Olivier Bruyere MSc1,2,3Kara pavelka
MD,PHD4,5 Lucio C. Rovati, MD,6
Rita Deroisy, MSc3 Marta Olejarova,
MD PHD 5 Jindriska Gatterova MD
5 Giampaolo Giacovelli,PHD,6 and
Jean-Yves Reginster,MD,PHD1,2,3,7.
ABSTRACT:
Objective: To investigate the effect
of glucosamine sulfate on long-term
symptoms and structure progression
in postmenopausal women with knee
osteoarthritis (OA).
Design: This study consisted of
a preplanned combination of two
three-year,randomized, placebo-controlled,
prospective, independent studies
evaluating the effect of glcosamine
sulfate on symptoms and structure
modification in OA and post-hoc
analysis of the results obtained
in post-menopausal women with knee
OA. Minimal joint space width was
assessed at baseline and after 3
years from standing anteroposterior
knee radiographs. Symptoms were
scored by the algo-functional WOMAC
index at baseline and after 3 years.
All primary statistical analyses
were performed in intention-to-treat,
comparing joint space width and
WOMAC changes between groups by
ANOVA.
Results:
Of 414 participants randomized in
the two studies, 319 were postmenopausal
women. At baseline, glucosamine
sulfate and placebo groups were
comparable for demographic and disease
characteristics, both in the general
population and in the postmenopausal
women subset, After 3 years, postmenopausal
participants in the glucosamine
sulfate group showed no joint space
narrowing [joint space change of
+0.003 mm (95%CI -0.09 TO 0.11)],
whereas participants in the placebo
group experienced a narrowing of
-0.33mm(95% CI,-0.44 to -0.22; P,<0.0001
between the two groups),percent
changes 3 years in the WOMAC index
showed an improvement in the glucosamine
sulfate group [-14.1%(95%,-22.2
to -5.9)] and a trend for worsening
in the placebo group(5.4%CI -4.9
to 15.7) (P=0.003 between the two
groups)
Conclusion:
This analysis, focusing on
a large cohort of postmenopausal
women, demonstrated for the first
time that a pharmacological intervention
for OA bas a disease-modifying effect
in this particular population, the
most frequently affected by knee
OA.
Key words:
Osteoarthritis-Glucosamine sulfate-women-menopause-joint
structure.
