Effects of Glucosamine and Chondroitin Sulfate on Cartilage Metabolism in OA: Outlook on Other Nutrient Partners Especially Omega-3 Fatty Acids

Table 2

Characteristics and results of selected reviews/meta-analyses-glucosamine.

Author(s), year	Analyzed publications	Trial details	Conclusions
Bruyere et al. 2008 [33]	(i) Towheed et al., Cochrane Review 2005 [34]	20 RCTs: GlcN·S superior to Plac. with a 28% improvement in pain and a 21% improvement in function (Lequ. index).	Significantly superior to placebo in terms of its ability to reduce levels of pain.
	(ii) Vlad et al. 2007 [35]	15 RCTs Summary effect sizes ranged: 0.05 to 0.16 in trials without industry involvement, but 0.47 to 0.55 in trials with industry involvement.	Heterogeneity among trials of glucosamine is larger than would be expected by chance. Glucosamine hydrochloride is not effective.
	(iii) Reginster 2007 [36] (update following Richy et al. 2007, [37])	3 pivotal RCTs: WOMAC pain and function subscores: significant beneficial effect of GlcN·S versus Plac.	The effect size was consistent across the parameters, and it was approx. 0.30 or slightly higher. This effect is small to medium, but it is clinically valid (>0.20), and especially, it is of the same magnitude as that commonly encountered with other OA treatments, including NSAIDs.
Poolsup et al. 2005 [38]		14 RCTs: GlcN·S: Risk of disease progression was reduced by 54% (𝑃=0.0011).; Pooled effect sizes for pain reduction and improvement in physical function were 0.41 (𝑃<0.0001) and 0.46 (𝑃<0.0001), respectively.	GlcN·S may be effective and safe in delaying the progression and improving the symptoms of knee OA.