Lancet. 2001 Jan 27;357(9252):251-6. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial.Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, Gossett C.Bone and Cartilage Metabolism Research Unit (WHO Collaborating Center for Public Aspects of Osteoarticular Disorders), University of Liege, Belgium. jyreginster@ulg.ac.beBACKGROUND: Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms. METHODS: We did a randomised, double-blind placebo controlled trial, in which 212 patients with knee osteoarthritis were randomly assigned 1500 mg sulphate oral glucosamine or placebo once daily for 3 years. Weightbearing, anteroposterior radiographs of each knee in full extension were taken at enrolment and after 1 and 3 years. Mean joint-space width of the medial compartment of the tibiofemoral joint was assessed by digital image analysis, whereas minimum joint-space width--ie, at the narrowest point--was measured by visual inspection with a magnifying lens. Symptoms were scored by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. FINDINGS: The 106 patients on placebo had a progressive joint-space narrowing, with a mean joint-space loss after 3 years of -0.31 mm (95% CI -0.48 to -0.13). There was no significant joint-space loss in the 106 patients on glucosamine sulphate: -0.06 mm (-0.22 to 0.09). Similar results were reported with minimum joint-space narrowing. As assessed by WOMAC scores, symptoms worsened slightly in patients on placebo compared with the improvement observed after treatment with glucosamine sulphate. There were no differences in safety or reasons for early withdrawal between the treatment and placebo groups. INTERPRETATION: The long-term combined structure-modifying and symptom-modifying effects of gluosamine sulphate suggest that it could be a disease modifying agent in osteoarthritis

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This 2001 WHO sponsored report in Lancet is relatively ancient history, and just one of several equally good[?] studies on glucosamine. Run a MEDLINE search, and don't leave out the reviews and comments. Might need to visit a local university medical library, but one could generate a really good argument for glucosamine or against it's routine use, using just study reports. It may depend on whether your approach is "Use it 'till it's proved worthless" or "Back off 'till we have demonstrated a basic population and dosing protocols where we can predict an effective outcome."

Among the original 5 supplements, glucosamine may be the most promising as far as clinical impact. But one good one will not not raise the credibility of all supplements. One thing that will always seem to pop up in medical commentary is the lack of regulation in the supplement industry. There is a huge fear, maybe more real than imagined, that actual contents of similarly labeled supplements will be dramatically different from manufacturer to manufacturer, and even from lot to lot.