How does glucosamine compare to other treatments?

Acetaminophen (also known as paracetamol) is often recommended as a first-line treatment for osteoarthritis. One study noted that 1500 mg of glucosamine sulfate taken once daily was approximately equivalent to 3000 mg of acetaminophen over a 6-month course of treatment, with both treatments being more effective than placebo.^[1]

Another meta-analysis compared the effectiveness of various treatments, including glucosamine, chondroitin, their combination, acetaminophen, and celecoxib (a non-steroidal anti-inflammatory drug), at managing pain, function, and stiffness in osteoarthritis. All interventions showed better pain relief than placebo, with celecoxib performing best, followed by the combination of glucosamine and chondroitin, then by chondroitin alone. With respect to physical function and stiffness, acetaminophen did not significantly outperform placebo, whereas glucosamine alone and celecoxib both had a significantly superior effect. Overall, acetaminophen was the least efficacious drug.^[2]

Additionally, one study in people with mild to moderate knee osteoarthritis given glucosamine sulfate at 1500 mg daily, either alone or in combination with an NSAID drug (e.g., ibuprofen or piroxicam), observed that while glucosamine was effective in reducing pain at 12 weeks compared to baseline, the combination therapy outperformed glucosamine alone.^[3]