Industry slams glucosamine, chondroitin meta-analysis

Results of a new meta-analysis into how (in)effective glucosamine and chondroitin may be for joint health has been dismissed as an ‘incomplete job’ by industry experts.

According to findings published in the British Medical Journal, evidence from 10 clinical trials with 3,803 people with knee or hip osteoarthritis showed that there were no clinically relevant effects of chondroitin, glucosamine, or their combination on perceived joint pain or on joint space narrowing.
Reviewers led by Prof Peter Jüni from the Institute of Social and Preventive Medicine at the University of Bern in Switzerland, subsequently dismissed the need for further research: “We believe it unlikely that future trials will show a clinically relevant benefit of any of the evaluated preparations,” they wrote.
Limitations and ‘convenient exclusions’
Commenting on the meta-analysis, Andrew Shao, PhD, senior vice president, scientific & regulatory affairs for the Council for Responsible Nutrition (CRN) told NutraIngredients-USA that the investigators “conveniently excluded a large portion of the evidence base” on the effects of glucosamine and chondroitin
“The majority of published studies involving glucosamine and/or chondroitin are positive,” said Dr Shao. “Even the GAIT trial, with a 60 percent placebo effect showed that Glucosamine and Chondroitin were effective at reducing pain in knee osteoarthritis patients with moderate-to-severe pain – and outperforming the Rx drug Celebre,” he added.
“Furthermore, both glucosamine and chondroitin are approved drugs for osteoarthritis in various countries in Europe. This surely would not be the case if they were ineffective.
“We also must recognize that consumers have voted with their wallets - choosing to continue to derive benefits from glucosamine and chondroitin supplements, with the category experiencing significant year over year growth over the past decade. If these were ineffective, then we would not observe this kind of growth.
“The bottom line for consumers is that overall the evidence indicates that glucosamine, chondroitin or the combination is effective for improving mobility and joint discomfort in osteoarthritis patients, while also demonstrating a strong safety profile. Consumers should continue to feel confident in choosing glucosamine and chondroitin,” said Dr Shao.
Incomplete job
Daniel Fabricant, PhD, vice president of scientific and global government affairs at the Natural Products Association (NPA) said he did not think the researchers "did a complete job of reviewing all the data at hand or all of the appropriate data given the tool (Bayesian statistics) they chose to use".
"Bayesian statistics, when used properly are allow for the inclusion of observational study data to compare those data along side with RCTs. Bayesian analysis is not predicated on randomization, and can be used to analyze data from observational studies in exactly the same way as for randomized trials... A powerful tool for certain but without looking at all the studies its sort of like driving a corvette and never taking it out of second gear."
Dr Fabricant also said that the reviewers "would be wise to be more discreet in their description of earlier RCTs, especially those with subgroups that did show some improvement. Blanket statements about efficacy are rarely accurate, especially given trials on OA which as they authors state have been conflicting.


--
National Association of Health Stores Ltd
PO Box 14177
Tranent EH34 5WX
t: 01875-341408
email: nahsoffice@gmail.com
www.nahs.co.uk
Company Registered in England, Number 05070874

Patrons:  Bioforce UK, Quest Vitamins
Associate Members:
Lifeplan, Higher Nature, PharmaNord, Solgar, The Health store, Viridian, Biocare, Natures Aid, Diversified Business Communications, Target Natural Media