Glicosamina: Diferenzas entre revisións

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Esta confusión levou ao [[National Institutes of Health]] nos EEUU a financiar un amplo ensaio clínico multicentro (o ensaio GAIT) para estudar a dor producida pola artrose de [[xeonllo]], comparando grupos tratados con [[condroitín sulfato]], glicosamina, e cunha combinación de ambos, con grupos tratados co placebo e [[celecoxib]].<ref>[http://www.clinicaltrials.gov/show/NCT00032890 Clinicaltrials.gov]</ref> Os resultados, publicados en 2006, indicaron que os pacientes que tomaron glucosamina HCl, condroitín sulfato, ou unha combinación de ambos non mostraron unha mellora estadisticamente significativa comparados cos pacientes que tomaron o placebo.<ref name=GAIT2006>{{cite journal |author=Clegg DO |title=Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis |journal=N. Engl. J. Med. |volume=354 |issue=8 |pages=795–808 |year=2006 |month=February |pmid=16495392 |doi=10.1056/NEJMoa052771 |author-separator=, |author2=Reda DJ |author3=Harris CL |display-authors=3 |last4=Klein |first4=Marguerite A. |last5=O'Dell |first5=James R. |last6=Hooper |first6=Michele M. |last7=Bradley |first7=John D. |last8=Bingham |first8=Clifton O. |last9=Weisman |first9=Michael H.}}</ref> Nos que tomaron celecoxib se houbo mellora significativa. Non obstante, os resultados deben ser tomados con cautela porque moitos pacientes presentaban só dores leves (o que dificulta medir o grao de melloría) e porque houbo unha resposta inusual ao placebo (60%). Ademais, non se probou con glicosamina sulfato, que en certos estudos mostrou ser significativamente máis efectiva ca o placebo (79,2% contra 54%; p = 0,002). <ref>{{cite journal |author=Towheed TE |editor1-last=Towheed |editor1-first=Tanveer |title=Glucosamine therapy for treating osteoarthritis |journal=[[Cochrane Database of Systematic Reviews (Online)]] |issue=2 |pages=CD002946 |year=2005 |pmid=15846645 |doi=10.1002/14651858.CD002946.pub2 |author-separator=, |author2=Maxwell L |author3=Anastassiades TP |display-authors=3 |last4=Shea |first4=B |last5=Houpt |first5=J |last6=Robinson |first6=V |last7=Hochberg |first7=MC |last8=Wells |first8=G}}</ref><ref>{{cite journal |author=Hochberg MC |title=Nutritional supplements for knee osteoarthritis--still no resolution |journal=[[The New England Journal of Medicine]] |volume=354 |issue=8 |pages=858–60 |year=2006 |month=February |pmid=16495399 |doi=10.1056/NEJMe058324 |url=}}</ref> <ref name="PDR Health">[http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/glu_0122.shtml PDR Health]</ref>
Os estudos e metaanálises levados a cabo en 2007, 2009 e 2010 foron tamén contraditorios e discutidos. <ref name=GUIDE2007>{{cite journal |author=Herrero-Beaumont G |title=Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator |journal=Arthritis Rheum. |volume=56 |issue=2 |pages=555–67 |year=2007 |month=February |pmid=17265490 |doi=10.1002/art.22371 |author-separator=, |author2=Ivorra JA |author3=Del Carmen Trabado M |display-authors=3 |last4=Blanco |first4=Francisco Javier |last5=Benito |first5=Pere |last6=Martín-Mola |first6=Emilio |last7=Paulino |first7=Javier |last8=Marenco |first8=José Luis |last9=Porto |first9=Armando}}</ref><ref name="pmid17599746">{{cite journal |author=Vlad SC, LaValley MP, McAlindon TE, Felson DT |title=Glucosamine for pain in osteoarthritis: why do trial results differ? |journal=[[Arthritis and Rheumatism]] |volume=56 |issue=7 |pages=2267–77 |year=2007 |month=July |pmid=17599746 |doi=10.1002/art.22728 |url=}}</ref> <ref name=Reginster2007>{{cite journal |author=Reginster JY |title=The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest |journal=[[Arthritis and Rheumatism]] |volume=56 |issue=7 |pages=2105–10 |year=2007 |month=July |pmid=17599727 |doi=10.1002/art.22852 |url=}}</ref> <ref>{{cite journal |journal=J Orthop Surg (Hong Kong) |date=2009 Apr |volume=17 |issue=1 |pages=72–6 |title=Review article: Glucosamine |author=Kirkham SG, Samarasinghe RK |pmid=19398798 |issn=1022-5536}}</ref> <ref>{{cite pmid|Vangsness Jr, C.; Spiker, W.; Erickson, J. (2009). "A review of evidence-based medicine for glucosamine and chondroitin sulfate use in knee osteoarthritis". Arthroscopy 25 (1): 86–94. doi:10.1016/j.arthro.2008.07.020. PMID 19111223}}.</ref> <ref>{{cite journal |author=Wandel S, Jüni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, Trelle S| title=Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis |journal=British Medical Journal| year=2010| volume=341 |issue=sep16 2| pages=c4675 |url=http://www.bmj.com/content/341/bmj.c4675.full.pdf | doi=10.1136/bmj.c4675 |quote=Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space.}}</ref>
 
Porén, a OARSI (''OsteoArthritis Research Society International'') recomenda actualmente a glicosamina como o segundo tratamento máis efectivo para os casos moderados de artrose. Igualmente, as directrices recentes da ''European League Against Rheumatism'' para a artrose de xeonllo danlle á glicosamina sulfato o maior grao de evidencia, o 1A, e de recomendación, o A.<ref name=Reginster2007/>