A Randomized Controlled Trial of Glucosamine Hydrochloride in the Treatment of Knee Osteoarthritis_West China Medical Journal

Authors：

SU Jiang , ZHANG Jing , WU Tong ,  ZHOU Bin

Department of Rheumatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

ZHOU Bin, Email: sujiangxy@126.com

Keywords：

骨关节炎，膝; 盐酸氨基葡萄糖; 碳酸钙D3片; 塞来昔布

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目的　评价盐酸氨基葡萄糖治疗膝骨关节炎的疗效。方法　将2012年1月－5月收治的150例膝骨关节炎患者随机分为A、B、C组。A组给予盐酸氨基葡萄糖治疗，B组给予碳酸钙D3片治疗，C组给予盐酸氨基葡萄糖联合碳酸钙D3片治疗，疗程8周。3组患者膝关节疼痛发作时服用塞来昔布并记录用量。比较试验前后3组患者骨关节炎指数评分（WOMAC）以及第1、8周塞来昔布用量变化情况。结果　3组患者WOMAC总分、疼痛程度评分、关节僵硬程度评分、日常活动困难程度评分改善值比较，差异均无统计学意义。经过8周治疗，塞来昔布每周用量减少值A、B、C组分别为（0.41 ± 0.17）、（0.16 ± 0.22）、（0.46 ± 0.19）g，A、C组高于B组（P＜0.01），A、C组每周用量减少值差异无统计学意义（P＞0.05）。结论　短期使用盐酸氨基葡萄糖治疗膝骨关节炎，在关节疼痛、僵硬及功能改善方面并不优于碳酸钙D3片，但可通过减少非甾体抗炎药物用量，使患者获益。

Citation： SU Jiang,ZHANG Jing,WU Tong,ZHOU Bin. A Randomized Controlled Trial of Glucosamine Hydrochloride in the Treatment of Knee Osteoarthritis. West China Medical Journal, 2012, 27(12): 1776-1779. doi: Copy

1.	Tat SK, Pelletier JP, Verges J, et al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study[J]. Arthritis Res Ther, 2007, 9(6): R117.
2.	Bruyere O, Reginster JY. Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis[J]. Drugs Aging, 2007, 24(7): 573-580.
3.	Richy F, Bruyere O, Ethgen O, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis[J]. Arch Intern Med, 2003, 163(13): 1514-1522.
4.	Towheed TE, Anastassiades T. Glucosamine therapy for osteoarthritis: an update[J]. J Rheumatol, 2007, 34(9): 1787-1790.
5.	Wandel S, Juni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis[J]. BMJ, 2010, 341: c4675.
6.	Bruyere O, Pavelka K, Rovati LC, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlledtrials[J]. Osteoarthritis Cartilage, 2008, 16(2): 254-260.
7.	Sawitzke AD, Shi H, Finco MF, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial[J]. Arthritis Rheum, 2008, 58(10): 3183-3191.
8.	Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee[J]. Rheumatology (Oxford), 2002, 41(3): 279-284.
9.	Cibere J, Thorne A, Kopec JA, et al. Glucosamine sulfate and cartilage typeⅡ collagen degradation in patients with knee osteoarthritis: randomized discontinuation trial results employing biomarkers[J]. J Rheumatol, 2005, 32(5): 896-902.
10.	Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis[J]. Arthritis Rheum, 2004, 51(5): 738-745.
11.	Vlad SC, LaValley MP, McAlindon TE, et al. Glucosamine for pain in osteoarthritis: why do trial results differ?[J]. Arthritis Rheum, 2007, 56(7): 2267-2277.
12.	Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy inpatients with osteoarthritis of the hip or knee[J]. J Rheumatol, 1988, 15(12): 1833-1840.
13.	中华医学会风湿病学分会. 骨关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(6): 416-419.
14.	Aghazadeh-Habashi A, Jamali F. The glucosamine controversy: a pharmacokinetic issue[J]. J Pharm Pharm Sci, 2011, 14(2): 264-273.
15.	Tat SK, Pelletier JP, Verges J, et al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study[J]. Arthritis Res Ther, 2007, 9(6): 117.
16.	Reginster JY, Richy F, Bruyere O. Glucosamine as a pain-modifying drug in osteorthritis. What’s new in 2006[J]. Rev Med Liege, 2006, 61(3): 169-172.
17.	Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis[J]. N Engl J Med, 2006, 354(8): 795-808.
18.	McAlindon T, Formica M, LaValley M, et al. Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial[J]. Am J Med, 2004, 117(9): 643-649.
19.	Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis[J]. Cochrane Database Syst Rev, 2005, 18(2): CD002946.
20.	Sawitzke AD, Shi H, Finco MF, et al. 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[J]. Ann Rheum Dis, 2010, 69(8): 1459-1464.
21.	Block JA, Oegema TR, Sandy JD, et al. The effects of oral glucosamine on joint health: is a change in research approach needed?[J]. Osteoarthritis Cartilage, 2010, 18(1): 5-11.
22.	Ali AA, Lewis SM, Badgley HL, et al. Oral glucosamine increases expression of transforming growth factor beta1 (TGFbeta1) and connective tissue growth factor (CTGF) mRNA in rat cartilage and kidney: implications for human efficacy and toxicity[J]. Arch Biochem Biophys, 2011, 510(1): 11-18.
23.	Biggee BA, Blinn CM, McAlindon TE, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness[J]. Ann Rheum Dis, 2006, 65(2): 222-226.

