Searching For Evidence Scenarios Glucosamine

Question: Discuss about theSearching For Evidence Scenariosfor Glucosamine. Answer: Clinical Question In men with knee pain which treatment option is more effective celecoxib or glucosamine? Key words/Search terms/Phrases Alternative Words P (Population/Patient) Men with knee pain Men with osteoarthritis I(Intervention/Indicator) Celecoxib administration NSAID administration C (Comparator/Control) Glucosamine administration Joint health supplement administration O (Outcome) Remediation of knee pain Pain management in knee osteoarthritis Database: Google Scholar Action Search Mode Results Limiters Key words typed Filtered articles by setting the time frame from 2013 till present date Articles having the key words in the title selected Articles without citations excluded The novel advancements in medical field have opened up newer opportunities for diverse treatment options pertinent to a specific clinical condition. The availability of the multiple treatment modalities has further put both the physician as well as the service user in a dilemma to choose from the alternatives. One such example may be cited in the case of administration of medicines celecoxib or glucosamine for treating knee pain in patients. Both have been reported to mitigate pain in knee and the evidences in favor of this claim will be discussed in the following essay through information retrieved from relevant journal articles. Celecoxib is a common non-steroidal anti inflammatory drug (NSAID) that functions by means of reducing the levels of hormones that accentuate pain and swelling in the body. It is essentially a cyclooxygenase-2 (COX-2) inhibitor that acts by alleviating the pain caused due to stiffness, swelling and pain in the joints especially of the knees. A study laid sufficient emphasis upon the efficacy of the NSAID in treatment of pain in the knees and the findings suggested that the celecoxib is fairly efficient as a NSAID in improving the pin and functionality in case of patients with knee pain (da Costa et al., 2016). Another recent empirical study has highlighted the issue of impacts in relation to the administration of celecoxib on pain management in patients after total knee arthroplasty (TKA). Apart from multimodal analgesia that encompass peripheral nerve block and patient controlled analgesia, the effectiveness of the oral administration of the selective COX-2 inhibitor during post ope rative pain management following TKA has been hypothesized . The need for opioid analgesic consumption under such circumstances has been presumed to lower following the oral administration of celecoxib for TKA (Mammoto et al., 2016). Further studies have studied the efficacy of the celecoxib drug in knee osteoarthritis condition to minimize the perception of pain. The feasibility of application and tolerance towards celecoxib administration was compared against another potent NSAID, ibuprofen for the treatment of symptoms related to knee osteoarthritis. Daily dosage of 200 mg of celecoxib in the affected population was found to harbor positive outcomes and generated greater satisfaction in contrast to the measured variables for ibuprofen. Upper gastrointestinal effects were found to be less frequent under the effect of celecoxib rather than ibuprofen or placebo. Thus the tolerance towards celecoxib in the concerned population was found to be satisfactory and as good as the administr ation of ibuprofen in mitigating the pain related symptoms (Gordo et al., 2017). Thus the evidences are suggestive of the efficiency of celecoxib as a prominent NSAID. Glucosamine has been reckoned as a joint health supplement that has the potential to diminish the rate of collagen degradation in the joint tissue thereby aiding in the slower progression of the disease related to osteoarthritis. In this regard studies have been done to provide an insight into the effectiveness of the drug in treating knee osteoarthritis. The safety and efficacy associated with the combinatorial therapy with chondrotion sulfate and glucosamne sulfate was assessed in a study and compared against the placebo among patients with symptomatic knee osteoarthritis. The findings revealed a lack of superiority of this combination therapy over placebo in ameliorating the joint pain and functional impairment in patients with knee osteoarthritis over 6 months (Roman?Blas et al., 2017). Another study evaluated the potency of the supplements like glucosamine and/or chondroitin in reducing the joint space narrowing as well as pain among people having knee osteoarthritis. Significan t reduction in terms of joint space narrowing at 2 years follow up was observed on allocation of combined chondrotin-glucosamine. However no significant benefit was noticed in any of the single treatment allocation groups above placebo (Fransen et al., 2015). On the other hand, a study demonstrated the efficacy of the oral supplementation of glucosamine on joint structures in case of individuals suffering from chronic joint pain. Assessment by virtue of 3T magnetic resonance imaging (MRI) was performed to evaluate the structural lesions in the knee joints. The results revealed no significant improvement in structural orientation in the knee joints evident through MRI morphologic features upon supplementation with glucosamine for individuals with chronic knee pain (Kwoh et al., 2014). Thus evidences related to pain amelioration through glucosamine administration alone are limited in case of patients having chronic knee pain and require further research and analysis to decipher the ef fects of glucosamine supplementation in this population. Therefore the patient in the given scenario might resort to glucosamine 1500 mg/day administration to avoid further deterioration of the existing condition thereby providing temporary relief to knee pain. Celecoxib 200 mg/day administration will act on alleviating the symptoms only may thus be kept at bay for the time being shifting the focus towards abatement of further deterioration of knee pain. References da Costa, B. R., Reichenbach, S., Keller, N., Nartey, L., Wandel, S., Jni, P., Trelle, S. (2016). Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. The Lancet, 387(10033), 2093-2105. doi: 10.1016/S0140-6736(16)30002-2 Fransen, M., Agaliotis, M., Nairn, L., Votrubec, M., Bridgett, L., Su, S., Woodward, M. (2015). Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Annals of the rheumatic diseases, 74(5), 851-858. Retrieved from https://ard.bmj.com/ Gordo, A. C., Walker, C., Armada, B., Zhou, D. (2017). Efficacy of celecoxib versus ibuprofen for the treatment of patients with osteoarthritis of the knee: A randomized double-blind, non-inferiority trial. Journal of International Medical Research, 45(1), 59-74. doi: 10.1177/0300060516673707. Kwoh, C. K., Roemer, F. W., Hannon, M. J., Moore, C. E., Jakicic, J. M., Guermazi, A., Boudreau, R. (2014). Effect of Oral Glucosamine on Joint Structure in Individuals With Chronic Knee Pain: A Randomized, Placebo?Controlled Clinical Trial. Arthritis Rheumatology, 66(4), 930-939. doi: 10.1002/art.38314. Mammoto, T., Fujie, K., Mamizuka, N., Taguchi, N., Hirano, A., Yamazaki, M., Hashimoto, K. (2016). Effects of postoperative administration of celecoxib on pain management in patients after total knee arthroplasty: study protocol for an open-label randomized controlled trial. Trials, 17(1), 45. doi: 10.1186/s13063-015-1106-2. Roman?Blas, J. A., Castaeda, S., Snchez?Pernaute, O., Largo, R., Herrero?Beaumont, G. (2017). Combined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With Knee Osteoarthritis: A Six?Month Multicenter, Randomized, Double?Blind, Placebo?Controlled Clinical Trial. Arthritis Rheumatology, 69(1), 77-85. doi: 10.1002/art.39819.