Glucosamine Research
40 peer-reviewed studies · Evidence score: 9/10
Safety of Anti-osteoarthritis Medications: A Systematic Literature Review of Post-marketing Surveillance Studies
Honvo G et al. • Drugs (2025)
This SR confirms previous evidence on the safety of anti-OA medications from meta-analyses of phase 3 RCTs.
- This SR confirms previous evidence on the safety of anti-OA medications from meta-analyses of phase 3 RCTs.
- Beyond the evidence here reported, the limitations of this research highlight the urgent need of a reporting guideline for post-marketing safety surveillance studies.
- Importantly, real-life safety surveillance of anti-OA medications should be strengthened with large cohort studies with control groups, and results should be disaggregated by disease populations for drugs common to several conditions.
Efficacy and safety of the combination of glucosamine and chondroitin for knee osteoarthritis: a systematic review and meta-analysis
Meng Z et al. • Archives of orthopaedic and trauma surgery (2023)
Our study confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent.
- Our study confirmed that the combination of glucosamine and chondroitin is effective and superior to other treatments in knee osteoarthritis to a certain extent.
- It is worthwhile to popularize and apply the combination in KOA treatment considering the point of effect, tolerability and economic costs.
- Additionally, regarding the limited number of studies and uneven trial quality, more high-quality trials are required to investigate the accurate clinical advantages of the combination.
The efficacy and safety of Jinwu Gutong capsule in the treatment of knee osteoarthritis: A meta-analysis of randomized controlled trials
Zhao J et al. • Journal of ethnopharmacology (2022)
JWGT is considered effective and safe in the treatment of KOA and is worthy of clinical application.
- The effective rate (OR = 2.56, 95% CI = 1.83 to 3.57, P < 0.001) and incidence of adverse reactions was significantly lower in the JWGT group than in the control group (OR = 0.13, 95% CI = 0.07 to 0.21, P < 0.001).
- Compared with hyaluronic acid (HA) alone, JWGT + HA had better clinical efficacy (OR = 3.08, 95% CI = 1.48 to 6.40, P < 0.001).
- JWGT is considered effective and safe in the treatment of KOA and is worthy of clinical application.
Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysis
Kessler CS et al. • Rheumatology international (2015)
Well-planned, well-conducted and well-published trials are warranted to improve the evidence for Ayurvedic interventions.
- For the compound preparation, Rumalaya, large and apparently unbiased effects beyond placebo were found for pain (standardized mean difference [SMD] -3.73; 95 % confidence interval [CI] -4.97, -2.50; P < 0.01) and global improvement (risk ratio 12.20; 95 % CI 5.83, 25.54; P < 0.01).
- There is also some evidence that effects of the herbal compound preparation Shunti-Guduchi are comparable to those of glucosamine for pain (SMD 0.08; 95 % CI -0.20, 0.36; P = 0.56) and function (SMD 0.15; 95 % CI -0.12, 0.36; P = 0.41).
- No severe adverse events were observed in all trials.
The Safety and Efficacy of Glucosamine and/or Chondroitin in Humans: A Systematic Review
Baden KER et al. • Nutrients (2025)
Overall, the evidence suggests that glucosamine and chondroitin are generally effective and well-tolerated, particularly for managing osteoarthritis and joint pain.
- Of the 2013 articles screened, 146 studies were included in our review, with nearly 60% being randomized controlled trials and most conducted in Europe, Asia, or the U.S.
- Most studies focused on osteoarthritis and joint pain, with over 90% of efficacy studies reporting positive outcomes and most safety studies indicating minimal or no adverse effects.
- Overall, the evidence suggests that glucosamine and chondroitin are generally effective and well-tolerated, particularly for managing osteoarthritis and joint pain.
Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee
Zeng C et al. • Scientific reports (2015)
The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA.
- All treatment options showed clinically significant improvement from baseline pain, but only glucosamine plus chondroitin showed clinically significant improvement from baseline function.
- In terms of the structure-modifying effect, both glucosamine alone and chondroitin alone achieved a statistically significant reduction in joint space narrowing.
- The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA.
