"The results were exciting," explains Dr. Lucio Rovati, 
one of the lead authors of the study and the head of the 
department of clinical pharmacology at the Rotta Research Lab 
in Italy. "It is the first time anyone has shown that a drug 
or compound can improve -- or at least delay -- the progression 
of osteoarthritis in a long-term treatment study." 

steoarthritis is a degenerative joint disease that the Arthritis 
Foundation says affects 20.7 million Americans. Normally, the ends 
of bones that form joints are covered with cartilage. In 
osteoarthritis, this cartilage wears away and the bones begin to
rub against each other, causing pain and loss of movement. 

Rovati and his colleagues studied 212 patients who had
osteoarthritis in their knees. Patients took either glucosamine or a 
placebo daily for three years. Glucosamine is an amino acid that is 
part of the structure of normal cartilage. 

Researchers took knee X-rays at regular intervals throughout the 
study and surveyed the patients every four months about their 
symptoms. Rovati explains that X-rays were one of the few ways to 
scientifically evaluate the progression of osteoarthritis. On an X-
ray, doctors can see the space in between joints, and this space 
represents the cartilage. If that joint space narrows, then the 
disease is progressing. 

The results were promising. Patients on the glucosamine reported 
improvement without side effects. "We found substantial joint space
narrowing on those patients on the placebo while the patients on
the glucosamine did not suffer from any joint space narrowing," 
Rovati says. 

"I would like to have a more intricate study done with MRI, because
you can have damage and have it not show up on an X-ray," says Dr. 
Jef Lieberman, a medical advisor to the Arthritis Foundation. "But 
this was clearly an interesting study that warrants further 
evaluation on how glucosamine helps in osteoarthritis." 

What To Do 

In this study, researchers found 1,500 mg daily to be an effective 
dose, but in Europe glucosamine is a prescription drug and so the 
quality and purity is guaranteed. In the United States, glucosamine
is a dietary supplement and not regulated in the same manner as 
prescription drugs. And, even though you can obtain glucosamine
over the counter in the United States., Rovati strongly recommends 
that patients with osteoarthritis discuss their treatment with their 
doctor. He says it is important for your doctor to know about 
everything you are taking. 

Lieberman agrees that you should consult your physician regarding
any treatment and he cautions that many products being sold as 
glucosamine sulfate actually contain very little of the compound.
He suggests buying standardized brands and says cost is really not a 
factor in quality. Lieberman says the best way to ensure quality is
to go to a compounding pharmacist and have them make the product
for you. For patients interested in glucosamine therapy, Lieberman 
recommends a four-month trial of the supplement, after which time
you and your doctor can discuss the results. 

For more information on arthritis and ways to treat it, visit the 
American College of Rheumatology or the Arthritis Foundation. 

SOURCES: Interviews with Lucio Rovati, M.D., head of the 
department of clinical pharmacology, Rotta Research Laboratory, 
Monza, Italy; Jef Lieberman, M.D., medical advisor, Arthritis 
Foundation, Decatur, Ga.; abstract from the American College of 
Rheumatology