Medical Literature References on Treatment of Osteoarthritis with Glucosamine Sulfate
Lopes Vaz A
Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine
sulphate in the management of osteoarthrosis of the knee in out-patients.
In: Curr Med Res Opin (1982) 8(3):145-9
A double-blind trial was carried out in 40 out-patients with unilateral osteoarthrosis of the knee to compare
the efficacy and tolerance of oral treatment with 1.5 g glucosamine sulphate or 1.2 g ibuprofen daily over a period of 8 weeks.
Pain scores decreased faster during the first 2 weeks in the ibuprofen than in the glucosamine treatment group. Although the
rate of decrease was slower, the reduction in pain scores was continued throughout the trial period in patients an glucosamine
and the difference between the two groups turned significantly in favour of glucosamine at Week 8. No significant differences
were observed in swelling or any of the other parameters monitored. Tolerance was satisfactory with both treatments, with
only minor complaints being reported by 2 patients on glucosamine compared with 5 patients on ibuprofen.
Pujalte JM Llavore EP Ylescupidez FR
clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis.
In: Curr Med Res Opin (1980)
The efficacy and tolerance of oral glucosamine sulphate were tested against placebo
in a prospective double-blind trial in 20 out- patients with established osteoarthrosis. Two capsules of either glucosaminene
sulphate (250 mg) or placebo were administered 3-times daily over a period of 6 to 8 weeks. Articular pain, joint tenderness
and restricted movement were semi-quantitatively scored 1 to 4 every 3 days, and individually averaged over the treatment
period (overall composite score). Possible side-reactions were similarly scored upon positive questioning of the patients.
Haematology, erythrocyte sedimentation rate, urine analysis and X-rays were recorded before and after treatment. Significant
alleviation of symptoms was associated with the use of the active drug at the prescribed dose. Similarly, patients given glucosamine
sulphate experienced earlier alleviation of symptoms compared with those who had placebo. The use of glucosamine sulphate
also resulted in a significantly larger proportion of patients who experienced lessening or disappearance of symptoms within
the trial period. No adverse reactions were reported by the patients treated with glucosamine, and no variation in laboratory
tests was recorded.
Registry Numbers: 3416-24-8 (Glucosamine)
JOURNAL OF MANIPULATIVE
AND PHYSIOLOGICAL THERAPEUTICS
(REFERENCE 4 OF 7)
management of spinal osteoarthritis with glucosamine sulfate and chiropractic treatment.
In: J Manipulative Physiol
Ther (1997 Jul-Aug) 20(6):400-14
OBJECTIVE: To evaluate the rationale behind the most commonly
used treatments of osteoarthritis, including nonsteroidal anti- inflammatory drugs (NSAIDs), and to assess more effective
conservative treatment options. SUMMARY OF BACKGROUND DATA: This review includes a description of the pathophysiology and
prevalence of osteoarthritis, joint physiology and NSAID treatment of osteoarthritis, as well as side effects on joints, the
gastrointestinal tract, kidneys and livers. Several studies of conservative treatment, consisting of supplementation of glucosamine
sulfate (which occurs naturally in the human body), exercise, and the use of chiropractic treatment for maintaining joint
function and preventing further destruction, are reviewed. DATA SOURCES: A computerized search of Medline using the key indexing
terms osteoarthritis, degenerative joint disease, nonsteroidal anti- inflammatory drugs, glucosamine sulfate, chiropractic
and manipulation. RESULTS: Numerous studies wee obtained under each subheading and reviewed by category. Human and animal-model
studies are described. CONCLUSION: The rationales for using NSAIDs in the treatment of osteoarthritis is controversial and
openly contested. Given the detrimental effects of NSAIDs on joints and other organs, their use should be discouraged and
their classification as a first choice conservative treatment should be abolished. A truly effective and conservative approach
to the treatment of osteoarthritis should include chiropractic manipulation, essential nutrient supplementation, exogenous
administration of glucosamine sulfate and rehabilitative stretches and exercises to maintain joint function. Because there
is no correlation between pain levels and the extent of degeneration detected by radiographic or physical examination, conservative
treatment should be initiated and sustained based on functional, objective findings and not strictly on how the patient feels.
