The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation
OA of the knee is a major source of disability in the UK, resulting in pain, loss of function and, for some, knee arthroplasty. Two components of cartilage structure, glucosamine and chondroitin, are available as food supplements and/or licensed medicines. This project undertook a systematic review of randomised controlled trials (RCTs) and observational data, and developed a cost-effectiveness model using cohort simulation. Value of information analysis was also conducted to inform future research priorities.
Glucosamine sulphate was found to have some clinical effectiveness. Cost-effectiveness was not conclusively demonstrated, with substantial uncertainty related to the magnitude and duration of quality of life gains. For other preparations, the evidence base was less consistent (chondroitin) or absent (glucosamine hydrochloride).
Outcome and Translation
Recommendations were made to the NIHR HTA Programme that future trials of interventions should focus on glucosamine sulphate as opposed to other preparations. Further, any future trial should prioritise collection of quality of life data using a generic, preference-based quality of life instrument.
HERU researchers involved in this research project: Paul McNamee and Zahidul Quayyum
External Collaborators: C Black, C Clar, P Royle, S Thomas (Population Health, University of Aberdeen); C MacEachern (Raigmore Hospital, Inverness) and R Henderson (NHS Grampian)
Black, C., Clar, C., Henderson, R., McNamee, P., MacEachern, C., Quayyum, Z., Royle, P. and Thomas, S.(2009) 'The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation', Health Technology Assessment, 13 (52).
McNamee, P., Quayyum, Z., Black, C., Clar, C., Henderson, R., Maceachran, C., Royle, P. and Thomas, S. (2010) 'The use of mapping in estimates of cost-effectiveness: helpful or harmful?', Society for Medical Decision Making, Toronto, October 2010.