From the Guidelines
Glucosamine is strongly recommended against for patients with knee, hip, and/or hand osteoarthritis (OA) due to a lack of efficacy and large placebo effects. The 2020 American College of Rheumatology guideline for the management of osteoarthritis of the hand, hip, and knee states that pharmaceutical-grade preparations of glucosamine have been studied in multiple trials, but the data deemed to have the lowest risk of bias fail to show any important benefits over placebo 1.
Some key points to consider:
- The potential toxicity of glucosamine is low, though some patients exposed to glucosamine may show elevations in serum glucose levels 1.
- Many patients perceive that glucosamine is efficacious, and clinicians should be aware of this when advising patients 1.
- The evidence indicates a lack of efficacy and large placebo effects, which is a change from the prior conditional recommendation against the use of glucosamine 1.
In terms of alternative approaches, maintaining a healthy weight, regular low-impact exercise, and anti-inflammatory foods may be beneficial for joint health. However, the use of glucosamine is not supported by the current evidence, and patients should be advised accordingly 1.
From the FDA Drug Label
Uses For the temporary relief of minor aches and pains of muscles and joints associated with simple backache, arthritis, strains, bruises and sprains The glucosamine drug label indicates it is used for the temporary relief of minor aches and pains of joints associated with conditions like arthritis.
- The label suggests a potential benefit for joints by providing relief from minor aches and pains. 2
From the Research
Glucosamine Benefits for Joints
- Glucosamine may have a small to moderate effect in reducing osteoarthritis-related pain, as indicated by a systematic review and meta-analysis of 17 studies 3.
- The use of glucosamine sulfate may result in a statistically significant reduction in pain, with a summary standardized mean difference of -0.35 3.
- However, glucosamine may have little effect on joint-space narrowing, with a summary standardized mean difference of -0.10 3.
Combination with Chondroitin
- The combination of glucosamine and chondroitin may not have an additional effect on reducing pain in knee osteoarthritis compared to using either supplement alone 4.
- Chondroitin, alone or in combination with glucosamine, may have a small to moderate effect in improving pain in participants with osteoarthritis, with an absolute risk difference of 10% lower 5.
Safety and Efficacy
- Glucosamine and chondroitin seem to be safe, with no serious adverse events reported 6.
- The effect sizes of glucosamine and chondroitin on osteoarthritis symptoms are generally small and may not be clinically relevant 6.
- More high-quality studies are needed to explore the role of glucosamine and chondroitin in the treatment of osteoarthritis 5, 6, 4.