Despite the lack of evidence, do you utilize glucosamine and chondroitin sulfate for osteoarthritis?

There have been numerous placebo-controlled trials and meta-analyses addressing this question over the last couple of decades, most concluding that neither glucosamine, chondroitin sulfate nor the combination provides better symptom relief than placebo (Fransen et al., PMID 24395557, Miller and Clegg, PMID 21220090, Clegg et al., PMID 16495392, Sawitzke et al., PMID 18821708). These agents have also failed to slow radiographic progression. Thus, I do not actively prescribe or encourage these agents for osteoarthritis. But without a significant side effect profile, and given anecdotal and open-label reports of successful symptomatic response, I have not discouraged patients who desire to try it (or are already taking it) since we lack any pr...

I do not agree with allowing the patients to take glucosamine, etc., since FDA has no oversight. I recall the tryptophan fiasco when 2000 people in the US were paralyzed by a bad batch from a fairly reputable company in Japan. We have no idea what is put in these pills and the cost to the patients is ludicrous. The NIH study of 3 groups of “ medicine” versus placebo showed across the 4 groups about a 50 percent clinical improvement suggesting a tremendous placebo response! No way should we okay its use.