Miss Kan, whom I interviewed during the home visit, is a 65-year-old woman with a two-year history of osteoarthritis of her knees. She was given celecoxib at first for treating the pain, however, the pain control was suboptimal despite good drug compliance. On her next follow-up, she was given glucosamine-chondroitin instead for her condition. The response was good and she claimed that there was no more pain in her knees, and the range of motion restored. The result inspired me to dig deep into the mechanism and action of the two drugs. Celecoxib, being a specific COX-2 inhibitor, inhibits the transformation of arachidonic acid to prostaglandin precursors, which reduces inflammation and pain. On the other hand, glucosamine-chondroitin promotes
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The research objective is focused, which is ‘to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA)’. Studies had to meet these 6 criteria so as to be included in the network of meta-analysis: 1. A randomized controlled trial; 2. About OA knee patients; 3. Contain at least two of the following medications as treatment: 200mg/day oral celecoxib, glucosamine, chondroitin, combination of glucosamine and chondroitin, and placebo; 4. Reporting function, pain, structure modifying effects or side effects of patients; 5. English literature; 6. Availability of data. Secondary studies, for example combined data analyses of randomized controlled trials, were excluded. These inclusion and exclusion criteria were set appropriately. The search method for literature was thorough. 3 electronic databases were used, namely Cochrane Library, PubMed and Embase. Also, the reviews and listed reference listed were examined manually. But there was no info on how many authors reviewed the studies, and whether the viewing process was independent or not, and whether there was unanimous agreement. The quality of each included study was assessed based on the design of study, the collection of data and the quality of analysis. A total of 7 potential risks of bias were identified, including random sequence generation, …show more content…
Glucosamine [-0.50 cm (-0.83 cm to -0.18 cm)], chondroitin [-0.45 cm (-0.85 cm to -0.08 cm)], combination of glucosamine and chondroitin [-0.68 cm (-1.18 cm to -0.15 cm)], celecoxib [-0.68 cm (-0.88 cm to -0.50 cm)] all showed a significant better effect on pain relief when compared to the placebo group. However, there was no significant difference between any two treatment groups.
The results from the study is closely applicable to Miss Kan, who tried celecoxib and glucosamine-chondroitin for her OA knee. Evidence showed that the pain relieving effect between celecoxib and glucosamine-chondroitin was clinically insignificant, meaning both treatments would have similar pain relieving effects. However, glucosamine-chondroitin was the only treatment group in the study to have clinically significant improvement from baseline pain and function, while celecoxib had a higher rate of gastrointestinal adverse effect when compared with other
The research objective is focused, which is ‘to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA)’. Studies had to meet these 6 criteria so as to be included in the network of meta-analysis: 1. A randomized controlled trial; 2. About OA knee patients; 3. Contain at least two of the following medications as treatment: 200mg/day oral celecoxib, glucosamine, chondroitin, combination of glucosamine and chondroitin, and placebo; 4. Reporting function, pain, structure modifying effects or side effects of patients; 5. English literature; 6. Availability of data. Secondary studies, for example combined data analyses of randomized controlled trials, were excluded. These inclusion and exclusion criteria were set appropriately. The search method for literature was thorough. 3 electronic databases were used, namely Cochrane Library, PubMed and Embase. Also, the reviews and listed reference listed were examined manually. But there was no info on how many authors reviewed the studies, and whether the viewing process was independent or not, and whether there was unanimous agreement. The quality of each included study was assessed based on the design of study, the collection of data and the quality of analysis. A total of 7 potential risks of bias were identified, including random sequence generation, …show more content…
Glucosamine [-0.50 cm (-0.83 cm to -0.18 cm)], chondroitin [-0.45 cm (-0.85 cm to -0.08 cm)], combination of glucosamine and chondroitin [-0.68 cm (-1.18 cm to -0.15 cm)], celecoxib [-0.68 cm (-0.88 cm to -0.50 cm)] all showed a significant better effect on pain relief when compared to the placebo group. However, there was no significant difference between any two treatment groups.
The results from the study is closely applicable to Miss Kan, who tried celecoxib and glucosamine-chondroitin for her OA knee. Evidence showed that the pain relieving effect between celecoxib and glucosamine-chondroitin was clinically insignificant, meaning both treatments would have similar pain relieving effects. However, glucosamine-chondroitin was the only treatment group in the study to have clinically significant improvement from baseline pain and function, while celecoxib had a higher rate of gastrointestinal adverse effect when compared with other