Systematic review of systematic reviews on the effect of orally administered glucosamine and/or chondroitin sulfate on osteoarthritis outcomes

ObjectiveTo track recent progress in the evaluation of orally administered glucosamine and/or chondroitin sulfate for osteoarthritis-related outcomes， and reanalyze the evaluation results.MethodsDatabase （CNKI， PUBMED and Cochrane Library） were searched for meta-analyses or systematic reviews on osteoarthritis and glucosamine and/or chondroitin published between 2018 and 2024. Effect size metrics such as SMD （standardized mean difference） and WMD （weighted mean difference） were extracted and summarized.ResultsSixteen systematic reviews were included in this study. Among these， ten evaluated glucosamine alone， eleven assessed chondroitin sulfate alone， and seven evaluated their combination. Regarding glucosamine （1 500-2 000 mg/d for ≥4 weeks）， some studies indicated a minor effect on improving joint stiffness （2 out of 3 studies） and reducing joint space narrowing （1 out of 2 studies）. However， no significant effect was observed on joint pain and joint function with glucosamine use. For chondroitin sulfate （800-1 200 mg/d for ≥12 weeks）， some studies indicated minor to moderate effects on pain relief （3 out of 9 studies） and improving joint function （3 out of 6 studies）. Additionally， two out of three studies suggested a minor effect on reducing joint space narrowing. No improvement in joint stiffness was observed with chondroitin sulfate. The combination of glucosamine and chondroitin sulfate did not show significant benefits. Compared to non-pharmaceutical-grade products， pharmaceutical-grade glucosamine and/or chondroitin sulfate may be more effective.ConclusionGlucosamine and chondroitin sulfate may provide modest symptomatic relief for osteoarthritis in certain individuals.