Written by Greg Arnold, DC, CSCS. In 465 patients with knee pain, those taking glucosamine and chondroitin had the same reduction in arthritis pain as Celebrex.
Osteoarthritis affected 26.9 million U.S. adults in 2005, a 28% increase from the 21 million Americans in 1990 (1). Healthcare costs for osteoarthritis total $5,700 per patient per year, costing up to $13.2 billion in lost worker productivity annually (1). The first-line treatment for osteoarthritis is over-the-counter medications called non-steroidal anti-inflammatory drugs. However, “potentially serious” side effects which can include kidney (2,3) and stomach (4,5) problems lead physicians to prescribe arthritis medications like Celebrex, which grossed $2.18 billion in 2013 (6).
Now a new study (7) suggests the supplement combination of glucosamine and chondroitin is comparable to Celebrex in helping manage pain for people with severe knee arthritis. The study consisted of 465 patients with moderate-to-severe pain from knee arthritis, classified as a score greater than 300 on a grading scale called the WOMAC scale (8). Patients were given either 1,200 milligrams of chondroitin sulfate with 1,500 milligrams of glucosamine hydrochloride per day (given in 3 400-mg and 500-mg doses per day = 240 subjects) or 200 milligrams of Celebrex per day (225 subjects) for 6 months. Subjects completed WOMAC questionnaires every month until the end of the study.
The researchers noted statistically significant reductions in pain reduction after 4 months, with a 43.6% decrease in the glucosamine/chondroitin group (372 to 209.9) and a 50.7% decrease in the Celebrex group (372 to 183.5, p = 0.02). By 6 months, both groups had achieved similar decreases in WOMAC scores, with a 50.1% decrease in the glucosamine/chondroitin group (185.7-point decrease) and a 50.2% decrease in the Celebrex group (186.8-point decrease), though statistical significance wasn’t reached (p = 0.53).
For the researchers, the combination of glucosamine and chondroitin “appears to be beneficial in the treatment of patients with osteoarthritis of the knee and should offer a safe and effective alternative for those patients with cardiovascular or gastrointestinal conditions.”
Source: Hochberg, Marc C., et al. “Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.” Annals of the rheumatic diseases (2015): annrheumdis-2014.
Posted February 9, 2015.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com
References:
- “Osteoarthritis” posted on the CDC website
- Clive DM, Stoff JS. Renal syndromes associated with nonsteroidal anti-inflammatory drugs. N Engl J Med 1984;310:563-72
- Perneger TV, Wheiton PK, Klag MJ. Risk of kidney failure associated with the use of acetaminophen, aspirin, and nonsteroidal anti-inflammatory drugs. N Engl J Med 1994;331:1675-9
- Sol AH, Weinstein WM, Kurata J, McCarthy D. Nonsteroidal anti-inflammatory drugs and peptic ulcer disease. Ann Intern Me 1991;114:307-19
- Wilcox CM, Shalek KA, Cotsonis G. Striking prevalence of over-the-counter nonsteroidal anti-inflammatory drug use in patients with upper gastrointestinal hemorrhage. Arch Intern Med 1994;154:42-5
- Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis 2015 Jan 14. pii: annrheumdis-2014-206792. doi: 10.1136/annrheumdis-2014-206792. [Epub ahead of print]
- “Celebrex Sales Data” posted on drugs.com
- Pham T, van der Heijde D, Altman RD, et al. OMERACT-OARSI initiative: Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials revisited. Osteoarthritis Cartilage 2004;12:389–99
