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Analgesics for Osteoarthritis—An Update

Slide: 31 of 32

Knowledge Gaps and Future Research Needs (3 of 3)

Most trials showing therapeutic benefits from glucosamine were conducted with pharmaceutical-grade glucosamine not available in the United States and may not be applicable to currently available over-the-counter preparations. Large trials comparing currently available over-the-counter preparations to oral NSAIDs are needed, as these are likely to remain available even if the FDA approves a pharmaceutical-grade glucosamine. Additional long-term trials are also required to further evaluate the effects of glucosamine on progression of joint space narrowing and to determine the clinical effects of any beneficial effects on radiographic outcomes.

Head-to-head trials of topical versus oral NSAIDs have not been large enough to evaluate the risks of serious CV and GI adverse effects. Additional head-to-head trials and large cohort studies may be required to adequately assess serious adverse effects.