Oral glucosamine sulphate not superior to placebo in treating osteoarthritis in temporomandibular joint

shutterstock_48486751 stomatologist shows x-ray

Osteoarthritis (OA)  of the temporomandibular joint is found in about 5-16% of those referred with temporomandibular disorders (TMD).  The aim of this study was to evaluate the effect of oral glucosamine sulphate, compared with placebo, on pain and function in patients diagnosed with osteoarthritis in the temporomandibular joints.

Patients with the research diagnostic criteria for temporomandibular disorder for TMJ osteoarthritis, confirmed on radiographic  were randomized to the daily intake of 1,200 mg glucosamine sulphate ( n=30) or identical placebo capsules( n=29)  in this double-blind trial.  Pain on visual and verbal rating scales and opening capacity were the main outcome measures. These were measured at baseline and at 6 weeks.

They found

  • Both groups were similar at baseline and signs and symptoms improved in both groups over time with no differences between the groups.
  • 8 patients in the glucosamine group and 2 in the placebo group stopped the medication prematurely.
  • Gastrointestinal side effects were reported by a total of 10 and 3 patients, respectively

They concluded

Oral glucosamine sulphate was not superior to placebo in reducing signs and symptoms of osteoarthritis in the TMJs in this short-term trial.

Cahlin BJ, Dahlström L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints-a randomized, controlled, short-term study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Oct 14. [Epub ahead of print] PubMed PMID: 22001199.

Comment :- This is a single short-term study and compliance appears to have been a concern in both groups with the placebo group using rescue medication.  A recent Cochrane review ( Towheed T et al 2009)  concluded

Pooled results from studies using a non-Rotta preparation or adequate allocation concealment failed to show benefit in pain and WOMAC function while those studies evaluating the Rotta preparation showed that glucosamine was superior to placebo in the treatment of pain and functional impairment resulting from symptomatic OA.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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