The long-term evaluation of glucosamine sulphate (LEGS) study

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There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommending paracetamol as 'the preferred long term oral analgesic'. This recommendation is based on the increased risk of serious gastrointestinal, cardiovascular and renal diseases with long-term NSAIDs use in older people. However, NSAIDs appear to provide better pain relief for patients with more than mild joint pain. Amongst patients with OA, there is much demand for the dietary supplement glucosamine and chondroitin. Marketing has led to the belief these products are able to slow the rate of joint destruction and cartilage loss and help ease joint pain with little risk of side effects. However, the few trials conducted to date have been inconclusive. A total of 600 patients with knee OA will be randomly allocated to glucosamine sulphate and chondroitin sulphate or matching placebo capsules for two years. Participants will be required to take four capsules, once daily for two years. Clinic visits for assessment, including knee radiographs, will be required at the start of the study as well as 1 year and 2 years later. The main outcomes will be the rate of joint space narrowing, knee pain and physical disability. If glucosamine results in slowing disease progression or in reducing pain, the widespread use of this product would effectively decrease pain, disability and possibly NSAIDs-related illnesses amongst the increasing number of people with OA.

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