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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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