Table 6

GRADE evidence profile

Quality assessment
Number of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsQuality
Pain measured on VAS, follow up (4 weeks–1 year)
3Randomised trialsSerious*Serious†Serious*No serious imprecisionNoneVery low
Function/disability measured on RMDQ, follow-up (4 weeks–1 year)
3Randomised trialsSerious*No serious inconsistencySerious‡No serious imprecisionNoneLow
Adverse effects
3Randomised trialsSerious*No serious inconsistencySerious‡No serious imprecisionNoneLow
  • *One study was open-label.31 There were limitations regarding unclear randomisation in another trial.32 One trial did not clearly employ an intention to treat analysis and compliance was also unclear.31

  • †Two trials with a low risk-of-bias failed to show any significant decrease in pain levels,30 ,32 whereas one trial with a high risk-of-bias31 showed a significant effect of glucosamine on back pain.

  • ‡One trial used male patients from US Navy special warfare community with a history of high activity levels and unique occupational exposures; hence the results may not be generalisable.32 One study used a mixed population of both knee and back pain patients and some patients had both, although data was separated by site.32