Glucosamine sulfate 676mg capsules

BackgroundKnee osteoarthritis (OA) is a common cause of pain and disability without a cure. Glucosamine is widely used as a symptomatic treatment owing to its safety, yet its clinical efficacy remains uncertain amid mixed trial results and conflicting guidelines. This umbrella review synthesized evidence from published systematic reviews and meta-analyses on the effectiveness and safety of glucosamine in knee OA.MethodsWe searched MEDLINE (via PubMed), Embase, Web of Science, and the Cochrane Library up to November 2025. Eligible studies were systematic reviews or meta-analyses of randomized trials in adults with knee OA comparing glucosamine (any formulation) with placebo or other non-surgical comparators and reporting pain, physical function, or joint structure. Two reviewers independently screened, extracted data, and assessed quality (AMSTAR-2). Key outcomes were pain (visual analog scale [VAS] and WOMAC [Western Ontario and McMaster Universities Osteoarthritis Index]), functional measures, joint space narrowing (JSN), and adverse events. Overlap among shared primary trials was quantified using the corrected covered area, and the resulting dependence was addressed using robust variance estimation to pool standardized mean differences (SMDs), with p ResultsNineteen reviews were included (most low or critically low quality). Glucosamine produced a small but statistically significant reduction in VAS pain (SMD - 0.36, p = 0.02), whereas WOMAC pain showed no significant difference. Functional outcomes (WOMAC total and function) showed no significant improvement. Glucosamine was associated with significant slowing of JSN progression (SMD - 0.32, p = 0.01), though this signal derived mainly from long-duration sulfate trials. The magnitude of the significant effects was at or below accepted MCID thresholds. Adverse event rates did not differ from placebo.ConclusionGlucosamine demonstrated at most minimal-to-modest efficacy for knee OA, yielding a small pain reduction and possible slowing of radiographic progression but no clear functional benefit, with effects at or below the threshold of clinical importance. Given the low quality of evidence, extensive overlap among reviews, and the predominantly out-of-pocket nature of glucosamine use, these findings should be interpreted with caution and weighed against cost in shared decision-making.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier (CRD420251207513).

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BackgroundGlucosamine has been proposed as a therapeutic option for temporomandibular disorders (TMD), particularly temporomandibular joint osteoarthritis (TMJ OA), but its effectiveness and safety remain uncertain.ObjectiveTo evaluate the benefits and harms of oral glucosamine supplementation in patients with TMJ OA and other/unspecified TMD.MethodsA systematic review was conducted in PubMed/MEDLINE, CENTRAL, Scopus, and Embase through October 8, 2025. Randomized controlled trials (RCTs) evaluating oral glucosamine supplementation in patients with any type of TMD, including TMJ OA, were selected. Meta-analyses were performed using random-effects models, and the GRADE methodology was applied to assess the certainty of the evidence.ResultsSeven RCTs were included. In patients with TMJ OA, compared with placebo, glucosamine may not result in a clinically important reduction in pain at ≤3 months (MD -1.58 mm; 95% CI -5.98 to 2.83; low certainty) and probably does not provide a clinically important reduction at 6 months despite statistical significance (MD -7.02 mm; 95% CI -11.95 to -2.09; moderate certainty). Glucosamine improved quality of life at 12 months (MD -4.14; 95% CI -6.41 to -1.87; high certainty). Compared with active controls, the effect on pain was uncertain, although quality of life may improve at 3 months. In patients with other/unspecified TMD, glucosamine may not meaningfully reduce pain but may increase maximum pain-free mandibular opening at 3 months. Evidence regarding adverse and serious adverse events was very uncertain across comparisons.ConclusionOral glucosamine does not provide a clinically important reduction in pain in TMJ OA or other/unspecified TMD but may improve quality of life in TMJ OA. Evidence for functional outcomes and adverse events remains uncertain, highlighting the need for high-quality randomized trials.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024531131, identifier CRD42024531131.

