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This systematic review and network meta-analysis (NMA) sought to determine the most effective glucosamine-based combination therapy for osteoarthritis of the knee.
Glucosamine with omega-3 and ibuprofen provides the most effective pain relief for knee osteoarthritis, with omega-3 ranking highest in both efficacy and safety.
This systematic review and network meta-analysis (NMA) sought to determine the most effective glucosamine-based combination therapy for osteoarthritis of the knee.
A frequentist random-effects model was used for the NMA. Standardized mean differences (SMDs) along with 95% confidence intervals (CIs) were calculated for primary outcomes. For pain outcomes, an SMD of 0.40 was set as the minimum clinically important difference (MCID), and evidence confidence was assessed via CINeMA.
A total of 30 randomized controlled trials (RCTs) involving 5,265 patients were analyzed. Glucosamine combined with omega-3 (SMD –2.59, moderate-quality evidence) and glucosamine with ibuprofen (SMD –2.27, moderate-quality evidence) remarkably reduced overall pain when compared to placebo. Additionally, glucosamine combined with chondroitin sulfate and methylsulfonylmethane demonstrated pain relief (SMD –2.25, low-quality evidence). However, no other interventions met the MCID threshold for clinically significant pain reduction. The results of clustered ranking results illustrated that glucosamine with omega-3 was most beneficial for alleviating pain and adverse events.
For knee osteoarthritis, glucosamine combined with omega-3 or ibuprofen markedly alleviates pain and may reduce NSAID-associated side effects. These findings can help refine treatment guidelines and boost clinical decision-making for better patient care.
Journal of Clinical Medicine
Comparative Efficacy of Glucosamine-Based Combination Therapies in Alleviating Knee Osteoarthritis Pain: A Systematic Review and Network Meta-Analysis
Sumsuzzman D et al.
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