Glucosamine, Chondroitin Comparable to Celecoxib for OA Pain?

Hochberg MC, Martel-Pelletier J, Monfort J, et al., Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.Ann Rheum Dis. 2015; Published online  Jan 14. doi: 10.1136/annrheumdis-2014-206792. [Epub ahead of print]

This randomized clinical trial finds the combination of glucosamine hydrochloride and chondroitin sulfate comparable to celecoxib (Celebrex) in reducing pain, swelling, and functional limitation after 6 months in people with moderate-to-severe knee osteoarthritis (knee OA).

The international phase IV Multicentre Osteoarthritis interVEntion trial with SYSADOA (MOVES) trial calls the combo is “a safe and effective alternative” for patients with cardiovascular or gastrointestinal conditions who cannot take non-steroidal anti-inflammatory drugs (NSAIDs).

A parallel-group, double-blind “non-inferiority” study, MOVES randomized606 knee OA patients treated in clinics in France, Germany, Poland and Spain to receive 200 mg celecoxib every day or a combination of 400 mg chondroitin sulfate plus 500 mg of glucosamine hydrochloride three times a day for 6 months.

Both treatments decreased pain scores according to the Western Ontario and McMaster osteoarthritis index (WOMAC) by around 50% after 6 months, with a similar reduction in WOMAC scores for function and joint stiffness.

Almost 80% of the patients met response criteria set by the Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) for decreased joint swelling and effusion, as well as a reduction in use of rescue medication.

Over the past decade, some clinical trials have found the glucosamine-chondroitin combo relieves knee OA pain and even reverses or restores degenerative changes in cartilage, while other trials conclude it’s little better than a placebo. Various meta-analyses seeking to resolve the debate have also come to varied conclusions.

In its updated 2014 non-surgical guidelines for managing knee OA, OARSI concluded that glucosamine and chondroitin were of “uncertain benefit” for knee OA.