Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib

Hochberg MC, Martel-Pelletier J, Monfort J, et al. · Annals of the Rheumatic Diseases

The combination met non-inferiority against celecoxib: WOMAC pain fell 185.7 points on a 0-500 scale (50.1%) against 186.8 (50.2%), a difference of -1.1 (95% CI -22.0 to 19.8; p=0.92) against a pre-set margin of 40 points. Nothing else separated either — stiffness fell 46.9% against 49.2% (p=0.43), function 45.5% against 46.4% (p=0.53), and 79.7% against 79.2% met OMERACT-OARSI response criteria at 6 months (p=0.91). Joint swelling more than halved in both arms.

Population

Knee OA patients with severe pain (MOVES trial, Europe)

Intervention

Chondroitin sulfate 1200 mg + glucosamine HCl 1500 mg daily for 6 months

Comparator

Celecoxib 200 mg/day (no placebo arm)

Limitations

No placebo arm, so a 50% fall in both arms cannot be separated from natural history and regression to the mean; the trial establishes that the two treatments are indistinguishable, not that either works. Sponsored by Bioiberica, a chondroitin manufacturer. Of 606 randomised, the primary per-protocol analysis rests on 522 and 465 completed, though the intention-to-treat sensitivity analyses agreed.