Effect of Glucosamine on Intraocular Pressure and Risk of Developing Glaucoma

Abstract

Background: The most frequently recommended slow-acting medication for osteoarthritis symptoms is glucosamine, although its effectiveness is questionable. Widely used glucosamine sulfate supplements may increase intraocular pressure (IOP). Methods: In the current study we analyzed online databases UK Biobank, MedWatch, and FinnGen to evaluate the relationship of glucosamine to IOP and glaucoma. We included budesonide and fluticasone in the analysis for comparison since these drugs are associated with increased IOP. Results: In UK Biobank subjects, glucosamine use was associated with increased corneal compensated IOP (P=0.002, two-tailed t-test). This was also true in subjects without glaucoma (P=0.002, two-tailed t-test). However, no significant association of glucosamine and IOP was detected in subjects with a diagnosis of glaucoma. In MedWatch, 0.21% of subjects taking glucosamine reported glaucoma, 0.29% of subjects using budesonide reported glaucoma, and 0.22% of subjects using fluticasone reported glaucoma. In contrast, 0.08% of subjects using any other drug reported glaucoma. This variability is significant (P<0.001, two-tailed Fisher exact test). Data from FinnGen on risk of primary open angle glaucoma (POAG) or glaucoma in subjects using glucosamine prior to the diagnosis of the disease revealed a significantly increased risk for both POAG (hazard ratio 2.35) and glaucoma (hazard ratio 1.95). Conclusion: Glucosamine supplementation is common but can be associated with increased IOP and could contribute to the pathogenesis of glaucoma. It may be prudent for ophthalmologists to elicit any history of glucosamine use from their patients and advise them accordingly. Further studies on the role of glucosamine in glaucoma are warranted.