I hear about this study on NPR, have not looked at the actual paper yet. The NPR coverage focused on pain relief but did the study look at actual effectivness of Glucosamine at healing / growing cartlage? In the context of this study is saying that there is limited benefit in terms of pain relief the same as saying it does not heal cartlage?

I'm not saying jt58 doesn't sometimes know what he is talking about, many autistic people are smart in their limited fields.

"A psychiatric disorder characterized by marked deficits in communication and social interaction"

I work for a company that sells a glucosamine product and I have never heard anyone speak badly about it. It seems to work quite well for ayone who tried it, course they're all old folks mostly, don't know if a lot of climbers have tried it but there you go, just my two cents. :)

Maybe it has been proven not to work in this most recent study, but look at the testimonials that have arisen. A small price to pay compared to the lifestyle improvements for those suffering from arthritis.

In their 2005 meta-analysis Towheed et al found that only trials that used the Rotta Pharmaceutical preparation of glucosamine sulfate showed reduction of pain, increase in function, and slowed progression of radiographic pathology of the knee. No benefits were found for non-Rotta preparations.

Plain language summary
Does glucosamine work for treating osteoarthritis?
To answer this question, scientists found and analyzed 20 research studies. The studies tested over 2500 people with osteoarthritis of the knee or hip. Most of the studies were 2 to 3 months long. People were either given glucosamine (as a pill or injection), or were in another group that had a fake pill or injection, or a non-steroidal anti-inflammatory drug (NSAID) to test which worked better. This Cochrane review provides the best evidence we have today.

How well does glucosamine work?
Pain: The high quality studies showed that pain improved about the same whether people took glucosamine or fake pills. If all of the studies are examined (including low quality and old studies), then glucosamine improved pain more than fake pills.
Pain improved by 13 more points on a scale of 0 to 100 with glucosamine than with fake pills.

Function: The high quality studies show that glucosamine improved pain more than fake pills when measured by one type of scale, but improved the same amount as fake pills when measured by another scale. This result is the same when all of the studies (including low quality and old studies) are analysed.

Studies testing only the Rotta brand of glucosamine (including low quality and old studies) showed that glucosamine improved pain more than fake pills. Glucosamine improved function more with glucosamine when measured by one type of scale but improved the same amount as fake pills when measured by another type of scale.

How safe is it?
The number of people taking glucosamine who had side effects was about the same as the number who took fake pills. Side effects mainly included stomach upset and other joint pain.

What is the bottom line?
It was shown in a previous Cochrane review that glucosamine taken for 6 weeks decreases pain and improves function (physical ability) in people with osteoarthritis.

When compared to the previous review, this review which analyzes newer studies and more high quality studies, shows there is "platinum" level evidence that pain does not improve as much when taking glucosamine for 2 to 3 months. Depending on the scale used to measure function (physical ability), function may not improve at all or as much.

Nice job of mis-characterizing the report...you should be a journalist. Many of the studies they analyzed were old or low-quality (single-blind, etc) but the newer high-quality studies gave less positive results. Several of the studies used injections, not pills.

Main results
Analysis restricted to eight studies with adequate allocation concealment failed to show benefit of glucosamine for pain and WOMAC function. Collectively, the 20 analyzed RCTs found glucosamine favoured placebo with a 28% (change from baseline) improvement in pain (SMD -0.61, 95% CI -0.95, -0.28) and a 21% (change from baseline) improvement in function using the Lequesne index (SMD -0.51 95% CI -0.96, -0.05). However, the results are not uniformly positive, and the reasons for this remain unexplained. WOMAC pain, function and stiffness outcomes did not reach statistical significance.

In the 10 RCTs in which the Rotta preparation of glucosamine was compared to placebo, glucosamine was found to be superior for pain (SMD -1.31, 95% CI -1.99, -0.64) and function using the Lequesne index (SMD -0.51, 95% CI -0.96, -0.05). Pooled results for pain (SMD -0.15, 95% CI -0.35, 0.05) and function using the WOMAC index (SMD 0.03, 95% CI -0.18, 0.25) in those RCTs in which a non-Rotta preparation of glucosamine was compared to placebo did not reach statistical significance. In the four RCTs in which the Rotta preparation of glucosamine was compared to an NSAID, glucosamine was superior in two, and equivalent in two. Two RCTs using the Rotta preparation showed that glucosamine was able to slow radiological progression of OA of the knee over a three year period (SMD 0.24, 95% CI 0.04, 0.43).