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Background and aimThis systematic review and meta-analysis aimed to evaluate whether habitual glucosamine use is associated with colorectal cancer risk and survival outcomes in the general population.MethodsFollowing PRISMA 2020 guidance, we systematically searched PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews from inception to January 10, 2026. Prospective cohort studies comparing glucosamine users with non-users and reporting adjusted effect estimates were eligible. Two reviewers independently extracted data and assessed study quality using the Newcastle-Ottawa Scale. Adjusted hazard ratios or relative risks were pooled using fixed- or random-effects models based on heterogeneity quantified with I².ResultsFrom 347 records, 18 prospective cohort studies met eligibility criteria; five outcomes (colorectal cancer incidence, colorectal cancer-specific mortality, all-cause mortality, cardiovascular mortality, and overall cancer mortality) were quantitatively synthesized. Glucosamine use was associated with a lower incidence of colorectal cancer across 5 studies (pooled HR 0.87, 95% CI 0.82 to 0.92; I² = 36%). For colorectal cancer-specific mortality, the evidence was limited to only 2 studies with substantial heterogeneity (I² = 81%) and effect estimates in opposite directions, and the pooled estimate showed no clear association (pooled RR 0.99, 95% CI 0.57 to 1.71); this outcome should therefore be regarded as inconclusive. Glucosamine use was also associated with lower all-cause mortality in 4 studies (pooled HR 0.84, 95% CI 0.76 to 0.94; I² = 65%), lower cardiovascular mortality in 4 studies (pooled HR 0.82, 95% CI 0.75 to 0.89; I² = 44%), and a modest reduction in overall cancer mortality in 4 studies (pooled HR 0.94, 95% CI 0.91 to 0.98; I² = 7%). Results were stable in leave-one-out sensitivity analyses. All estimates represent associations derived from observational cohort studies and cannot establish causation.ConclusionsCurrent cohort evidence indicates that glucosamine use is associated with a modestly lower risk of developing colorectal cancer and with lower mortality from all causes, cardiovascular disease, and cancer overall. The evidence for colorectal cancer-specific mortality was based on only 2 studies with substantial heterogeneity and remains inconclusive. Because all included studies were observational, these findings represent associations rather than evidence of a causal protective effect. Given the modest effect sizes, healthy-user bias and residual confounding are plausible and possibly major explanations for the observed associations, and even a small degree of unmeasured confounding could account for part or all of them. Well-designed studies with improved exposure characterization, and ideally causal designs such as Mendelian randomization, are needed to determine whether these associations are causal and clinically meaningful.

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PurposeKnee osteoarthritis (KOA) creates a substantial global socioeconomic burden. Celecoxib remains a standard pharmacological treatment, but its long-term safety profile raises concerns. Several adjuvant therapies-probiotics, metformin, krill oil, and glucosamine/chondroitin (CS+GH)-have produced encouraging results in individual trials; however, direct head-to-head comparisons are absent. This network meta-analysis (NMA) compares the efficacy and safety of these five interventions to inform individualized treatment decisions in clinical practice.MethodsRCTs published from database inception through February 2026 were retrieved from PubMed, Web of Science, Embase, and the Cochrane Library. A random-effects NMA was conducted using Stata 18.0 and R (MetaInsight). Continuous outcomes were synthesized as mean differences (MD) and dichotomous safety endpoints as risk ratios (RR). Interventions were ranked by surface under the cumulative ranking curve (SUCRA), and evidence quality was assessed using the GRADE framework.ResultsTwenty-three RCTs met the inclusion criteria. No significant network inconsistency (P > 0.05) or publication bias was detected. For analgesic efficacy, celecoxib ranked highest on VAS pain improvement (MD = -0.48, 95% CI -0.78 to -0.17, SUCRA = 0.93) and WOMAC total scores (SUCRA = 0.912), followed by CS+GH (0.756). Probiotics (0.66) and metformin (0.63) showed potential efficacy, but the final network certainty for most of these auxiliary comparisons was low or very low, mainly due to severe imprecision and the absence of direct head-to-head trials. These SUCRA-based rankings should therefore be interpreted cautiously in clinical settings. On WOMAC subscales, celecoxib was associated with the largest improvements in pain and physical function; krill oil ranked highest on the pain subscale (SUCRA = 0.99), while probiotics and metformin had the most favorable safety profiles (SUCRA = 0.885 and 0.724, respectively).Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261345598, identifier: CRD420261345598.

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