Dietary Supplements and Arthritis

Supplements fail to relieve joint pain in patients with knee or hip osteoarthritis.
The AP (9/17) reports, "Two popular supplements used to treat joint pain don't work and health authorities should stop paying for them," assert the authors of a new paper appearing in BMJ. "For the past decade, glucosamine and chondroitin have been recommended by doctors to treat arthritis in the hip or knee." Accordingly, global "sales of glucosamine supplements hit nearly $2 billion in 2008."
To investigate the effectiveness of these drugs, researchers in Switzerland "searched electronic databases and conference proceedings from their beginnings to June 2009, and they also contacted appropriate experts and searched relevant Web sites," Medscape (9/16, Barclay) noted. "Inclusion criteria were large-scale, randomized controlled trials enrolling more than 200 patients with knee or hip osteoarthritis and comparing glucosamine, chondroitin, or their combination vs. placebo or head to head." Investigators eventually pinpointed 10 "trials meeting eligibility criteria" that included "a total of 3,803 patients."
The researchers soon realized that the trials -- "either taken together or separately -- failed to demonstrate a clinically significant benefit for patients with knee or hip osteoarthritis," MedPage Today (9/16, Gever) reported. "The more objective measurement of joint space narrowing also was not significantly improved with glucosamine or chondroitin," the authors explained. "Moreover, when benefits were found, they tended to be in industry-funded trials as opposed to those without commercial sponsorship."
Nevertheless, "the supplements are safe, the study researchers write," WebMD (9/16, Martin) reported. In agreement, Jason Theodosakis, MD, of the University of Arizona, said, "You have to ask yourself, would you take a supplement containing glucosamine and chondroitin, have about two-thirds of a chance of getting significant relief, with some evidence that you can slow your disease progression, or just numb your symptoms with acetaminophen or anti-inflammatory drugs and risk ulcers, allergies, kidney or liver damage, hypertension, heart attacks and possibly death." He added, "The risk/benefit for glucosamine and chondroitin far outweighs that of the FDA-approved drugs for osteoarthritis." HealthDay (9/16, Reinberg), and the Chicago Tribune (9/16) "Julie's Health Club" blog also cover the study.