 572 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence [K/L] grade 2 or grade 3 changes and JSW of at least 2 mm at baseline). Patients with primarily lateral compartment narrowing at any time point were excluded. Patients who had been randomized to 1 of the 5 groups in the GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The minimum medial tibiofemoral JSW was measured at baseline, 12 months, and 24 months. The primary outcome measure was the mean change in JSW from baseline.

RESULTS

The mean JSW loss at 2 years in knees with OA in the placebo group, adjusted for design and clinical factors, was 0.166 mm. No statistically significant difference in mean JSW loss was observed in any treatment group compared with the placebo group. Treatment effects on K/L grade 2 knees, but not on K/L grade 3 knees, showed a trend toward improvement relative to the placebo group. The power of the study was diminished by the limited sample size, variance of JSW measurement, and a smaller than expected loss in JSW.

CONCLUSION

At 2 years, no treatment achieved a predefined threshold of clinically important difference in JSW loss as compared with placebo. However, knees with K/L grade 2 radiographic OA appeared to have the greatest potential for modification by these treatments.

Authors+Show Affiliations

University of Utah School of Medicine, Salt Lake City, UT 84132, USA. allen.sawitzke@hsc.utah.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18821708

Citation

Sawitzke, Allen D., et al. "The Effect of Glucosamine And/or Chondroitin Sulfate On the Progression of Knee Osteoarthritis: a Report From the Glucosamine/chondroitin Arthritis Intervention Trial." Arthritis and Rheumatism, vol. 58, no. 10, 2008, pp. 3183-91.
Sawitzke AD, Shi H, Finco MF, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis Rheum. 2008;58(10):3183-91.
Sawitzke, A. D., Shi, H., Finco, M. F., Dunlop, D. D., Bingham, C. O., Harris, C. L., ... Clegg, D. O. (2008). The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis and Rheumatism, 58(10), pp. 3183-91. doi:10.1002/art.23973.
Sawitzke AD, et al. The Effect of Glucosamine And/or Chondroitin Sulfate On the Progression of Knee Osteoarthritis: a Report From the Glucosamine/chondroitin Arthritis Intervention Trial. Arthritis Rheum. 2008;58(10):3183-91. PubMed PMID: 18821708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. AU - Sawitzke,Allen D, AU - Shi,Helen, AU - Finco,Martha F, AU - Dunlop,Dorothy D, AU - Bingham,Clifton O,3rd AU - Harris,Crystal L, AU - Singer,Nora G, AU - Bradley,John D, AU - Silver,David, AU - Jackson,Christopher G, AU - Lane,Nancy E, AU - Oddis,Chester V, AU - Wolfe,Fred, AU - Lisse,Jeffrey, AU - Furst,Daniel E, AU - Reda,Domenic J, AU - Moskowitz,Roland W, AU - Williams,H James, AU - Clegg,Daniel O, PY - 2008/9/30/pubmed PY - 2008/12/17/medline PY - 2008/9/30/entrez SP - 3183 EP - 91 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 58 IS - 10 N2 - OBJECTIVE: Osteoarthritis (OA) of the knee causes significant morbidity and current medical treatment is limited to symptom relief, while therapies able to slow structural damage remain elusive. This study was undertaken to evaluate the effect of glucosamine and chondroitin sulfate (CS), alone or in combination, as well as celecoxib and placebo on progressive loss of joint space width (JSW) in patients with knee OA. METHODS: A 24-month, double-blind, placebo-controlled study, conducted at 9 sites in the United States as part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), enrolled 572 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence [K/L] grade 2 or grade 3 changes and JSW of at least 2 mm at baseline). Patients with primarily lateral compartment narrowing at any time point were excluded. Patients who had been randomized to 1 of the 5 groups in the GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The minimum medial tibiofemoral JSW was measured at baseline, 12 months, and 24 months. The primary outcome measure was the mean change in JSW from baseline. RESULTS: The mean JSW loss at 2 years in knees with OA in the placebo group, adjusted for design and clinical factors, was 0.166 mm. No statistically significant difference in mean JSW loss was observed in any treatment group compared with the placebo group. Treatment effects on K/L grade 2 knees, but not on K/L grade 3 knees, showed a trend toward improvement relative to the placebo group. The power of the study was diminished by the limited sample size, variance of JSW measurement, and a smaller than expected loss in JSW. CONCLUSION: At 2 years, no treatment achieved a predefined threshold of clinically important difference in JSW loss as compared with placebo. However, knees with K/L grade 2 radiographic OA appeared to have the greatest potential for modification by these treatments. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/18821708/The_effect_of_glucosamine_and/or_chondroitin_sulfate_on_the_progression_of_knee_osteoarthritis:_a_report_from_the_glucosamine/chondroitin_arthritis_intervention_trial_ L2 - https://doi.org/10.1002/art.23973 DB - PRIME DP - Unbound Medicine ER -