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Abstract Controversial issues on efficacy of glucosamine Noppakun Thammatacharee*

*Health Insurance System Research Office

Objective: The purpose of this study was to review the efficacy and cost-effectiveness of Glucosamine.

Method: A review of meta-analysis, randomized controlled trial with at least 12-month follow-up in patients and cost-effectiveness analysis of Glucosamine between 2005-2010 was undertaken. The re- view did not consider old studies because there was evidence suggesting publication bias.

Results: Compared with placebo Glucosamine was no more effective than placebo (statistical non- difference) in people with osteoarthritis on WOMAC pain and WOMAC function, RMDQ and EQ-5D scores also showed no or small effect on narrowing the joint space width. Both generic and innovative Glucosamine had ICER greater than one time Thai GDP per capita.

Conclusion: Available evidence suggests that Glucosamine has low effect, therefore low cost-effec- tiveness. Up until now it is still a controversial issue among prescribers and health insurers, especially the in the Civil Servant Medical Benefit Scheme that whether it should be included the cost of treatment in public health insurance system.

Key word: Glucosamine

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Glucosamine and cost-effectiveness 2 2 2

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vs placebo WOMAC function

Wilkens et al (2010) RCT Lumbar 250 Glucosamine RMDQ NS

vs placebo EQ-5D

Lee et al (2009) Meta-analysis Knee 1,502_ GS vs placebo JSW NS (1 year)

Small/moderate (3 years) RCT Hip 222 GS vs placebo WOMAC pain NS

Rozendaal et al (2009)* WOMAC function

Rozendaal et al (2008) JSW

Sawitzke et al (2008) RCT Knee 572 Glucosamine JSW NS

vs placebo

Kawasaki et al (2008) RCT Knee 142 GH vs placebo JSW NS

Messier et al (2007) RCT Knee 89 GH vs placebo WOMAC function NS

WOMAC pain

GH = Glucosamine Hydrochloride, GS = Glucosamine Sulfate NS = Statistically non-significant difference

*Subgroup analysis

†√«¡∑—Èß Glucosamine ·≈–º≈‘μ¿—≥±åÕ◊Ëπ (Chondroitin) ¥â«¬

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‡Õ° “√Õâ“ßÕ‘ß

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ß“πº≈°“√ ”√«® ∂“π°“√≥å°“√ —Ëß„™â¬“·≈–¡“μ√°“√§«∫§ÿ¡°“√

 —Ë߬“¢Õß‚√ß欓∫“≈π”√àÕß ÛÙ ·Ààß „π¿“æ√«¡°àÕπ‡√‘Ë¡¥”‡π‘π°“√.

°√¡∫—≠™’°≈“ß; ÚııÛ.

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