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September 13, 2000

Efficacy of Glucosamine and Chondroitin for Treatment of Osteoarthritis

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(10):1241. doi:10.1001/jama.284.10.1239

To the Editor: In their systematic quality assessment and meta-analysis of the effectiveness of GS and CS for the treatment of OS, Dr McAlindon et al1 did not mention that shark cartilage serves as a major source of these products.

The United Nations Food and Agricultural Organization report that virtually 70% of the world's fisheries (including shark fisheries) are fully exploited to overexploited, depleted, or in a state of collapse.2 In the United States, which is one of the few countries that effectively manages any of its fisheries, the number of some species of coastal sharks has been reduced by 75% to 85% over the past 20 years.3 Sharks are caught for their fins (to be used in soup), their cartilage (to be used in supplements), and their meat, as well as inadvertently through the use of long-line fishing. In 1995, more than 100 million sharks from the 400 known species were killed.3 Furthermore, unregulated fisheries in other countries and in international waters support a thriving, worldwide gray-market trade in shark skeletons.4

In the midst of the largest global extinction since the demise of the dinosaurs 65 million years ago, when more than 5000 species are lost per year (10,000 times the naturally occurring rate of extinction),5 we must take special care to preserve all creatures and promote biodiversity. Given that many currently available pharmaceutical and "neutraceutical" products are derived from or patterned after molecules found in plant and animal species, we must balance a respect for human, plant, and animal life and ensure that a continuing source of effective organismal products are available for patients.

McAlindon  TELaValley  MPGulin  JPFelson  DT Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis.  JAMA. 2000;283:1469-1475.Google Scholar
Greenpeace International, Dead ahead—industrial fishing fleets set course for disaster. May 1998. Available at: http://www.greenpeace.org/~oceans/globaloverfishing/deadahead.html. Accessed March 30, 2000.
Benchley  P Sharks.  Audubon. May-June 1998:53-57.Google Scholar
Rivlin  MA Bad to the bone.  Amicus J. Spring 2000:12-18.Google Scholar
Wilson  EO Threats to biodiversity.  Sci Am. 1989;261:108-116.Google Scholar