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Received Jun 20, 2017; Accepted Aug 2, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Osteoarthritis (OA) is a chronic joint condition. It affects over 250 million people worldwide with significant impact on quality of life, health care, and society in general [1–3]. According to the World Health Organization (WHO) Global Burden of Disease Study 2010, hip and knee OA is the 11th leading cause of disability and shows a growing trend [4]. Vos et al. (2012) reported that knee OA accounts for 83% of the total burden of the disease [3]. There is no definitive cure or treatment to reverse the condition. Treatments are typically restricted to pain alleviation by a combination of pharmacological and nonpharmacological approaches. Unfortunately, only half of the patients experience pain reduction with pharmacological treatments [5]. In addition, modest improvements may be achieved by weight loss and physical activities [6]. Surgical interventions are sometimes warranted for severe cases. However, surgery is not always feasible due to constraints on costs or due to comorbidities [7, 8]. Therefore, there is a need for exploration of novel therapeutics for symptom management.
One such option is dietary supplementation with glucosamine and/or chondroitin. Despite their widespread use, the efficacy of glucosamine and chondroitin has undergone significant scrutiny over the past decade. The glucosamine/chondroitin Arthritis Intervention Trial (“GAIT Trial”) found no evidence for effective pain reduction in knee osteoarthritis; however, a subgroup analysis noted a statistical trend toward pain relief in patients with moderate to severe knee pain. According to Clegg et al., some of the discrepancies observed in relief of OA related discomfort or pain may be due to the varying dosages tested as well as other study design flaws [9]. Recent guidelines for the management of symptomatic knee osteoarthritis published by the Economic Aspects of Osteoporosis and Osteoarthritis ESCEO suggest use of prescription dose (1500 mg) of patented crystalline glucosamine sulfate as a first-line therapy...