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A progress report on supplements for osteoarthritis

There are a lot of supplements that are supposed to improve aspects of osteoarthritis. But what's the evidence that they actually help?

Study under review: Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.

Introduction

Osteoarthritis is a degenerative joint disease resulting in pain, stiffness, and swelling. It most commonly affects the knees, hips, and hands, and is frequently characterized by damage to cartilage. An estimated 12% of the U.S. population, particularly the elderly, have osteoarthritis, and hip and knee osteoarthritis are the 11th leading cause[1] of disability worldwide. In addition, the economic burden of osteoarthritis is estimated to be 0.25% to 0.50% of a country’s GDP (the annual market value of all goods and services within the country). Osteoarthritis is a disease that needs attention and researchers should be encouraged to investigate options for its prevention and treatment.

Distinct risk factors[2] for osteoarthritis, summarized in Figure 1, include genetic susceptibility, morphological variations in bones and joints, traumatic joint injury, excessive joint stress, aging, and obesity. Obesity[3] is a major risk factor for osteoarthritis of the knee, and weight loss[4] can lead to improvements in the condition, though more long-term studies are warranted. Exercise[5] can be useful[6] for reducing pain and improving joint function, though exercising with sore joints can be difficult, and not all forms of exercise are suitable for every patient[7]. Pharmaceutically, treatment mostly revolves around the use of non-steroidal anti-inflammatories (NSAIDs[8]). While effective in reducing pain, these drugs[9] aren’t without their risks[10], which include stroke and heart attacks.

Supplements are a popular drug alternative among people with osteoarthritis. Supplements for joint health can be loosely placed in two overlapping categories: structural and repair, which are intended to provide building blocks of joint tissue and facilitate its reconstruction, and anti-inflammatory agents, which reduce pain and may help prevent the deterioration of cartilage[11].

Glucosamine and chondroitin are the best known and most used supplements for osteoarthritis. They are currently the only supplement endorsed[12] by the Osteoarthritis Research International group, and are used by 54-59% of people with osteoarthritis who decide to take supplements. However, a quick walk into any supplement store will reveal many other products marketed under the guise of joint health. The study under review is a systematic review and meta-analysis of randomized controlled trials involving several joint supplements, so as to provide a broad and updated picture of which compounds may benefit joint health.

Osteoarthritis is a common degenerative disease of the joints. Many people with osteoarthritis resort to using supplements to help alleviate joint pain and stiffness, but both the efficacy and safety of popular supplements remains controversial. The study under review is a systematic review and meta-analysis aimed at clarifying the present state of the evidence for various joint supplements.

Who and what was studied?

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The big picture

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Other Articles in Issue #40 (February 2018)