By: Susan Aldridge, medical journalist, PhD
There has been a great deal of interest in the use of dietary supplements, such as glucosamine, to help maintain joint health and mobility. Recent news reports suggest that too many people are going to see their GP with minor problems - costing the health service across the UK nearly £2bn a year. Although there is currently no cure for osteoarthritis or rheumatoid arthritis, treatment could focus more on self-management and lifestyle changes to alleviate pain – and glucosamine and other natural supplements could perhaps play a role in this.
Glucosamine is certainly popular The market for glucosamine in the UK has been estimated to be in excess of £80 million a year. But the use of glucosamine in the treatment of osteoarthritis remains controversial. Many placebo-controlled studies have produced negative results, and previous meta-analyses have led experts to conclude that glucosamine hydrochloride is ineffective in osteoarthritis at the widely-used dose of 500 mg three times a day.
However, despite the fact that the National Institute for Health and Clinical Excellence (NICE) does not recommend glucosamine as a treatment for osteoarthritis, many patients are still paying around £10 per month to buy glucosamine over the counter, and many providers continue to fund glucosamine prescriptions, despite a lack of clear evidence for its benefits.
One alternative to glucosamine is GOPO® - an active compound isolated from Rosa Canina, which is a species of rosehip. Studies suggest that GOPO® may be anti-inflammatory, working via specific molecular pathways. In recent research, rheumatoid arthritis patients who took a rosehip supplement containing GOPO® were far less disabled and had fewer tender and swollen joints than those who did not. In this latest research, patients with rheumatoid arthritis were randomized to receive either 5 grams of GOPO® per day or placebo on top of their usual medications. Patients rated their level of disability every three months, while their doctors assessed how badly swollen and tender their joints were. The benefits of the rosehip powder were measurable after just three months of treatment and, at the six month assessment, the number of tender joints had almost halved in GOPO®-treated patients compared with placebo-treated patients. Everyday activity levels and quality of life also improved significantly in those who took the rosehip capsules.
Whillich SN, Rossnagel K, Roll S et al. Rose hip herbal remedy in patients with rheumatoid arthritis – a randomised controlled trial. Phytomedicine 2010; 17:87-93