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NHS should not fund glucosamine

No benefits found in review of glucosamine and chondroitin research

Louise Prime

Friday, 17 September 2010

Glucosamine and chondroitin are ineffective in reducing pain or damage from hip or knee osteoarthritis and should not be paid for by the NHS or health insurers, say researchers on bmj.com today. But they add that, as their research showed that the supplements do no harm, patients may continue to buy them themselves if they perceive that they gain some benefit.

Internationally, sales of the glucosamine supplements alone reached $2bn in 2008, and GPs and rheumatologists have increasingly prescribed both supplements, yet evidence on their use is mixed. So researchers in Bern, Switzerland, conducted a meta-analysis of 10 previously published studies into the safety and effects of glucosamine and chondroitin on pain and joint damage arising from osteoarthritis of the hips and knees. A total of 3803 patients were involved in these trials.

The researchers, led by Professor Peter Jüni at the University of Bern in Switzerland, analysed the results of these studies for changes in perceived pain after using glucosamine and chondroitin, alone or in combination, either against placebo or in head-to-head comparison. They also looked at reported changes in joint space narrowing.

They found that there was no clinically relevant benefit in either pain or joint space narrowing, with either supplement or with both combined. They acknowledge that many patients remain convinced of the products’ benefits, but suggest that this could be explained by the placebo effect or the naturally variable course of osteoarthritis.

 “Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space,” say the authors. But because the supplements are not dangerous “we see no harm in having patients continue these preparations as long as they perceive a benefit and cover the cost of treatment themselves.”

They conclude: “Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.”

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