Document Detail


Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.
MedLine Citation:
PMID:  20847017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of glucosamine, chondroitin, or the two in combination on joint pain and on radiological progression of disease in osteoarthritis of the hip or knee. Design Network meta-analysis. Direct comparisons within trials were combined with indirect evidence from other trials by using a Bayesian model that allowed the synthesis of multiple time points.
MAIN OUTCOME MEASURE: Pain intensity. Secondary outcome was change in minimal width of joint space. The minimal clinically important difference between preparations and placebo was prespecified at -0.9 cm on a 10 cm visual analogue scale.
DATA SOURCES: Electronic databases and conference proceedings from inception to June 2009, expert contact, relevant websites. Eligibility criteria for selecting studies Large scale randomised controlled trials in more than 200 patients with osteoarthritis of the knee or hip that compared glucosamine, chondroitin, or their combination with placebo or head to head. Results 10 trials in 3803 patients were included. On a 10 cm visual analogue scale the overall difference in pain intensity compared with placebo was -0.4 cm (95% credible interval -0.7 to -0.1 cm) for glucosamine, -0.3 cm (-0.7 to 0.0 cm) for chondroitin, and -0.5 cm (-0.9 to 0.0 cm) for the combination. For none of the estimates did the 95% credible intervals cross the boundary of the minimal clinically important difference. Industry independent trials showed smaller effects than commercially funded trials (P=0.02 for interaction). The differences in changes in minimal width of joint space were all minute, with 95% credible intervals overlapping zero. Conclusions Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.
Authors:
Simon Wandel; Peter Jüni; Britta Tendal; Eveline Nüesch; Peter M Villiger; Nicky J Welton; Stephan Reichenbach; Sven Trelle
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2010-09-16
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  341     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-09-28     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  c4675     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / therapeutic use*
Chondroitin / therapeutic use*
Glucosamine / therapeutic use*
Humans
Osteoarthritis, Hip / drug therapy*
Osteoarthritis, Knee / drug therapy*
Randomized Controlled Trials as Topic
Treatment Outcome
Grant Support
ID/Acronym/Agency:
G0800800//Medical Research Council; G0802413//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 9007-27-6/Chondroitin; N08U5BOQ1K/Glucosamine
Comments/Corrections
Comment In:
Ann Intern Med. 2011 Mar 15;154(6):JC3-4   [PMID:  21403067 ]
Evid Based Med. 2011 Apr;16(2):52-3   [PMID:  21224279 ]
BMJ. 2010;341:c6328   [PMID:  21062884 ]
BMJ. 2010;341:c6338   [PMID:  21062886 ]
BMJ. 2010;341:c6335   [PMID:  21062885 ]
J Fam Pract. 2011 Oct;60(10):610-2   [PMID:  21977488 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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