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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,2021/1/28,#,Osteoarthritis of hip and knee is increasing,non-steroidal anti-inflammatory drugs was used as the pain killer,NSAIs cause serious gastrointestinal and cardiovascular adverse events,especially with long term use,Glucosamine was used to be thought as disease modifying agents and recommended for years,Global sales,：,$2bn(1.3bn,0.8bn)in 2008,60%compared with 2003,2013 reaching$2.3bn,Results from randomized trials about the effectiveness of chondroitin and glucosamine are conflicting,Introduction,Osteoarthritis of hip and knee,Article#1,2010.BMJ,Impactor 20.75,Article#12010.BMJ,Article#1,Aim:,To determine the effect of glucosamine,chondroitin,or the two in combination on joint pain and on radiological progression of disease in osteoarthritis of the hip or knee,Design,:network meta-analysis,Outcomes,:pain release,change in minimal width of joint space,Eligibility criteria:,Large scale randomized controlled trials in more than 200 patients with osteoarthritis of the knee or hip that compared glucosamine,chondroitin,or their combination with placebo or head to head,General character,:10 trials in 3803 patients were included.,Article#1Aim:To determine th,Method,Statistical analysis:,multivariable Bayesian hierarchical random effects models,Significant difference,:we back transformed effect sizes to differences on a 10 cm visual analogue scale on the basis of a median pooled,SD of 2.5 cm,found in large scale osteoarthritis trials that assessed pain on a 10 cm visual analogue scale.,We prespecified a minimal clinically important difference of,0.37 SD units,corresponding to,0.9 cm on a 10 cm,visual analogue scale.,joint space clinically important difference:,SD of 1.2 mm,Method Statistical analysis:m,Result,Result,Result,Result,Result,Result,Result,tests for interaction were all negative(P0.20 for interaction),Result tests for interaction w,Result,Joint space:,The difference was,-0.2 mm(-0.3 to 0.0 mm),in glucosamine,-0.1 mm(-0.3 to 0.1 mm),in favour of chondroitin,0.0 mm(-0.2 to 0.2 mm),for the combination,Result Joint space:,Conclusion,We believe it,unlikely,that future trials will show a clinically relevant benefit of any of the evaluated preparations,Our findings indicate that glucosamine,chondroitin,and their combination,do not result in a relevant reduction of joint pain,nor affect joint space narrowing compared with placebo.,Some patients,however,are convinced that these preparations are beneficial,which might be because of the,natural course of osteoarthritis,regression to the mean,or the placebo effect,Conclusion We believe it unlik,Limitations,Meta-analysis,heterogeneity between trials needed to be considered,inconsistency between direct and indirect comparisonswas also need to be considered,LimitationsMeta-analysis,Article#2,2017.ARD(Ann Rheum Dis):12.811,Level of Evidence Level I,Retrospective study,Article#22017.ARD(Ann Rheu,Article#2,Aim:,to evaluate the effectiveness of oral glucosamine in subgroups of people with hip or knee osteoarthritis(OA)using individual patient data,Design,:retrospective study with individual patient data(IPD),Outcomes,:pain and function,Article#2Aim:to evaluate the,Result,Result,Result,Result,Result,Result,NSAIs cause serious gastrointestinal and cardiovascular adverse events,especially with long term use,We prespecified a minimal clinically important difference of 0.,Thanks for your attention！,20 for interaction),Blue fgures represent high pain(WOMAC pain 70),high BMI(27 kg/m2),female sex,K&L grades 34 and presence of inammation subgroups,respectively.,Significant difference:we back transformed effect sizes to differences on a 10 cm visual analogue scale on the basis of a median pooled SD of 2.,General character:10 trials in 3803 patients were included.,The difference was-0.,Design:retrospective study with individual patient data(IPD),tests for interaction were all negative(P0.,tests for interaction were all negative(P0.,Statistical analysis:multivariable Bayesian hierarchical random effects models,tests for interaction were all negative(P0.,Aim:to evaluate the effectiveness of oral glucosamine in subgroups of people with hip or knee osteoarthritis(OA)using individual patient data,Some patients,however,are convinced that these preparations are beneficial,which might be because of the natural course of osteoarthritis,regression to the mean,or the placebo effect,Red figures represent low pain(WOMAC pain 70),low BMI(27 kg/m2),male sex,K&L grades 02 and absence of inammation subgroups,respectively.,Glucosamine does not result in a relevant reduction of joint pain and function，nor affect joint space narrowing compared with placebo.,The study did not identify a subgroup for which glucosamine showed any significant beneficial effects over placebo for pain or function in either the short term or long term.,Stratification only for participants with knee OA or for type of glucosamine did not result in any differences in outcomes.,Than
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