Chondroitin for osteoarthritis
Singh JA et al. • The Cochrane database of systematic reviews (2015)
A review of randomized trials of mostly low quality reveals that chondroitin (alone or in combination with glucosamine) was better than placebo in improving pain in participants with osteoarthritis in short-term studies.
- Loss of minimum joint space width in the chondroitin group was statistically significantly less than in the placebo group, with a relative risk difference of 4.7% less (95% CI 1.6% to 7.8% less; n = 2 trials) (level of evidence, high; risk of bias, low).
- Chondroitin was associated with statistically significantly lower odds of serious adverse events compared with placebo with Peto odds ratio of 0.40 (95% CI 0.19 to 0.82; n = 6 trials) (level of evidence, moderate).
- Chondroitin did not result in statistically significant numbers of adverse events or withdrawals due to adverse events compared with placebo or another drug.
Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank
Runhaar J et al. • Annals of the rheumatic diseases (2017)
Although proposed and debated for several years, open trial data are not widely made available for studies of glucosamine for OA, especially those sponsored by industry.
- Five trials (all independent of industry, n=1625) compared glucosamine with placebo, representing 55% of the total number of participants in all published placebo-controlled RCTs.
- Although proposed and debated for several years, open trial data are not widely made available for studies of glucosamine for OA, especially those sponsored by industry.
- Further research warranted to confirm findings
Effectiveness and Safety of SYSADOAs Used in Eastern and Western Regions for the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials-SYSADOAs Are Effective and Safe for Knee OA
Park YB et al. • Medicina (Kaunas, Lithuania) (2025)
Level of Evidence: Therapeutic Level II.
- Regarding the safety profile, the risk ratios did not differ significantly between the treatment and control groups, including the placebo and non-placebo subgroups.
- Conclusions: Glucosamine, chondroitin, and SKCPT/SKI306X improved the pain and function and were non-inferior to pharmacologic drugs for up to 12 months.
- These findings support the clinical use of these SYSADOAs to treat knee OA.
Role of Glucosamine and Chondroitin in the Prevention of Cancer: A Meta-Analysis
Liu B et al. • Nutrition and cancer (2023)
Moreover, NSAIDs use may have a synergistic protective effect.
- The odds ratio (OR), corresponding to the 95% confidence interval (95% CI), was used to assess the association between chondroitin and/or glucosamine intake and cancer risk.
- Overall, chondroitin and/or glucosamine intake was associated with a lower risk of colorectal cancer (OR = 0.91, 95% CI, 0.87-0.94) and lung cancer (OR = 0.84, 95% CI, 0.79-0.89).
- Subgroup analysis supported the protective effect of different SYSADOAs (chondroitin and/or glucosamine) intake.
Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs
Gwinnutt JM et al. • RMD open (2022)
The current literature suggests that there is moderate evidence for a small benefit for certain dietary components.
- The current literature suggests that there is moderate evidence for a small benefit for certain dietary components.
- High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.
- Further research warranted to confirm findings
Oral Glucosamine in the Treatment of Temporomandibular Joint Osteoarthritis: A Systematic Review
Derwich M et al. • International journal of molecular sciences (2023)
Further long-term, randomized, double-blind studies, with a unified methodology, ought to be performed to draw the general recommendations for the use of oral glucosamine in the treatment of TMJ OA.
- Administration of oral glucosamine for a longer period of time, i.e., 3 months, led to a significant reduction in TMJ pain and a significant increase in maximum mouth opening.
- The most important aspect affecting the clinical efficacy of oral glucosamine in the treatment of TMJ OA was the total administration time.
- It also resulted in long-term anti-inflammatory effects within the TMJs.
Association of Pharmacological Treatments With Long-term Pain Control in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis
Gregori D et al. • JAMA (2018)
In this systematic review and network meta-analysis of studies of patients with knee osteoarthritis and at least 12 months of follow-up, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo.
- Associations with improvement in joint space narrowing were found for glucosamine sulfate (SMD, -0.42 [95% CrI, -0.65 to -0.19]), chondroitin sulfate (SMD, -0.20 [95% CrI, -0.31 to -0.07]), and strontium ranelate (SMD, -0.20 [95% CrI, -0.36 to -0.05]).
