MedicalResearch.com Interview with:
Jos Runhaar, PhD
Department of General Practice
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Most international guidelines report an overall lack of efficacy of glucosamine for osteoarthrits. We however know that it is a very heterogeneous disease. Therefore, it is possible that there are certain subgroups of osteoarthritis patients that actually might have effect from glucosamine; for instance subgroups based on different pathologies underlying the clinical presentation, different co-morbidities, or different disease stages.
For investigating efficacy in subgroups large sample sizes are needed, and certain methodological techniques are necessary, to get a valid and robust answer. Several years ago, a group of renowned international osteoarthritis researchers started the OA Trial Bank especially for investigating these subgroup effects of osteoarthritis treatments and collect individual patient data of worldwide-performed intervention studies in osteoarthritis patients. When using the individual patient data of multiple studies, it brings us the large sample size and allows us to use the right methods. We do these subgroup analyses in the OA Trial Bank for many different interventions, not just for glucosamine. The subgroup analyses for glucosamine and for corticosteroid injections are published, the others are ongoing (for instance exercise, orthoses and topicals) or planned and still waiting for funding.
The study did show, however, that glucosamine can be extremely beneficial for pets, and specifically dogs who have joint related issues. Knowing the most valuable sources of glucosamine for dogs is important, as it can be extracted and gained from multiple sources, and each have their own varied levels of quality and potency.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: That based on the shared individual patient data there were no overall effects of oral glucosamine over placebo on short and long-term pain and function of hip and knee osteoarthritis patients, and that we could not find significant effects for subgroups based on pain severity, BMI, sex, radiographic severity of the osteoarthritis, or inflammatory signs accompanying the osteoarthritis
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We plan to update these subgroup analyses in the Osteoarthritis Trial Bank every five years. We hope that by then more studies are willing to share their data, so that we can make even more robust subgroup effect estimations. Especially, we hope that the data from the industry led trials, that showed the largest effects in the past, will become available to the OA Trial Bank.
MedicalResearch.com: Is there anything else you would like to add?
Response: Although propagated by many research organizations worldwide, open access to data from clinical studies is still far from common practice. We hope that initiatives for data sharing will be embraced by the research community in the near future.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Runhaar J, Rozendaal RM, Middelkoop MV, et al
Annals of the Rheumatic Diseases Published Online First: 28 July 2017. doi: 10.1136/annrheumdis-2017-211149
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