Consumers’ perception of the efficacy and tolerance of glucosamine in joint diseases

Abstract

In Australia, 18% of the population, representing around one in five Australians, experience or are diagnosed with some form of arthritis. This equates to about 3.85 million Australians. The 2008 Crosby Textor Public Opinion Poll (Chong 2012) shows that Australians are more worried about developing arthritis than any other disease. The average cost in terms of arthritis treatment per person per year is $6200, with 61% of arthritis costs borne by the individuals themselves. Glucosamine is an over the-counter complementary medicine marketed for the treatment and relief of various types of arthritis; however, it is only clinically indicated for osteoarthritis. The existing research is conflicting regarding its efficacy. Aim: The aim of this study is to explore consumer perception of the efficacy of, and tolerance for, glucosamine preparations in inflammatory joint diseases. Method: The first component of the study was a qualitative observational survey based, with a 20-question survey administered to members of the community to capture their personal experience of the efficacy and toxicity of glucosamine. Survey questions were based on a visual pain and joint function scale. The second part of the study was an analysis based on an unidentifiable historical patient report to investigate if patients use glucosamine alone or with other medications indicated for the treatment of arthritis, what form of glucosamine salt was used, how long they have been using glucosamine and at what dose. Results: Out of 87 participants (aged 40–84 years, both male and female), 91.9% and 91.7% stated that glucosamine reduced their pain and improved their joint movement respectively. Pain was perceived to be reduced by 3–4 points (out of a possible 5 or more) in 46.5% of participants and 1–2 points’ improvement out of possible 5 or more in joint movement was found in 51.7% of participants. Sixty participants who used glucosamine for six months or more indicated a reduction in their pain and improvement in their joint function by at least 1 point on the scale ranging up to 5 points. The majority of the 60 participants who used glucosamine for six months or more indicated a pain improvement of 3–4 points on the scale. Six participants indicated that glucosamine was not effective in reducing their pain, and four participants indicated that it did not improve their joints function; those participants took glucosamine for less than six months. All others (n=17) had less significant improvement ( Discussion: This study provided insight on the possible benefits of glucosamine in relieving oxidative stress associated with arthritis, given its strong antioxidant activity. Critical analysis of the literature revealed that most studies that reported effectiveness of glucosamine used glucosamine sulphate whilst concluding that glucosamine was not effective when used in the hydrochloride formulation. Few studies investigated the effectiveness of glucosamine in other types of arthritis and no research has been conducted on the antioxidant activity of glucosamine in arthritis treatment. Conclusion: The results of this study indicate that health professionals have a degree of confidence in the benefits of glucosamine as a complementary treatment for osteoarthritis. Five out of 87 participants had rheumatoid arthritis and, whilst this is a small percentage of the total sample, they reported that it was effective. It is therefore recommended that further research be conducted on the efficacy of glucosamine in different types of arthritis and examining the antioxidant role of glucosamine given the oxidative stress associated with arthritis.