Tom,
For those who missed the National, here's an article on the Glucosamine study:
docguide.com
Glucosamine Sulphate Proves
Worth In Long-Term Osteoarthritis
Trial
A DGReview of :"Long-term effects of glucosamine
sulphate on osteoarthritis progression: a randomised,
placebo-controlled clinical trial"
Lancet
01/26/2001
By Harvey McConnell
Long-term effects of glucosamine sulphate can moderate
the symptoms and changes to joint structure associated with
osteoarthritis.
The symptom-modifying effects of glucosamine sulphate
have been shown in several short- and medium-term
clinical trials, and the drug has shown a good safety
profile. There has been a need, however, for a long-term
trial, points out lead researcher Dr. Jean Reginster, Bone
and Cartilage Metabolism Unit, CHU Centre Ville, Liege,
Belgium.
Glucosamine sulphate is the sulphate derivative of the
natural aminomonosaccharide glucosamine. Glucosamine,
a normal constituent of glycosaminoglycans in cartilage
matrix and synovial fluid, could have various
pharmacological actions in articular cartilage and joint
tissues.
"In this study, glucosamine sulphate was approved as a
prescription drug, therefore, our results cannot be
generalized to other glucosamine products (or compound
mixtures) such as those available in some countries as
dietary supplements," the report points out.
In a randomised, placebo-controlled trial with colleagues
in Britain, Italy and the United States, the researchers
randomized 212 patients with knee osteoarthritis to
treatment with 1500 mg sulphate oral glucosamine or
placebo once daily for three years.
Weight bearing, anteroposterior radiographs of each knee
in full extension were taken at enrolment and after one and
three years.
Mean joint-space width of the medial compartment of the
tibiofemoral joint was assessed by digital image analysis,
whereas minimum joint-space width at the narrowest point
was measured by visual inspection with a magnifying lens.
Symptoms were scored by the Western Ontario and
McMaster Universities (WOMAC) osteoarthritis index
groups.
Researchers found no significant joint-space loss after
three years in the 106 patients treated with glucosamine
sulphate -- 0.06 mm. However, among the 106 patients on
placebo there was a progressive joint-space narrowing,
with a mean joint-space loss of 0·31 mm.
Results were similar with minimum joint-space narrowing.
Assessment by WOMAC scores found symptoms worsened
slightly in patients on placebo compared with the
improvement observed after treatment with glucosamine
sulphate.
Dr. Reginster and colleagues conclude that "further studies,
with longer follow-up and different designs, are needed to
assess whether these changes are predictive of further
clinical progression of osteoarthritis -- eg, modifying the
indication for possible joint surgery or the time to
substantial disability."
Dr. Tim McAlindon, Arthritis Center, Boston University
Medical Center in a commentary said the study is a
landmark in osteoarthritis research, emphasising the
importance of the improved pain and disability scores in
patients given glucosamine.
Dr. McAlindon notes that glucosamine is available in many
countries as a food supplement rather than as prescribed
medication. "It is time for the [medical] profession to
accommodate the possibility that many nutritional products
may have valuable therapeutic effects and to regain the
credibility of the public at large".
Lancet 2001;357:251-56. "Long-term effects of glucosamine
sulphate on osteoarthritis progression: a randomised,
placebo-controlled clinical trial" |
