Study shows pain relief possible from dietary supplements









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James O’Dell, M.D.

Results of a National Institutes of Health funded trial show the combination of glucosamine and chondroitin work as well or better in relieving knee pain from moderate to severe osteo-arthritis than standard prescription therapy.

The study appears in this week’s New England Journal of Medicine.

The combination of glucosamine and chondroitin sulfate are already widely used and promoted in the United States as a treatment for osteoarthritis. There has been a debate in the scientific community about the efficacy of these compounds and whether they needed to be used together.

The results from the NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) now provide evidence that patients with moderate to severe osteoarthritis may get significant relief from this well tolerated combination. One out of every six Americans suffer from osteoarthritis and this number rises as we age.

“We compared standard pain relief therapy for osteoarthritis of the knee with both placebo, and with supplements,” said James O’Dell, M.D., professor of internal medicine at UNMC and one of the authors of the study.

“What we found is that if you have moderate to severe pain from O.A. of the knee, a combination of glucosamine/chondroitin is significantly more effective than placebo, and as least as effective as Celebrex in relieving pain.”

Many patients with knee osteoarthritis currently use Celebrex or other non-steroidal anti-inflammatory drugs (NSAIDS). Both offer significant benefit, and many people tolerate the drugs well. But others do not. Celebrex is the only Cox II inhibitor drug still on the market, after other Cox II inhibitors were linked to heart disease. Frequent use of NSAIDS can lead to complications including ulcers, hypertension, blood clots, heart attacks, fluid retention and kidney failure.

“This study is important because we need as many options for treating pain and dysfunction resulting from severe osteoarthrits as possible,” Dr. O’Dell said.

The principal investigator for the NIH GAIT study is Dr. Daniel O. Clegg, from the University of Utah School of Medicine. Sixteen centers took part in the study, which enrolled 1,583 patients with knee osteoarthritis.

Dr. O’Dell, a nationally recognized rheumatologist, was responsible for enrolling 276 patients — over one-sixth of the study population.

Dr. O’Dell emphasized the GAIT study showed that only those patients with moderate to severe knee pain found relief with Glucosamine/Chondroitin.

“It’s important to note these supplements weren’t shown to be effective at relieving mild pain in patients with knee osteoarthritis.”

Dr. Dan Clegg, the principal investigator of the study said, “I urge people with osteoarthritis to follow a comprehensive plan for managing their arthritis pain. Developing and maintaining a healthy lifestyle is key to the successful management of osteoarthritis — eat right, exercise regularly, lose excess weight and consider the use of medications based on your degree of pain.”

In a second part of the study, researchers will track whether taking glucosamine and chondroitin sulfate alone and in combination affects progression of knee osteoarthritis. Results of the second part of the study are expected in about a year.