1. 　Tat SK, Pelletier JP, Verges J, et al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study[J]. Arthritis Res Ther, 2007, 9(6): R117.
2. 　Bruyere O, Reginster JY. Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis[J]. Drugs Aging, 2007, 24(7): 573-580.
3. 　Richy F, Bruyere O, Ethgen O, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis[J]. Arch Intern Med, 2003, 163(13): 1514-1522.
4. 　Towheed TE, Anastassiades T. Glucosamine therapy for osteoarthritis: an update[J]. J Rheumatol, 2007, 34(9): 1787-1790.
5. 　Wandel S, Juni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis[J]. BMJ, 2010, 341: c4675.
6. 　Bruyere O, Pavelka K, Rovati LC, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlledtrials[J]. Osteoarthritis Cartilage, 2008, 16(2): 254-260.
7. 　Sawitzke AD, Shi H, Finco MF, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial[J]. Arthritis Rheum, 2008, 58(10): 3183-3191.
8. 　Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee[J]. Rheumatology (Oxford), 2002, 41(3): 279-284.
9. 　Cibere J, Thorne A, Kopec JA, et al. Glucosamine sulfate and cartilage typeⅡ collagen degradation in patients with knee osteoarthritis: randomized discontinuation trial results employing biomarkers[J]. J Rheumatol, 2005, 32(5): 896-902.
10. 　Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis[J]. Arthritis Rheum, 2004, 51(5): 738-745.
11. 　Vlad SC, LaValley MP, McAlindon TE, et al. Glucosamine for pain in osteoarthritis: why do trial results differ?[J]. Arthritis Rheum, 2007, 56(7): 2267-2277.
12. 　Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy inpatients with osteoarthritis of the hip or knee[J]. J Rheumatol, 1988, 15(12): 1833-1840.
13. 　中华医学会风湿病学分会. 骨关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(6): 416-419.
14. 　Aghazadeh-Habashi A, Jamali F. The glucosamine controversy: a pharmacokinetic issue[J]. J Pharm Pharm Sci, 2011, 14(2): 264-273.
15. 　Tat SK, Pelletier JP, Verges J, et al. Chondroitin and glucosamine sulfate in combination decrease the pro-resorptive properties of human osteoarthritis subchondral bone osteoblasts: a basic science study[J]. Arthritis Res Ther, 2007, 9(6): 117.
16. 　Reginster JY, Richy F, Bruyere O. Glucosamine as a pain-modifying drug in osteorthritis. What’s new in 2006[J]. Rev Med Liege, 2006, 61(3): 169-172.
17. 　Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis[J]. N Engl J Med, 2006, 354(8): 795-808.
18. 　McAlindon T, Formica M, LaValley M, et al. Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial[J]. Am J Med, 2004, 117(9): 643-649.
19. 　Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis[J]. Cochrane Database Syst Rev, 2005, 18(2): CD002946.
20. 　Sawitzke AD, Shi H, Finco MF, et al. 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[J]. Ann Rheum Dis, 2010, 69(8): 1459-1464.
21. 　Block JA, Oegema TR, Sandy JD, et al. The effects of oral glucosamine on joint health: is a change in research approach needed?[J]. Osteoarthritis Cartilage, 2010, 18(1): 5-11.
22. 　Ali AA, Lewis SM, Badgley HL, et al. Oral glucosamine increases expression of transforming growth factor beta1 (TGFbeta1) and connective tissue growth factor (CTGF) mRNA in rat cartilage and kidney: implications for human efficacy and toxicity[J]. Arch Biochem Biophys, 2011, 510(1): 11-18.
23. 　Biggee BA, Blinn CM, McAlindon TE, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness[J]. Ann Rheum Dis, 2006, 65(2): 222-226.

West China Medical Journal

A Randomized Controlled Trial of Glucosamine Hydrochloride in the Treatment of Knee Osteoarthritis

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