Two nationwide surveys of 2,000 general practitioners and postal questionnaires sent to 30,000 patients with osteoarthritis confirms patients who use non-steroidal anti-inflammatory drugs (NSAIDs) experience a high incidence of gastrointestinal side effects.

In the survey, 97 percent of the general practitioners reported that their patients had suffered GI symptoms when taking NSAIDS. Thirty-eight percent of the doctors reported patients who went to the hospital as a result of their NSAID use. Four percent of the doctors treated patients who ultimately died due to NSAID side effects. Most of the general practitioners (92%) said they were concerned about the safety of NSAIDS.

Inadequate pain relief was the most common reason reported by GPs and osteoarthritis patients for dissatisfaction with NSAID treatment. Seventeen percent of the patients reported stomach upsets or irritation as their main reason for being unsatisfied with NSAID treatment.

A number of natural alternatives have been shown to be viable alternatives to NSAIDS in the treatment of osteoarthritis. One published review reported that glucosamine sulfate has reversed or stopped osteoarthritis progression without inducing serious adverse effects. The reviewers pointed out that data from short-term human trials suggests that glucosamine sulfate may gradually and progressively reduce joint pain and tenderness, as well as improve range of motion and walking speed in osteoarthritis patients. Studies have demonstrated that glucosamine can produce greater than 50% overall improvement in symptom scores in osteoarthritis patients and that it may be equal or superior to ibuprofen in controlling symptoms. One double-blind investigation of 178 osteoarthritis patients showed that both glucosamine and ibuprofen significantly reduced the symptoms of osteoarthritis, but glucosamine tended to be more effective. Two weeks after treatment was discontinued, both groups continued to experience improvement, but this improvement was more pronounced in the glucosamine group. The researchers concluded, The present study confirms that glucosamine sulfate (GS) is a selective drug for osteoarthritis, as effective on the symptoms of the disease as NSAIDs but significantly better tolerated.

References:
Brian Crichton, Martin Green. GP and Patient Perspectives on Treatment With Non-steroidal Anti-inflammatory Drugs for the Treatment of Pain. Curr Med Res Opin. 18(2):92-96, 2002.

Qiu GX, Gao SN, Giacovelli G, Rovati L, Setnikar I. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung. 1998;48(5):469-74.

da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis. Ann Pharmacother. 1998;32(5):580-7.

The information in this article is not intended to provide personal medical advice, which should be obtained from a medical professional, and has not been approved by the U.S. FDA.

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