The use of NSAIDs should be limited to the treatment of gross inflammation and analgesics should only be used in the short-term
when absolutely necessary for pain palliation. The present conservative approach could lead not only to a better quality of
life but also to the saving of health care dollars by reducing the iatrogenic morbidity and mortality associated with NSAID
Registry Numbers: 3416-24-8 (Glucosamine)
(REFERENCE 5 OF 7)
The neglect of glucosamine as a treatment for osteoarthritis--a
In: Med Hypotheses (1994 May) 42(5):323-7
from progressive catabolic loss of cartilage proteoglycans, owing to an imbalance between synthesis and degradation. Standard
drug therapy is only of palliative benefit and may exacerbate loss of cartilage. Glucosamine is an intermediate in mucopolysaccharide
synthesis, and its availability in cartilage tissue culture can be rate-limiting for proteoglycan production. A number of
double-blind studies dating from the early 1980s demonstrate that oral glucosamine decreases pain and improves mobility in
osteoarthritis, without side effects. Nevertheless, medical researchers and physicians in the US have totally ignored this
rational and safe therapeutic strategy. By mechanisms that are still unclear, the natural methyl donor S-adenosylmethionine
also promotes production of cartilage proteoglycans, and is therapeutically beneficial in osteoarthritis in well-tolerated
oral doses. These and other safe nutritional measures supporting proteoglycan synthesis, may offer a practical means of preventing
or postponing the onset of osteoarthritis in older people or athletes.
Registry Numbers: 29908-03-0 (S-Adenosylmethionine)
(REFERENCE 6 OF 7)
MJ Rivera IC Bignamini AA
Oral glucosamine sulphate in the management of arthrosis: report on a multi-centre open investigation
In: Pharmatherapeutica (1982) 3(3):157-68
An open study was carried out
by 252 doctors throughout Portugal to assess the effectiveness and tolerability of oral glucosamine sulphate in the treatment
of arthrosis. Patients received 1.5 g daily in 3 divided doses over a mean period of 50 +/- 14 days. The results from 1208
patients were analyzed and showed that the symptoms of pain at rest, on standing and on exercise and limited active and passive
movements improved steadily through the treatment period. The improvement obtained lasted for a period of 6 to 12 weeks after
the end of treatment. Objective therapeutic efficacy was rated by the doctors as 'good' in 59% of patients, and 'sufficient'
in a further 36%. These results were significantly better than those obtained with previous treatments (except for injectable
glucosamine) in the same patients. Sex, age, localization of arthrosis, concomitant illnesses or concomitant treatments did
not influence the frequency of responders to treatment. Oral glucosamine was fully tolerated by 86% of patients, a significantly
larger proportion than that reported with other previous treatments and approached only by injectable glucosamine. The onset
of possible side-effects was significantly related to pre-existing gastro-intestinal disorders and related treatments, and
to concomitant diuretic treatment.
Registry Numbers: 3416-24-8 (Glucosamine)
(REFERENCE 7 OF 7)
E Casa B Bompani R Scali G Scali M
Glucosamine sulphate: a controlled clinical investigation in arthrosis.
Pharmatherapeutica (1981) 2(8):504-8
Efficacy and tolerance of a new preparation of pure glucosamine
sulphate, in injectable and oral form, were investigated in 30 patients with osteoarthrosis. Two groups of in-patients with
chronic degenerative articular disorders received daily for 7 days either 400 mg glucosamine sulphate or a piperazine/chlorbutanol
combination by intravenous or intramuscular injection. During the 2 following weeks, the patients receiving glucosamine had
oral glucosamine capsules (6 x 250 mg daily); the other group had placebo. Efficacy was tested by semi-quantitative scoring
of pain at rest and during active and passive movements, as well as limitation of articular function, before and after 7 and
21 days of treatment. Patients were positively questioned daily for possible intolerance symptoms. Haematology, circulatory
data and urine analysis were tested before and after treatment. During both initial parenteral treatments, each symptom significantly
improved, but to a faster and greater extent in the group treated with glucosamine. During the maintenance period, a further
improvement was recorded in the patients treated with glucosamine, whereas in those on placebo the symptom scores increased
almost to the pre-treatment level. This was considered the major difference between basic therapy, such as with glucosamine,
as purely symptomatic treatment. Clinical and biological tolerance were excellent with both treatments, and no definitely
drug-related complaints were recorded. It is suggested that parenteral and/or oral treatment with pure glucosamine sulphate
should be considered as basic therapy for the management of primary or secondary degenerative osteoarthrosis disorders.
Numbers: 3416-24-8 (Glucosamine)