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Friday, September 17, 2010

Ineffective: glucosamine and chondroitin for arthritis

A new meta-analysis (a synthesis of many randomized cinical trials) by Juni and colleagues published in the British Medical Journal this week has found that glucosamine and chondroitin supplements, popularly prescribed and taken for arthritis,are not significantly effective in reducing the joint space narrowing that comes from arthritis nor the pain intensity of arthritis.

10 years ago I was asked to answer a question on a Johns Hopkins "Intellihealth" question and answer site about whether glucosamine and chondroitin were effective for arthritis. I said that taking these things for arthritis would be expected to be about as effective as eating kidney would be for kidney disease, or brains for neurodegenerative disorders. I was very surprised, then, when some trials showed an effect of these compounds and I had to retract my answer. So I guess I can feel a little less concerned that I misled anyone in the past, seeing from this meta-analysis that the industry-independent studies show very little or no effect and even the ones funded by the pharmaceutical and supplement industries show very tiny effects of no clinical significance.

While there doesn't seem to be anything toxic about taking these compounds, and they may have very small effects, they are expensive. I agree with the authors that insurers probably should not pay for them given the hundreds of more effective preventive interventions in medicine which right now are not being paid for by health insurance which should take higher priority, which for arthritis would include exercise or yoga classes.

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