Table 1 Recommendations for the use of glucosamine in the management of osteoarthritis

OARSI

'Treatment with glucosamine and/or chondroitin sulphate may provide symptomatic benefit in patients with knee OA. If no response is apparent within 6 months treatment should be discontinued'

EULAR

Knee OA

'There is growing evidence to support the use of two of these agents for their symptomatic effects - namely, glucosamine sulphate (1A) and chondroitin sulphate (1A), but for the others the evidence is weak or absent'

Hip OA

'SYSADOA (glucosamine sulphate, chondroitin sulphate, diacerhein, avocado soybean unsaponifiable, and hyaluronic acid) have a symptomatic effect and low toxicity, but effect sizes are small, suitable patients are not well defined, and clinically relevant structure modification and pharmacoeconomic aspects are not well established'

ACR

'While a number of studies support the efficacy of both glucosamine and chondroitin sulfate for palliation of joint pain in patients with knee OA, the subcommittee believes that it is premature to make specific recommendations about their use at this time because of methodologic considerations, including lack of standardized case definitions and standardized outcome assessments, as well as insufficient information about study design in a number of these published reports'

NICE

'The use of glucosamine or chondroitin products is not recommended for the treatment of osteoarthritis'