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Clinical
Trials
Study
Findings: Glucosamine Sulfate Significantly Reduces Progression
Of Knee Osteoarthritis Over 3 Years: A Large, Randomised, Placebo-Controlled,
Double-Blind, Prospective Trial. J Y Reginster, R Deroisy,
I Paul, R L Lee, Y Henrotin, G Giacovelli, J Dacre, L C Rovati,
C Gosset.
Background. Results
of clinical trials like, the one above, support a role for glucosamine
sulfate as a Symptom Modifying Drug in osteoarthritis (OA). This
study was designed to test the long-term effects of the drug on
the progression of knee OA joint structural changes and symptoms.
Specifics: 212
patients with knee OA (ACR criteria) were randomly assigned, in
a double-blind fashion, to the continuous treatment with oral
glucosamine sulfate 1500 mg once-a-day or placebo for 3 years.
Weight-bearing, antero-posterior radiographs of each knee were
taken at enrolment and after 1 and 3 years standardising patient
positioning and radiographic procedure. Total mean joint space
width (JSW) of the medial compartment of the tibio-femoral joint
was assessed by digital image analysis by a validated computerised
algorithm, with the narrowest medial joint space at enrollment
being taken for the primary evaluation (signal joint). Symptoms
were scored at each 4-month visit by the (total) WOMAC index,
VA3.0 version. Data were analysed separately according to a per-protocol
(PP) approach on 3-year completers, or on an intention-to-treat
(ITT) basis including all randomised patients by the last-observation-carried-forward.
Results. The two groups of 106 patients each were comparable for
demographic and disease characteristics. Placebo-treated patients
had an average joint space narrowing (JSN) of approximately 0.08-0.1
mm/year, while no JSN occurred in the glucosamine sulfate group.
A slight worsening in symptoms was evident at the end of treatment
with placebo, compared to the improvement observed after glucosamine
sulfate.
|
PP
Placebo
(N=71) |
PP
Glucosamine
sulfate (N=68) |
ITT
Placebo
(N=106)
|
ITT
Glucosamine
sulfate (N=105) a |
JSW
enrolment
(in mm)
|
5.46 (0.15)
|
5.39 (0.16)
|
5.39 (0.12)
|
5.23 (0.13)
|
JSN 3 years
(in mm)
|
-0.31 (0.13)
|
+0.07 (0.12)
b
|
-0.24 (0.10) |
+0.12 (0.09) c
|
WOMAC
enrolment |
894 (59)
|
1024 (59)
|
940 (47)
|
1030 (46)
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% variation
3 years |
+9.8% (12.3)
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-24.3% (6.4) d
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+5.5% (8.6)
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-15.4% (5.4) e
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Data are presented as mean
(SE). a: 1 enrollment
radiograph missing; b:
p=0.038, c: p=0.007,
d: p=0.016, e:
p=0.04 vs. placebo (ANOVA)
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Conclusions:.
Combined Structure and Symptom Modifying effects suggest that glucosamine
sulfate may be a possible Disease Modifying agent in OA.
Disclosure:
Work reported in this abstract was supported by the Rotta Research
Group
Source:American College of Rheumatology 1999 Annual Meeting, Boston,
MA Presentation Date: Wednesday, November 17, 1999 ACR Plenary
Abstract.
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