Effect of Glucosamine on Pain-Related Disability in Patients with Chronic Low Back Pain and Degenerative Lumbar Osteoarthritis. A Randomized Controlled Trial

Context: Chronic low back pain (LBP) with degenerative lumbar osteoarthritis (OA) is widespread in the adult population. Although glucosamine is increasingly used by patients with chronic LBP, little is known about its effect in this setting. Objective: To investigate the effect of glucosamine in patients with chronic LBP and degenerative lumbar OA. Design, Setting, and Participants: A double-blind, randomized, placebocontrolled trial conducted at Oslo University Hospital Outpatient Clinic, Oslo, Norway, with 250 patients older than 25 years of age with chronic LBP (> 6 months) and degenerative lumbar OA. Interventions: Daily intake of 1500 mg of oral glucosamine (n = 125) or placebo (n = 125) for 6 months, with assessment of effect after the 6-month intervention period and at 1 year (6 months postintervention). Main Outcome Measures: The primary outcome was pain-related disability measured with the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes were numerical scores from pain-rating scales of patients at rest and during activity, and the quality-of-life EuroQol-5 Dimensions (EQ-5D) instrument. Data collection occurred during the intervention period at baseline, 6 weeks, 3 and 6 months, and again 6 months following the intervention at 1 year. Group differences were analyzed using linear mixed models analysis. Results: At baseline, mean RMDQ scores were 9.2 (95 % confidence interval [CI], 8.4-10.0) for glucosamine and 9.7 (95 % CI, 8.9-10.5) for the placebo group (P = 0.37). At 6 months, the mean RMDQ score was the same for the glucosamine and placebo groups (5.0; 95 % CI, 4.2-5.8). At 1 year, the mean RMDQ scores were 4.8 (95 % CI, 3.9-5.6) for glucosamine and 5.5 (95 % CI, 4.76.4) for the placebo group. No statistically significant difference in change between groups was found when assessed after the 6-month intervention period and at 1 year: RMDQ (P = 0.72), LBP at rest (P = 0.91), LBP during activity (P = 0.97), and quality-of-life EQ-5D (P = 0.20). Mild adverse events were reported in 40 patients in the glucosamine group and 46 in the placebo group (P = 0.48). Conclusions: Among patients with chronic LBP and degenerative lumbar OA, 6-month treatment with oral glucosamine compared with placebo did not result in reduced painrelated disability after the 6-month intervention and after 1-year follow-up.