Zusammenfassung
Meta-Analysen können einen Beitrag zur Evidenz-basierten Medizin liefern. In den zu Glucosamin publizierten systematischen Übersichtsarbeiten wurde die symptomatische Wirksamkeit in der Vergangenheit überwiegend als moderat bis groß beschrieben. Die Ergebnisse der einzelnen klinischen Studien stützten diese Bewertung nicht einheitlich. In den letzten Jahren wurden nun einige neue Studien mit hoher Qualität publiziert. Die aktuelle Studienlage zur symptomatischen Therapie mit Glucosamin bei Patienten mit Gonarthrose wird vorgestellt, gewertet und mit den Ergebnissen der aktuellen Meta-Analysen verglichen.
Summary
Meta-analyses can contribute to the field of evidencebased medicine. In the systematic analyses so far published, the symptomatic efficacy of glucosamine was described to be moderate to large. The results of the individual clinical studies however do not support these findings unanimously. In the past couple of years, some new studies of high quality standard were published. This publication gives an overview and an evaluation of the current available studies for the symptomatic treatment of patients with gonarthrosis with glucosamine. It also compares the results of the individual studies with those of recent meta-analyses.
Article PDF
Avoid common mistakes on your manuscript.
References
BGA (1988) Bekanntmachung über die Zulassung und Registrierung von Arzneimitteln (Aufbereitungsmonographien für den humanmedizinischen Bereich: D-Glucosamin. BAnz. Nr. 35 718
BGA (1992) Bekanntmachung über die Zulassung und Registrierung von Arzneimitteln (Aufbereitungsmonographien für den humanmedizinischen Bereich): D-Glucosamin. BAnz. Nr. 104:4540
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drung therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840
Cibere J, Kopec JA, Thorne A et al (2004) Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 51(5):738–745
Cohen J (1977) Stastical power analysis for the behavioral sciences. Acamic Press, New York
Committee for Proprietary Medicinal Products (1998) Points to consider on clinical investigation of medicinal products used in the treatment of OA (CPMP/EWP/784/97)
Drovanti A et al (1980) Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo-controlled, double-blind investigation. Clin Ther 3:266–272
Ehrich EW, Davies GM, Watson DJ, Bolognese JA, Seidenberg BC, Bellamy N (2000) Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessment in patients with osteoarthritis. J Rheumatol 27(11):2635–2641
Houpt JB, McMillan R, Paget-Dellio D, Russell A, Gahunia HK (1998) Effect of glucosamine hydrochloride (GHcl) in the treatment of pain of osteoarthritis of the knee. J Rheumatol 25(Suppl 52):8
Houpt JB, McMillar R (1999) Effect of glucosamin hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 26(11):2423–2430
Hughes R, Carr (2002) A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgestic in osteoarthritis of the knee. Rheumatology 41:279–284
Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12
Jordan KM, Arden NK, Doherty M et al (2003) EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies including Therapeutic Trials (ESCISIT) Ann Rheum Dis 62:1145–2255
Lequèsne MG (1997) The algofunctional indices for hip and knee osteoarthritis. J Rheumatol 24:779–781
McAlindon TE et al (2000) Glucosamine and chondroitin for treatment of osteoarthritis. A systematic quality assessment and meta-analysis. JAMA 283(11):1469–1474
McAlindon T, Formica M, LaValley M, Lehmer M, Kabbara K (2004) Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial. Am J Med 117(9):643–649
Noack W (1994) Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis and Cartilage 2:51–59
Pavelka K et al (2002) Glucosamine sulfate use and delay of progression of knee osteoarthritis. A 3-year randomized, placebo-controlled, double-blind study. Arch Intern Med 162:2113–2123
Points to Consider on Application with 1. Meta-Analyses; 2. One Pivotal Study (CPMP/EWP/2330/99) (http://www.emea.eu.int/)
Pujalte JM et al (1980) Double-blindclinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr med Res Opin 7:110–114
Recommendations from a task force of the Osteoarthritis Research Society (1996) Design and conduct of clinical trials in patients with osteoarthritis. Osteoarthritis and Cartilage 4:217–243
Reginster J et al (2001) Long-term effects of glucosamine sulfate on osteoarthritis progression. a randomised, placebo-controlled clinical trial. The Lancet 357:251–256
Richy F et al (2003) Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis. A comprehensive meta-analysis. Archives of Internal Medicine 163:1514–1522
Rindone JP (2000) Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. Western Journal of Medicine 17:91–94
Rovati LC (1997) The clinical profile of glucosamine sulfate as a selective symptom modifying drug in osteoarthritis: current data and perspectives. Osteoarthritis Cartilage 5(Supp A):72
Todd KH, Funk JP (1996) The minimum clinically important difference in physician-assigned visual analog pain scores. Acad Emerg Med 3(2):142–146
Towheed TE, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MC (2004) Glucosamine therapy for treating osteoarthritis (Cochrane Review). In: The Cochrane Library
Towheed TE, Maxwell L, Anastassiades TP et al (2005) Glucosamine therapy for treating osteoarthritis (Cochrane Review). In: The Cochrane Library
Tubach F, Ravaud P, Baron G et al (2005) Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement. Ann Rheum Dis 64(1):29–33
Usha PR, Naidu MUR (2004) Randomized, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clinical Drug Investigation 24(6):353–563
WHO (2005) Pharmaceutical Newsletter No. 1, p 4
Zenk JL, Helmer TR, Kuskowski MA (2002) The effects of milk protein concentrate on the symptoms of osteoarthritis in adults: an exploratory, randomized, double-blind, placebo-controlled trial. Current Therapeutic Research 63(7):430–442
Author information
Authors and Affiliations
Additional information
Diese Arbeit repräsentiert nicht notwendigerweise die offizielle Position des BfArM
Rights and permissions
About this article
Cite this article
Reiter, S. Evidenzbasierte Bewertung der symptomatischen Therapie von Glucosamin. Z. Rheumatol. 64, 456–466 (2005). https://doi.org/10.1007/s00393-005-0777-6
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00393-005-0777-6