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Superiority Over NSAIDs

  • Unlike NSAIDs, which act through the inhibition of cyclooxygenase and modification of prostaglandin synthesis, the mechanism of action of glucosamine appears to be linked to its ability to stimulate  synthesis of the proteoglycans needed to stabilize cell membranes and increase intracellular ground substance.

  • Forty-one patients with a diagnosis of unilateral osteoarthritis of the knee were randomly assigned to either a glucosamine group (500 mg glucosamine three times per day) or an ibuprofen group (400 mg ibuprofen three times per day) for eight weeks of treatment. Self-assessed pain scores decreased in both treatment groups. The ibuprofen-treated  patients experienced a more dramatic reduction in pain during the initial two weeks of treatment; however pain scores stabilized at this point and no further reductions were reported. While reduction in pain was not as rapid for individuals being treated with glucosamine after four weeks of treatment, reduction in pain was greater in glucosamine -treated patients than in ibuprofen-treated patients. In contrast to individuals treated with ibuprofen, continued administration of glucosamine also resulted in a continued decrease in individual pain scores throughout the eight weeks of therapy4 .

  • Two groups of patients with chronic degenerative articular disorders received either 400 mg of glucosamine or a piperazine/chlorbutanol (P/C) combination either IV or IM daily for seven days4.  After completion of the injections the group who had been receiving glucosamine was given 500 mg of glucosamine orally three times daily for two weeks, while the other group of patients was placed on placebo. Symptoms improved in both groups during parenteral treatment; however a faster and greater improvement in symptoms was reported for the individuals receiving glucosamine (58% decreases in symptoms as opposed to 31% for P/C group). An additional reduction in the symptom score (13%) was reported by individuals receiving follow-up oral glucosamine while individuals on placebo had a reversal of symptom scores with their symptoms returning to approximately pretreatment levels.

  • Crolle and D'Este4, utilizing a similar protocol reported the same favorable outcome in terms of symptom improvement. Additionally, they observed a significant functional improvement, as measured in walking speed over 20 meters with the glucosamine group improving their speed by 72%.

  • Rovati4 similarly reported that administration of glucosamine was more effective than placebo and comparable in effect to ibuprofen for treatment of osteoarthritis of the knee. Since the anti-inflammatory ability of glucosamine is different than that of NSAIDs it is possible the two might have a synergistic effect in alleviating some types of inflammation. Evidence indicates a combined treatment utilizing glucosamine with either voltaren, indomethacin or piroxicam5 can decrease the amount of NSAID required to produce an antiexudative result by a factor of between 2-2.7 times with preservation  of activity5 .