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Meta-Analysis
. 2018 Sep;37(9):2479-2487.
doi: 10.1007/s10067-018-4106-2. Epub 2018 Apr 30.

Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis

Toru Ogata  1 , Yuki Ideno  2 , Masami Akai  3 , Atsushi Seichi  4 , Hiroshi Hagino  5   6 , Tsutomu Iwaya  7 , Toru Doi  1   8 , Keiko Yamada  8 , Ai-Zhen Chen  9 , Yingzi Li  10 , Kunihiko Hayashi  11
Affiliations
Meta-Analysis

Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis

Toru Ogata et al. Clin Rheumatol. 2018 Sep.

Abstract

Osteoarthritis (OA) of the knee is one of the main causes of mobility decline in the elderly. Non-surgical treatments such as administration of supplements to strengthen the joint cartilage matrix have become popular not only for pain relief but also for joint preservation. Glucosamine has been used in many countries based on the increasing evidence of its effectiveness for OA. Although there are many previous studies and systematic reviews, the findings vary and different conclusions have been drawn. We aimed to review recent randomized controlled trials on glucosamine for knee OA to reveal up-to-date findings about this supplement. We also performed a meta-analysis of some of the outcomes to overcome the unsolved bias in each study. Eighteen articles written between 2003 and 2016 were analyzed. Many used visual analogue scale (VAS) pain scores and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which were assessed in our meta-analysis. We found a marginally favorable effect of glucosamine on VAS pain scores. The effect on knee function, as measured by the WOMAC, was small and not significant. A newly established knee OA scale, the Japanese Knee Osteoarthritis Measure (JKOM), is commonly used in Japan. Although the number of subjects was small, the JKOM meta-analysis indicated that glucosamine is superior to a placebo in alleviating knee OA symptoms. Given this, we concluded that glucosamine has the potential to alleviate knee OA pain. Further studies are needed to evaluate the effect of glucosamine on knee function and joint preservation, as well as to evaluate the combined effect with other components, such as chondroitin.

Keywords: Glucosamine; Knee OA; Osteoarthritis; WOMAC.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Changes in visual analog scale pain score in patients treated with glucosamine versus placebo. Funnel plot shows effect size versus standard error of effect size. Generally, the smaller the study, the bigger the standard error of effect size. Dotted lines represent the expected variation of effect size in comparison to standard error. SMD: standardized mean difference
Fig. 3
Fig. 3
Changes in WOMAC pain sub-score in patients treated with glucosamine versus placebo
Fig. 4
Fig. 4
Changes in visual analog scale pain score in patients treated with glucosamine alone or glucosamine with chondroitin. a Summarized effect size of three studies which used glucosamine alone. b Summarized effect size of studies which used glucosamine and chondroitin
Fig. 5
Fig. 5
Changes in Western Ontario and McMaster Universities Osteoarthritis Index physical function sub-score in patients treated with glucosamine versus placebo
Fig. 6
Fig. 6
Changes in Western Ontario and McMaster Universities Osteoarthritis Index total score in patients treated with glucosamine versus placebo
Fig. 7
Fig. 7
Changes in Japanese Knee Osteoarthritis Measure score in patients treated with glucosamine versus placebo
See this image and copyright information in PMC

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