Nice job of mis-characterizing the report...you should be a journalist. Many of the studies they analyzed were old or low-quality (single-blind, etc) but the newer high-quality studies gave less positive results. Several of the studies used injections, not pills.

Main results
Analysis restricted to eight studies with adequate allocation concealment failed to show benefit of glucosamine for pain and WOMAC function. Collectively, the 20 analyzed RCTs found glucosamine favoured placebo with a 28% (change from baseline) improvement in pain (SMD -0.61, 95% CI -0.95, -0.28) and a 21% (change from baseline) improvement in function using the Lequesne index (SMD -0.51 95% CI -0.96, -0.05). However, the results are not uniformly positive, and the reasons for this remain unexplained. WOMAC pain, function and stiffness outcomes did not reach statistical significance.

In the 10 RCTs in which the Rotta preparation of glucosamine was compared to placebo, glucosamine was found to be superior for pain (SMD -1.31, 95% CI -1.99, -0.64) and function using the Lequesne index (SMD -0.51, 95% CI -0.96, -0.05). Pooled results for pain (SMD -0.15, 95% CI -0.35, 0.05) and function using the WOMAC index (SMD 0.03, 95% CI -0.18, 0.25) in those RCTs in which a non-Rotta preparation of glucosamine was compared to placebo did not reach statistical significance. In the four RCTs in which the Rotta preparation of glucosamine was compared to an NSAID, glucosamine was superior in two, and equivalent in two. Two RCTs using the Rotta preparation showed that glucosamine was able to slow radiological progression of OA of the knee over a three year period (SMD 0.24, 95% CI 0.04, 0.43).

So, like I said, while there is still uncertainty, the best evidence to date favors Rotta brand glucosamine sulfate.

So, like I said, while there is still uncertainty, the best evidence to date favors Rotta brand glucosamine sulfate.

Left out Main Results because it will confuse most people here.

Considering that none of the tests have directly compared the two versions of glucosamine and the results with sulfate are mixed at best, it's premature to recommend paying a lot more -- especialy since Rotta funded some of the studies.

I'm curious why you defend such shakey science yet refuse to acknowledge the validity of more solid studies...

i dont currently use glucosamine myself but i do use it alot on many of my patients. as they are all animals this negates the placebo effect.

Billcoe (in response to what you said to me two pages back),

your response doesn't crap on my story, because, my story wasn't an isolated incident. My fingers, to get specific, my knuckles, had been getting stiff and sore for well over a year. I don't even know exactly when they started getting sore, because it had been going on for so long. Ibuprofen helped some, but there's only so much it could do, and it mainly just hid pain, rather than fixed the problem. THEN I had that hard climbing day, which made my hands so sore I couldn't clench a fist and THEN I tried glucosamine and within a month every pain/stiffness/swelling issue in my knuckles was gone. So the pattern is this: years of pain, enormous culmination of pain, one month of glucosamine, hardest climbing trip I'd taken in 8 years of climbing, with no pain whatsoever, and none ever since.

And, to add further evidence that it is the glucosamine: there have been times when I've been so low on cash I just decided to not buy the pills (cause they can be pricey, depending on where you get them). And, after a while, my hands would start to hurt. Then, after growing a brain and realising that my health shouldn't be compromised to save a few bucks, I'd go buy the pills, and, wallah! The pain would disappear again.

I know it sounds too good to be true - like some kind of wonder pill. Well, for me, it seems to be. If this is placebo affect it is one hell of a strong placebo affect, and I sure as hell intend to keep taking it. Also, the MSM in the formula I think is pretty huge - I bought just the glucosamine-chondroiton mix one time, and the results weren't as good.

Will

Don't throw up your hands just yet! There is a way around the uncertainty.

If jt58 agrees with the study then the situation is black and white and the study is valid, regardless of the lack of statistical significance or flawed design. Otherwise, regardless of how many studies suggest a result different than jt58's beliefs, there is no proof of anything and all suggestions are to discarded.

we all wait patiently for the definitive word...

Well, now it's just a matter of time until JT5.6 gets here since you called him out.

First of all, there is no evidence that glucosamine hydrochloride has any benefit, and there are theoretical grounds for favoring the sulfate, so it makes no sense at all to use glucosamine HCl.

To me, the only rational choices are (1) and (3), since at the present time, the only scientific evidence showing a befefit for glucosamine is for Rotta glucosamine sulfate.

in a world of infinite color and possibility jt58 manages, once again, to pull out the subtle shades of black and white