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Subsequent investigations have found further explanations for its anti-inflammatory and anti-catabolic mechanisms of action. In vitro and in vivo studies have detailed different lines of evidence for how glucosamine can act on joint tissues from OA patients. In addition, many clinical trials have demonstrated various degrees of efficacy for glucosamine in OA patients. Based on the published data, the Osteoarthritis Research Society International (OARSI) [2,3] and the European League Against Rheumatism (EULAR) [4,5] have recommended the use of glucosamine sulfate for the management of knee and hip OA. In contrast, the American College of Rheumatology (ACR) [6] and the UK National Institute for Health and Clinical Excellence (NICE) have not recommended glucosamine in the management of OA (Table (Table1).1). None of the current guidelines have recommended the use of glucosamine hydrochloride, only glucosamine sulfate. Finally, it is important to point out that OARSI recommends that treatment with glusosamine sulfate is discontinued if no symptomatic response is apparent within 6 months of use.
It has been approved for the treatment of osteoarthritis (OA) in Europe to promote cartilage and joint health and is sold over the counter as a dietary supplement in the United States.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392795/ |
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