Hotline Archive - Glucosamine Sulfate and Chondroitin Sulfate for Osteoarthritis
January 1997
Health and nutrition stores and several news shows including the New York Times and the Today Show have been touting nutritional supplements known as glucosamine sulfate and chondroitin sulfate for treating nonspecific arthritis. Glucosamine and chondroitin sulfate are synthesized in the body. Glucosamine is an artificially synthesized salt of glucosamine while chondroitin sulfate is composed of repeating units of glucosamine with attached sugar molecules. Both are important in the repair and maintenance of cartilage.
In the early 1980s studies (1) with glucosamine in animal models suggested it could slow cartilage breakdown. Glucosamine is thought to stimulate cartilage to synthesize glycosaminoglycans and proteoglycans and may inhibit proteolytic enzymes.
Over the past 15 years, several small short-term controlled human studies (2-4) showed a modest decrease in OA symptoms. No convincing studies yet show a clear long-term chondroprotective effect.
While these studies are promising, double-blind, long-term studies using large numbers of patients with OA are required to evaluate the safety and efficacy of these substances. Patients should consult with their primary care physician and rheumatologist regarding arthritis medications. They should follow the ACR guidelines for treatment of OA including weight control, analgesic and anti-inflammatory medications, exercise, heat/cold applications, self-help aids, joint protection and surgery.
Glucosamine and chondroitin sulfate cannot currently
be recommended for use in the treatment of OA or other types of arthritis. As
dietary supplements, these substances have not been approved by the FDA.
- Setniker I, Pacine MA, Revel L: Antiarthritic effects of glucosamine sulfate studied in animal models. Drug Res 41(1) 542-549, 1991.
- Reichelt A, Forster KK, Fischer M, Rovati LC, Setnikar I: Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. A randomized, placebo-controlled, double-blind study. Arzneimittelforschung, 44: 75-80, 1994.
- Rovati LC: Clinical research in osteoarthritis: design and results of short-term trials with disease-modifying drugs. Int J Tissue React, 14:5, 243-51, 1992.
- Giordano N, Nardi P, Senesi, M, Palumbo F, Battisti E, Gonelli S, Franci B, Campagna MS, Gennari C: The efficacy and safety of glucosamine sulfate in the treatment of gonarthritis. Clin Ter. 147(3): 99-105, Mar 1996.
Jan. 27, 1997
Robert Thoburn, MD
William Ginsburg, MD
Co-editors, ACR Hotline
Hotline is provided by the ACR Communications and Marketing Committee as a service to members. This Hotline reflects the views of the author(s) and does not represent a position statement of the College.
