Glucosamine Sulfate as Preferred Medication for Knee Osteoarthritis

Newswise — European GUIDE (Glucosamine Unum In Die [once a day] Efficacy) medical investigation results indicate that glucosamine sulfate may have more ability to control pain due to knee osteoarthritis than does acetaminophen, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Diego, California.

Glucosamine, which is dispensed as a prescription drug in Europe and available as a dietary supplement in the U.S., has been suggested to improve cartilage biology and counteract factors contributing to joint degeneration, inflammation and symptoms of osteoarthritis.

On-going randomized, placebo-controlled, double-blind trials are being conducted worldwide to assess the effectiveness of oral glucosamine in combating the discomfort of knee osteoarthritis compared to standard symptomatic medications. U.S. researchers from the National Institutes of Health are utilizing GAIT (the Glucosamine/Chondroitin Arthritis Intervention Trial) to compare nutraceutical glucosamine hydrochloride with the anti-inflammatory celecoxib (Celebrex), dividing the glucosamine into three separate daily doses.

European researchers, employing GUIDE, have been comparing glucosamine sulfate with the typically-recommended acetaminophen which is usually taken in three or four 1000 mg doses. The original prescription formulation of glucosamine sulfate soluble powder used provided higher glucosamine levels in the blood to mirror recent favorable glucosamine trials. (Glucosamine sulfate is a slightly different substance than glucosamine hydrochloride. The formulation used in GUIDE is not comparable to most formulations available in the U.S.)

GUIDE investigators followed 318 patients (88 percent women) with symptomatic knee osteoarthritis. Based on randomized groupings, patients took either oral glucosamine sulfate soluble powder (1500 mg once a day), acetaminophen (1000 mg tablets three times a day), or a placebo over a six-month period. All groups were allowed ibuprofen as needed.

Results showed that both glucosamine sulfate and acetaminophen had greater efficacy than placebo use in reducing pain. However, patients taking glucosamine sulfate appeared to experience more relief than did those on acetaminophen.

"Once-daily 1500 mg oral doses of glucosamine sulfate might be the preferred treatment for symptoms of knee osteoarthritis," summarizes Gabriel Herrero-Beaumont, MD, Director of the Rheumatology Department, Jiménez Díaz Foundation - CAPIO, Madrid, Spain. "Based on these results, physicians who typically recommended acetaminophen may well find their patients gain more comfort taking glucosamine sulfate."

The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on the ACR's annual meeting, see http://www.rheumatology.org/annual.