Trial shows glucosamine ineffective for lower back pain

Trial shows glucosamine ineffective for lower back pain

A randomized controlled trial was conducted to determine the effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis.

Context Chronic low back pain (LBP) with degenerativelumbar osteoarthritis (OA) is widespread in the adult population.Although glucosamine is increasingly used by patients with chronicLBP, little is known about its effect in this setting.

Objective To investigate the effect of glucosamine inpatients with chronic LBP and degenerative lumbar OA.

Design, Setting, and Participants A double-blind, randomized,placebo-controlled trial conducted at Oslo University HospitalOutpatient Clinic, Oslo, Norway, with 250 patients older than25 years of age with chronic LBP (>6 months) and degenerativelumbar OA.

Interventions Daily intake of 1500 mg of oral glucosamine(n = 125) or placebo (n = 125) for 6 months,with assessment of effect after the 6-month intervention periodand at 1 year (6 months postintervention).

Main Outcome Measures The primary outcome was pain-relateddisability measured with the Roland Morris Disability Questionnaire(RMDQ). Secondary outcomes were numerical scores from pain-ratingscales of patients at rest and during activity, and the quality-of-lifeEuroQol-5 Dimensions (EQ-5D) instrument. Data collection occurredduring the intervention period at baseline, 6 weeks, 3 and 6months, and again 6 months following the intervention at 1 year.Group differences were analyzed using linear mixed models analysis.

Results At baseline, mean RMDQ scores were 9.2 (95% confidenceinterval [CI], 8.4-10.0) for glucosamine and 9.7 (95% CI, 8.9-10.5)for the placebo group (P = .37). At 6 months, themean RMDQ score was the same for the glucosamine and placebogroups (5.0; 95% CI, 4.2-5.8). At 1 year, the mean RMDQ scoreswere 4.8 (95% CI, 3.9-5.6) for glucosamine and 5.5 (95% CI,4.7-6.4) for the placebo group. No statistically significantdifference in change between groups was found when assessedafter the 6-month intervention period and at 1 year: RMDQ (P = .72),LBP at rest (P = .91), LBP during activity (P = .97),and quality-of-life EQ-5D (P = .20). Mild adverseevents were reported in 40 patients in the glucosamine groupand 46 in the placebo group (P = .48).

Conclusions Among patients with chronic LBP and degenerativelumbar OA, 6-month treatment with oral glucosamine comparedwith placebo did not result in reduced pain-related disabilityafter the 6-month intervention and after 1-year follow-up.

Trial Registration Identifier: NCT00404079

Participants Philip Wilkens, MChiro; Inger B. Scheel, PhD; Oliver Grundnes, PhD; Christian Hellum, MD; Kjersti Storheim, PhD

JAMA. 2010;304(1):45-52.

Author Affiliations: Department of Orthopaedics, Oslo University Hospital, and University of Oslo, Oslo, Norway (Mr Wilkens and Drs Grundnes, Hellum, and Storheim); SINTEF Health Research, Oslo, Norway (Dr Scheel); Norwegian Research Center for Active Rehabilitation (NAR), Oslo, Norway (Mr Wilkens and Dr Storheim). Dr Grundnes is now with Hjelp 24 NIMI, Oslo, Norway.

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