From a recent review by ConsumerLab
"Due to concerns about the quality of evidence (i.e. most of the studies showing a benefit have been company-funded, while studies with the least risk of bias have not found a benefit) the American College of Rheumatology/Arthritis Foundation has advised against supplementation with glucosamine for knee, hip or hand osteoarthritis. It also advised against chondroitin supplementation for knee and hip osteoarthritis, but noted that one trial suggests a benefit with chondroitin sulfate for hand osteoarthritis(Kolasinki, Arthritis Rheumatol 2020)." 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee
First published: 06 January 2020
https://doi.org/10.1002/art.41142 https://onlinelibrary.wiley.com/doi/ful ... /art.41142Glucosamine is strongly recommended against in patients with knee, hip, and/or hand OA.Pharmaceutical‐grade preparations of glucosamine are available and have been studied in multiple trials. However, discrepancies in efficacy reported in studies that were industry sponsored as opposed to publicly funded have raised serious concerns about publication bias 34, 35. In addition, there is a lack of a clear biologic understanding of how efficacy would vary with the type of salt studied. The data that were deemed to have the lowest risk of bias fail to show any important benefits over placebo. These recommendations represent a change from the prior conditional recommendation against the use of glucosamine. The weight of the evidence indicates a lack of efficacy and large placebo effects. Nonetheless, glucosamine remains among the most commonly used dietary supplements in the US 31, and clinicians should be aware that many patients perceive that glucosamine is efficacious. Patients also often perceive that different glucosamine formulas are associated with different degrees of efficacy and seek advice on brands and manufacturers. The potential toxicity of glucosamine is low, though some patients exposed to glucosamine may show elevations in serum glucose levels 36.
Chondroitin sulfate is strongly recommended against in patients with knee and/or hip OA as are combination products that include glucosamine and chondroitin sulfate,but is conditionally recommended for patients with hand OA.A single trial suggested analgesic efficacy of chondroitin sulfate, without evidence of harm, in hand OA.