观察性研究表明，用于治疗关节疼痛和骨关节炎的葡萄糖胺与癌症发病率降低有关，尽管他们的研究设计受到选择偏差的影响。我们使用减轻这种选择偏差的研究设计来评估这种关联。我们使用英国临床实践研究数据链来识别 1995 年至 2017 年间诊断患有骨关节炎的一组患者。流行的新用户队列设计用于将氨基葡萄糖起始剂与非用户在时间条件倾向评分上进行匹配，并跟踪直至癌症发病。评估癌症发病率的风险比 (HR) 和 95% 置信区间 (CI)，以比较使用和不使用氨基葡萄糖的情况。骨关节炎患者的研究队列包括 20,541 名氨基葡萄糖起始剂患者，与 20,541 名非使用者相匹配。平均随访 8 年，癌症的总体发病率为每年千分之 16.4。与不使用葡萄糖胺相比，使用葡萄糖胺的任何癌症发病率的 HR 为 0.97 (95% CI 0.91-1.02)。对于肺癌，使用氨基葡萄糖的 HR 为 0.99 (95% CI 0.83-1.18)，而对于结直肠癌为 1.11 (95% CI 0.93-1.33)，对于女性乳腺癌为 1.07 (95% CI 0.93-1.23)前列腺癌为 1.03 (95% CI 0.88-1.22)。 在这项针对骨关节炎患者的大型现实研究中，旨在模拟一项试验，结果显示，使用葡萄糖胺治疗并没有降低癌症的发病率。这一发现进一步证明，之前的研究并非基于新用户，而是受到选择偏差的影响。我们的研究不支持使用葡萄糖胺来预防骨关节炎患者的癌症。本文受版权保护。版权所有。

Observational studies have associated glucosamine, used to treat joint pain and osteoarthritis, with reductions in cancer incidence, though their study design was affected by selection bias. We assessed this association using a study design that mitigates this selection bias.We used the UK Clinical Practice Research Datalink to identify a cohort of patients diagnosed with osteoarthritis during 1995-2017. The prevalent new-user cohort design was used to match glucosamine initiators with non-users on time-conditional propensity scores and followed until cancer incidence. Hazard ratios (HR) and 95% confidence intervals (CI) of cancer incidence were estimated to compare glucosamine use with non-use.The study cohort of osteoarthritis patients included 20,541 glucosamine initiators who were matched to 20,541 non-users. Over an average follow-up of 8 years, the overall incidence rate of any cancer was 16.4 per 1000 per year. The HR of any cancer incidence with glucosamine use was 0.97 (95% CI 0.91-1.02), compared with non-use. For lung cancer, the HR with glucosamine use was 0.99 (95% CI 0.83-1.18), while it was 1.11 (95% CI 0.93-1.33) for colorectal cancer, 1.07 (95% CI 0.93-1.23) for breast cancer in women and 1.03 (95% CI 0.88-1.22) for prostate cancer.In this large, real-world study of patients with osteoarthritis, designed to emulate a trial, treatment with glucosamine did not reduce the incidence of cancer. This finding reinforces that previous studies, not based on new users, were affected by selection bias. Our study does not support the use of glucosamine to prevent cancer in patients with osteoarthritis.This article is protected by copyright. All rights reserved.