Researchers discuss the utility of glucosamine for preventing joint destruction and inflammation

In this article, American researchers discussed the use of glucosamine in the treatment of osteoarthritis. Their review was published in the Journal of Dietary Supplements.

• Despite giving mixed results in clinical trials against osteoarthritis, glucosamine’s ability to prevent joint destruction and inflammation is well-documented in studies involving rodent models of arthritis and spontaneous osteoarthritis.
• Research suggests that oral glucosamine’s effect is markedly dose-dependent, likely reflecting a regulation of tissue levels of UDP-N-acetylglucosamine.
• This regulation, in turn, influences mucopolysaccharide synthesis and the extent of protein O-GlcNAcylation.
• The minimal oral dose of glucosamine that works against arthritis elevates plasma glucosamine to the same levels achieved when the standard clinical dose (1.5 grams daily) is administered as a bolus.
• The response of plasma glucosamine levels to an increase in glucosamine intake is nearly linear.
• Interestingly, every published clinical trial has used the same 1.5 g dose recommended by Rottapharm for its proprietary glucosamine sulfate product decades ago, despite there being no evidence that the dose is optimal with respect to efficacy and side effects.
• According to the researchers, if this dose is clinically efficient, then variations in patient populations targeted, the assessment vehicles employed and the potency of glucosamine preparations tested would yield some null results.
• They also suspect that failure to employ bolus dosing is a factor in the null results observed in the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) study and in other trials.

The researchers believe that clinical studies should instead focus on the dose-dependency of glucosamine’s influence on osteoarthritis to determine its efficacy.

Journal Reference:

Mccarty MF, O’keefe JH, Dinicolantonio JJ. GLUCOSAMINE FOR THE TREATMENT OF OSTEOARTHRITIS: THE TIME HAS COME FOR HIGHER-DOSE TRIALS. Journal of Dietary Supplements. 18 April 2018;16(2):179–192. DOI: 10.1080/19390211.2018.1448920