- In this systematic review and network meta-analysis of studies of patients with knee osteoarthritis and at least 12 months of follow-up, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo.
- Larger RCTs are needed to resolve the uncertainty around efficacy of medications for knee osteoarthritis.
Is glucosamine effective for osteoarthritis?
Harrison-Muñoz S et al. • Medwave (2017)
We concluded it is not clear whether glucosamine decreases pain or improves functionality in osteoarthritis because the certainty of the evidence is very low.
- To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases.
- We identified 11 systematic reviews including 35 randomized trials answering the question of interest.
- We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.
Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis
Liu X et al. • British journal of sports medicine (2018)
The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low.
- Another six (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine and chondroitin) revealed statistically significant improvements on pain, but were of unclear clinical importance.
- Chondroitin demonstrated statistically significant, but not clinically important structural improvement (effect size -0.30, -0.42 to -0.17).
- The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low.
Safety of Symptomatic Slow-Acting Drugs for Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis
Honvo G et al. • Drugs & aging (2019)
GS and CS can be considered safe treatments for patients with OA.
- In studies that allowed concomitant OA medications, diacerein was associated with significantly more dermatological disorders (OR 2.47; 95% CI 1.42-4.31; I2 = 0%) and more dropouts due to AEs (OR 3.18; 95% CI 1.85-5.47; I2 = 13.4%) than was placebo.
- No significant increase in serious or severe AEs was found with diacerein versus placebo.
- GS and CS can be considered safe treatments for patients with OA.
Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials
Simental-Mendía M et al. • Rheumatology international (2018)
However, there is no additional effect using both therapeutic agents in combination for the management of symptomatic knee OA.
- Their combination did not show this behavior (WMD - 0.28 mm, 95% CI - 8.87, 8.32, p = 0.95).
- None of the glucosamine, chondroitin or their combination had a significant positive effect on the total WOMAC index and its subscores.
- Oral supplementation with glucosamine or chondroitin sulfate reduces pain in knee OA.
Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials
Zhu X et al. • Journal of orthopaedic surgery and research (2018)
Given the effectiveness of these symptomatic slow-acting drugs, oral chondroitin is more effective than placebo on relieving pain and improving physical function.
- Given the effectiveness of these symptomatic slow-acting drugs, oral chondroitin is more effective than placebo on relieving pain and improving physical function.
- Glucosamine showed effect on stiffness outcome.
- Regarding on the limited number of combination therapy, further studies need to investigate the accurate effectiveness.
Treatment modalities for hip and knee osteoarthritis: A systematic review of safety
Aweid O et al. • Journal of orthopaedic surgery (Hong Kong) (2018)
Careful consideration should be given to medical management taking into account known co-morbidities.
- Highest gastrointestinal complications were reported for diclofenac (odds ratio (OR) = 4.77 (3.94, 5.76)) and lowest for total knee replacement (HR = 0.6 (0.49, 0.75)).
- Ibuprofen had the highest renal complications (OR = 2.32 (1.45, 3.71)), whereas celecoxib had the highest cardiovascular risk (OR = 2.26 (1, 5.1)) and lowest was for tramadol (RR = 1.1 (0.87, 1.4)).
- Results show that medical management of hip and knee OA, particularly with non-steroidal anti-inflammatory drugs, may carry higher mortality compared to surgery.
Topical therapies for knee osteoarthritis
Rodriguez-Merchan EC • Postgraduate medicine (2018)
Although some controversy exists on the role of topical NSAIDs, current management guidelines advise topical NSAIDs as an option and even first-line therapy for knee OA treatment, particularly among elderly patients.
- Although some controversy exists on the role of topical NSAIDs, current management guidelines advise topical NSAIDs as an option and even first-line therapy for knee OA treatment, particularly among elderly patients.
- Topical NSAIDs may be contemplated as similar options to oral NSAIDs and are associated with fewer gastrointestinal complications when compared with oral NSAIDs.
- Caution should be taken with the use of both topical and oral NSAIDs, including close adherence to dosing regimens and monitoring, especially for patients with previous complications of NSAIDs.