גלוקוזמין לא עוזר לכאב גב כרוני

במאמר שהתפרסם ביולי 2010 בעיתון המכובד JAMA, מתואר מחקר שנערך בנורווגיה ובדק 250 חולים עם כאבי גב תחתון שסובלים גם מניווניות של החוליות כתוצאה מאוסטאוארטריטיס.

בתקציר המאמר שתראו בהמשך, ניסו לבדוק אם גלוקוזאמין עובד ומקל על הכאב עד כדי הפחתת הנכות, יותר מאשר פלצבו.

 

החולים לקחו כל יום 1500 מ"ג של התכשיר או של כדור דומה שלא מכיל חומר פעיל, למשך חצי שנה.

המסקנה במאמר שגלוקוזאמין אצל חולים מהסוג הזה, לא מפחית נכות ע"י הקטנת הכאב, יותר מאשר מתן פלצבו.

תכשירים שמכילים גלוקוזמין ונמכרים בישראל הם:גלוקוזאמין, מגה-גלופלקס ואחרים.

לתקציר המאמר באנגלית:

 

JAMA, Vol. 304 No. 1, July 7, 2010

http://jama.ama-assn.org/cgi/content/abstract/304/1/45

Effect of Glucosamine on Pain-Related Disability in Patients With Chronic Low Back Pain and Degenerative Lumbar Osteoarthritis

A Randomized Controlled Trial

Philip Wilkens, MChiro; Inger B. Scheel, PhD; Oliver Grundnes, PhD; Christian Hellum, MD; Kjersti Storheim, PhD

JAMA. 2010;304(1):45-52.

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, placebo-controlled 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 = .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, 4.7-6.4) 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 = .72),LBP at rest (P = .91), LBP during activity (P = .97), and quality-of-life EQ-5D (P = .20). Mild adverse events were reported in 40 patients in the glucosamine groupand 46 in the placebo group (P = .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 pain-related disability after the 6-month intervention and after 1-year follow-up.

Trial Registration clinicaltrials.gov Identifier: NCT00404079


Author Affiliations: Department of Orthopaedics, Oslo University Hospital, and University of Oslo, Oslo, Norway (Mr Wilkens and Drs Grundnes, Hellum, and Storheim); SINTEF Health Research, Oslo, Norway (Dr Scheel); Norwegian Research Center for Active Rehabilitation (NAR), Oslo, Norway (Mr Wilkens and Dr Storheim). Dr Grundnes is now with Hjelp 24 NIMI, Oslo, Norway.

עדכון אחרון (שבת, 05 מאי 2012 04:30)