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Osteoarthritis (Knee and Hip)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Glucosamine: Most research shows that taking glucosamine sulfate can provide pain relief for individuals with osteoarthritis, especially those with osteoarthritis of the knees.8 Data from double-blind studies showed glucosamine was superior to ibuprofen in patients with osteoarthritis of the knee.9
Herbal and Supplement Use in Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Drug interactions: Acetaminophen: adding glucosamine to acetaminophen may decrease pain in patients with osteoarthritis. Some research suggests that the sulfate portion of glucosamine sulfate might contribute to its effect in osteoarthritis.79Anti-diabetic drugs: glucosamine might increase insulin resistance or decrease insulin production leading to worsened diabetes and a decrease in effectiveness of diabetic drugs.80Topoisomerase II inhibitors: glucosamine might induce resistance to etoposide and doxorubicin by reducing the drug’s inhibition of topoisomerase II. Other drugs such as mitoxantrone and anthracyclines may also be affected.81Warfarin: taking chondroitin in combination with glucosamine might increase the anticoagulant effects of warfarin and increase risk of bruising and bleeding. May increase INR.76
Glycosaminoglycans
Published in Luke R. Bucci, Nutrition Applied to Injury Rehabilitation and Sports Medicine, 2020
Research on the effects of glucosamine on a common injury seen in sports medicine — chondromalacia patellae — showed promising results, indicating that glucosamine may have broad applications for repair of cartilage, and perhaps other connective tissues, given the known mechanisms of action. All connective tissues and cells must synthesize hyaluronan, GAGs, and collagen in order to regenerate, repair, or produce extracellular matrix. Glucosamine offers a single agent that stimulates synthesis of all macromolecular components of cartilage. Thus, application to other degenerative joint diseases is a logical extension of the known properties of glucosamine. Any conditions that involve repair of cartilage and joints is an indication for glucosamine therapy. Such conditions would include osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, invertebral disc conditions, chondromalacia, tendinitis, bursitis, osteochondrosis, postsurgical repair of traumatic injury to joints, traumatic injury to joints, and tenosynovitis. Speculative uses would include repair of other connective tissues, such as tendon or ligament tears and repair, skin wound healing, and fracture repair.
Assessment of pharmacy students’ knowledge, attitude, and practice toward herbal dietary supplements
Published in Journal of American College Health, 2022
Sarah A. Nakhal, Souraya A. Domiati, Mohamed E. K. Amin, Abdalla M. El-Lakany
Fish oil or Omega-3 is one of the most commonly consumed dietary supplements that provides many health benefits, including protection against a number of diseases such as cardiovascular, eye, and mental diseases, aids in weight loss, and reduce inflammation. Another consumed dietary supplement is fiber or psyllium used as a bulk-forming laxative. Furthermore, cranberry used for treating or preventing urinary tract infection (UTI), improving heart health, fighting age-related damage, and supporting the digestive system. Glucosamine and chondroitin are used for the treatment of osteoarthritis, despite the proof that they are no more effective than placebo in delaying the progression of cartilage loss in patients with moderate-to-severe knee osteoarthritis.14 Indeed, in the current study, these 5 herbal products were most frequently used by pharmacy students. This can be correlated by the fact that students refer mostly to the Internet (56%) as a source of information due to easy accessibility. In fact, according to the finding of Alhomoud et al.,6 the Internet carries a vast range of information, resources, and services. Textbooks accounted for the lowest percentage, although they are the most trusted source of information.
What is the selection process for osteoarthritis pharmacotherapy?
Published in Expert Opinion on Pharmacotherapy, 2020
Shirley P. Yu, David J. Hunter
Nutraceuticals are popular with their direct marketing and labeling of the products stating its potential benefits for specific chronic conditions. The use of fish oil, vitamin D, glucosamine, chondroitin sulfate are all discouraged in OA guidelines. There is limited evidence of their efficacy in OA, and glucosamine, the most commonly used supplement is now strongly recommended against by OA guidelines [13]. There are concerning publication biases in glucosamine trials with a trend toward a larger effect size in industry-sponsored trials [39]. Lately, there has been more topical focus toward curcumin, the principal curcuminoid extracted from turmeric root (curcuma longa). Curumin is thought to be an inhibitor of nuclear factor-kappa β (NF- κβ) and may have pain reduction effects in OA. A recent double-blind multi-center, randomized placebo controlled trial of a bio-optimized curcuma longa extract showed a significant decrease in knee OA pain, with positive trends for Patient Global Assessment of Disease Activity and serum sColl2-1, a biomarker of cartilage degradation [40]. The study is of short duration with 150 participants, and further large-scale investigational trials are required before conclusive recommendations can be made for this nutraceutical.
Glucosamine for the Treatment of Osteoarthritis: The Time Has Come for Higher-Dose Trials
Published in Journal of Dietary Supplements, 2019
Mark F. McCarty, James H. O'Keefe, James J. DiNicolantonio
Despite the marked inconsistencies in the clinical research literature with glucosamine, there are ample grounds for suspecting that, in adequately potent doses, it is indeed useful in osteoarthritis. One key consideration is that the onset of pain relief with supplemental glucosamine is said to be gradual, taking several weeks to be most noticeable; when glucosamine is discontinued, pain may take a week or more to return (McCarty, 1994). This is not the pattern of benefit that one would expect to see with a placebo effect. Moreover, whereas there are some clinical trials reporting benefit and others failing to note benefit, where are the studies in which glucosamine performed worse than placebo? The fact that the commercial market for glucosamine supplements remains substantial despite the broad publicity given to negative clinical trials is consistent with the possibility that some people are indeed getting genuine benefit. The clear efficacy of glucosamine in animal models of arthritis, albeit usually at doses proportionately higher than those employed clinically, also suggests that glucosamine may have genuine clinical potential in arthritis. (Admittedly, some of these may be closer to rheumatoid arthritis in their pathogenesis than osteoarthritis, which brings up the interesting point that the only double-blind study to have tested glucosamine in patients with rheumatoid arthritis found that it did indeed confer some symptomatic benefit [Nakamura et al., 2007].)