Clinical efficacy and safety of glucosamine, chondroitin sulphate, their
combination, celecoxib or placebo taken to treat osteoarthritis of the knee:
2-year results from GAIT.
Author(s): Sawitzke AD, Shi H, Finco MF, Dunlop DD, Harris CL, Singer NG, Bradley JD, Silver
D, Jackson CG, Lane NE, Oddis CV, Wolfe F, Lisse J, Furst DE, Bingham CO, Reda
DJ, Moskowitz RW, Williams HJ, Clegg DO.
Affiliation(s): University of Utah School of Medicine, 30E 1900 S SOM 4B200, Salt Lake City UT
84132, USA. allen.sawitzke@hsc.utah.edu
Publication date & source: 2010, Ann Rheum Dis. , 69(8):1459-64
BACKGROUND: Knee osteoarthritis (OA) is a major cause of pain and functional
limitation in older adults, yet longer-term studies of medical treatment of OA
are limited.
OBJECTIVE: To evaluate the efficacy and safety of glucosamine and chondroitin
sulphate (CS), alone or in combination, as well as celecoxib and placebo on
painful knee OA over 2 years.
METHODS: A 24-month, double-blind, placebo-controlled study, conducted at nine
sites in the US ancillary to the Glucosamine/chondroitin Arthritis Intervention
Trial, enrolled 662 patients with knee OA who satisfied radiographic criteria
(Kellgren/Lawrence grade 2 or 3 changes and baseline joint space width of at
least 2 mm). This subset continued to receive their randomised treatment:
glucosamine 500 mg three times daily, CS 400 mg three times daily, the
combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24
months. The primary outcome was a 20% reduction in Western Ontario and McMaster
University Osteoarthritis Index (WOMAC) pain over 24 months. Secondary outcomes
included an Outcome Measures in Rheumatology/Osteoarthritis Research Society
International response and change from baseline in WOMAC pain and function.
RESULTS: Compared with placebo, the odds of achieving a 20% reduction in WOMAC
pain were celecoxib: 1.21, glucosamine: 1.16, combination glucosamine/CS: 0.83
and CS alone: 0.69, and were not statistically significant.
CONCLUSIONS: Over 2 years, no treatment achieved a clinically important
difference in WOMAC pain or function as compared with placebo. However,
glucosamine and celecoxib showed beneficial but not significant trends. Adverse
reactions were similar among treatment groups and serious adverse events were
rare for all treatments.
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