In the September 2009 issue of the journal "Advances in Therapy," German researchers report that the addition of omega-3 polyunsaturated fatty acids to the over-the-counter arthritis treatment glucosamine sulfate resulted in improved alleviation of symptoms compared to glucosamine alone. The trial is the first, to the authors' knowledge, to test the combination in patients with osteoarthritis.

In their introduction to the article, Joerg Gruenwald and his coauthors explain that a chronic imbalance between the synthesis and degradation of cartilage matrix leads to the loss of joint tissue that occurs in osteoarthritis. Glucosamine and omega-3 fatty acids appear to be successful in adjusting this imbalance in the direction of new cartilage synthesis.

The researchers enrolled 177 men and women between the ages of 40 and 75 with moderate-to-severe hip or knee osteoarthritis. Participants were randomized to receive three capsules daily of 500 milligrams glucosamine sulfate with or without 200 milligrams of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for 26 weeks. Questionnaires concerning pain, stiffness and physical function limitations were administered before the treatment period, after 13 weeks, and at the trial's conclusion.

One hundred sixty-five participants showed a response of at least a 20 percent reduction in pain scores, with no significant difference between treatment groups. When an at least 80 percent reduction in pain was evaluated among those who complied with the study protocol, 44 percent of those in the combination group compared to 32 percent of those who received only glucosamine were categorized as responders. Morning stiffness and pain in the hips and knees were reduced by 48.5-55.6 percent in those who received both glucosamine and omega-3 fatty acids and by 41.7-55.3 percent in the glucosamine only group. Additionally, combination therapy was received by twice as many patients who reported a 90 to 100 percent reduction in pain compared to those who received glucosamine alone.

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