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Clinical Trial Conducted Successfully Via the Internet (Does Glucosamine Help in Osteoarthritis?)

October 13, 2004 - In a study published in the current issue of The American Journal of Medicine, the Internet was used to conduct a clinical trial of glucosamine in patients with knee osteoarthritis. As one of the most frequently used dietary supplements in the United States, recommended in the popular press as a remedy for osteoarthritis, this substance has been the subject of several recent trials, with mixed results.

The authors, from the Divisions of Rheumatology and Clinical Care Research, Tufts–New England Medical Center, Boston, Massachusetts; and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, were examining not only the effectiveness of glucosamine but also, and perhaps more importantly, whether a clinical trial can be conducted over the Internet.

While the results of the trial showed no difference between glucosamine and placebo, Timothy McAlindon, MD, MPH , notes, “Our findings should be interpreted in light of several unique aspects of the Internet-based design, and in view that this study was performed primarily to test the feasibility and methodological aspects of this approach, rather than the efficacy of glucosamine itself.” The authors were able to recruit over 200 subjects and conduct most of the procedures of a controlled clinical trial, such as outcome assessment, pill counts, and ascertainment of adverse events, completely over the Internet.

Dr. McAlindon continues, “We embarked on this study against a background of numerous positive industry-funded glucosamine trials. Since then, however, three independently funded traditional clinical trials have been published, all with null outcomes.

While our results are consistent with those of these trials…further studies will be needed to resolve the issue of the effectiveness of glucosamine products. The Internet-based clinical trial approach may be an effective way to perform such studies quickly and efficiently.”

The study is reported in “Effectiveness of Glucosamine for Symptoms of Knee Osteoarthritis: Results from an Internet-Based Randomized Double-Blind Controlled Trial” by Timothy McAlindon, MD, MPH, Margaret Formica, MSPH, Michael LaValley, PhD, Melissa Lehmer, MPH, and Karim Kabbara, MCIS. The article appears in The American Journal of Medicine, Volume 117, Number 9 (November 1, 2004 issue), published by Elsevier.

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