One form of a supplement may retard knee osteoarthritis.
* THE QUESTION Does long-term treatment with the dietary supplement glucosamine sulfate affect the progression of knee osteoarthritis?
* PAST STUDIES have shown that current treatments for osteoarthritis -- a disease where the joint cartilage breaks down -- help alleviate pain and disability but do not affect the progression of the disease. Glucosamine sulfate, an amino sugar that is found in the body, is thought to play a role in cartilage formation and repair.
* THIS STUDY examined the effects of a prescription form of glucosamine sulfate that is available in Europe on 202 patients with mild to moderate knee osteoarthritis. The participants were randomly assigned to receive either 1,500 milligrams of the drug or a placebo daily for three years. Five percent of those who received the drug experienced severe narrowing of the space in their knee joints, compared with 14 percent of those who received the placebo. Also, those taking the drug experienced as much as 25 percent improvement in pain and disability, compared with only minor improvement for those in the placebo group. Both groups experienced limited digestive tract problems and transient abdominal pain.
* WHO MAY BE AFFECTED BY THESE FINDINGS? People with mild to moderate knee osteoarthritis.
* CAVEATS Rottapharm, a manufacturer of glucosamine sulfate, funded the study. In addition, the results may not apply to the various formulations of the dietary supplement that are available in the United States. Finally, glucosamine sulfate may not have the same effect on severe knee osteoarthritis.
* BOTTOM LINE People with knee osteoarthritis may wish to consult their physician about using glucosamine sulfate.
* FIND THIS STUDY Oct. 14 issue of the Archives of Internal Medicine; abstract online at http://archinte.ama-assn.org/.
Aspirin after bypass surgery helps prevent complications.
* THE QUESTION Does aspirin use immediately after artery bypass surgery lead to bleeding and other complications?
* PAST STUDIES have shown that aspirin use before surgery may lead to heavy blood loss during the operation. On the other hand, withholding aspirin after surgery can put patients at risk for heart attack, stroke, kidney failure and bowel problems resulting from the formation of blood clots.
* THIS STUDY examined the effect of aspirin on 5,065 bypass surgery patients. The 3,001 participants who received aspirin during the first 48 hours after surgery had a 60 percent lower rate of death during their hospitalization than those who did not receive aspirin (1.3 percent vs. 4 percent). Those who received aspirin also had a lower rate of complications such as heart attack and stroke (9.4 percent vs. 15.4 percent). Surprisingly, the patients on aspirin also had 63 percent fewer bleeding complications (1.9 percent vs. 5.2 percent).
* WHO MAY BE AFFECTED BY THESE FINDINGS? People undergoing artery bypass surgery.
* CAVEATS This was not a randomized trial. In addition, the 48-hour window for using aspirin is very broad and the results may be different in the first hours after surgery. Finally, the optimal dose of aspirin is not clear; the amounts used in this study ranged from 80 to 650 milligrams.
* BOTTOM LINE People undergoing artery bypass surgery may wish to consult their physician about taking aspirin, unless they have bleeding problems. The American College of Chest Physicians recommends 325 milligrams of aspirin a day for one year, starting six hours after bypass surgery.
* FIND THIS STUDY Oct. 24 issue of the New England Journal of Medicine; abstract online at www.nejm.org.
-- Haleh V. Samiei