Is there an echo in here? Didn’t I have another item about this just recently? I did indeed: on July 8 I shared news that glucosamine made no difference for back pain patients, and here we are again with yet another F-grade for glucosamine, this time for knee pain (which is the problem that most people take the stuff for). If glucosamine were a student, its parents would get called in for a conference about little glucosamine’s poor performance. Perhaps there’s something going on at home? This is how the latest report card reads:
Over 2 years, no treatment [neither glucosamine nor chondroitin sulphate] achieved a clinically important difference in [knee] pain or function as compared with placebo.
(The conventional pain-killer celecoxib did not have any effect either.)
The pile of glucosamine failures is now getting rather tall. This morning Dr. Harriet Hall reviewed the evidence of absence of any glucosamine benefits in more detail at ScienceBasedMedicine.org and concludes that glucosamine proponents
… can always complain that maybe it works for knees but not for hips, or that a different dosage might have worked better, or that it works for some small sub-set of patients. There will always be “one more study” to do. … This new study confirms my opinion that we shouldn’t spend any more research dollars doing “one more study” on glucosamine.
Here’s the references for both of glucosamine’s recent epic fails:
- Sawitzke 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. Ann Rheum Dis. 2010.
- Wilkens et al. Effect of Glucosamine on Pain-Related Disability in Patients With Chronic Low Back Pain and Degenerative Lumbar Osteoarthritis: A Randomized Controlled Trial. Journal of the American Medical Association. 2010.
Not that this evidence will actually stop people from “believing” in glucosamine and buying it in bulk! Glucosamine bottlers will really appreciate everyone’s continued gullibility.
2 Comments
I was just in to see my orthopedist yesterday for PFPS sustained during an acute trauma. Having read the Wilkens et al piece earlier in the month I was amazed when he suggested I get on glucosamine…mentioned the study to him and he said “It seems to work for some people, so it’s up to you.”
What kind of madness is this! “Take 3 lizards twice a day with a dragon’s tooth for knee pain” would be just as rational. This is a great blog, thanks for injecting science back into pain treatment!
It is peculiar that we’ve gotten a decade into the 21st Century and many physicians still haven’t realized that the plural of “anecdote” is not evidence, and that medical advice needs to be based on evidence as much as possible. There’s nothing wrong with saying that something is experimental and discussing it as an option, but it’s crazy to recommend treatments that have bombed numerous fair tests of their effectiveness.
But people will believe in nearly anything — there were testimonials for radioactive hot springs as a treatment; people have literally taken poison and claimed “it worked for me”; etc — and doctors will continue to defer to patient’s anecdotes.