February 27, 2006 – Glucosamine, one of the most consumed natural health products in the country, would not be more effective than a placebo in relieving osteoarthritis, conclude American researchers in a large clinical trial published in the prestigious New England Journal of Medicine1. Is this a reason to stop taking glucosamine? No, say the experts.
“We forget to look at this trial in the light of all the predominantly positive data on glucosamine,” notes Mark Blumenthal, director of the American Botanical Council2. Glucosamine has in fact been the subject of several meta-analyzes which have concluded that it relieves pain associated with osteoarthritis and provides more mobility to the joints.3.
“We also forget to say that these products are safe and have a reasonable cost compared to prescription drugs. They sometimes offer almost the same effectiveness as drugs, which have documented side effects, ”says Mark Blumenthal.
|
Highlights of the study1
|
According to Mark Blumenthal, celecoxib did not do much better than glucosamine with a reduction in pain in 70% of cases compared to 64% for glucosamine. “Given the side effects of celecoxib and its relatively small advantage over placebo and glucosamine, people should just go without. It is not worth it. This is not what the researchers reported, but the data points in this direction, in my opinion, ”he added.
For his part, pharmacist Jean-Yves Dionne said he was surprised at the particularly high rate of the placebo effect in this trial. “Usually,” he says, “the placebo effect is not as strong in osteoarthritis trials. One should question why this trial yielded results that differ so much from other studies in this regard. “Mark Blumenthal goes even further:” It is very curious and it casts doubt on the validity of all the results “.
Complementary medicine expert Edzard Ernst points out that the placebo group reacted as if they believed they were receiving proper treatment, depending not only on the therapeutic benefits, but also on the adverse effects they experienced. “This is a very high quality study. But even if the differences between the treatments and the placebo are generally not significant, I doubt that this study will completely reverse all the existing evidence (note: concerning glucosamine and chondroitin), which are rather favorable ” , explains this professor attached to the Peninsula Medical School at the University of Exeter in England.
Depending on the severity: supplement or drug?
The study authors note that the glucosamine / chondroitin mixture was found to be more effective in patients with moderate to severe pain. In these subjects, celecoxib had no significant effect compared to placebo. Note that, of the 1,583 subjects, 78% suffered from mild pain while only 22% experienced moderate to severe pain.
According to pharmacist Jean-Yves Dionne, the results could have differed if the proportion of participants with moderate to severe pain had been higher. “Basically,” he says, “these results indicate that celecoxib can relieve patients with mild pain, while the glucosamine / chondroitin mixture would be more effective in more pain. But the authors of the article in New England Journal of Medicine did not phrase it that way. “
During the interview, Mark Blumenthal of the American Botanical Council did not fail to flay the media, which he said misinforms the public about natural health products by simply repeating the summary of results and press releases issued by the research teams.
“What is really unfortunate is that all of this is confusing not only readers and listeners, but also healthcare professionals, who read the same newspapers and listen to the same media as their patients,” he says. . Often times, they only read the headlines and the beginning of the article, so they don’t pick up on the nuances. “
Pierre Lefrançois, Françoise Ruby and Johanne Lauzon – PasseportSanté.net
According to Canadian press.
1. Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis, N Engl J Med, 2006 Feb 23; 354 (8): 795-808.
2. The American Botanical Council is a not-for-profit organization dedicated to providing accurate and reliable information on medicinal plants.
3. For more details, see our factsheet on glucosamine.
