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

Abstract：

OBJECTIVE:To investigate the efficacy and safety of dietary supplements for patients with osteoarthritis. DESIGN:An intervention systematic review with random effects meta-analysis and meta-regression. DATA SOURCES:MEDLINE, EMBASE, Cochrane Register of Controlled Trials, Allied and Complementary Medicine and Cumulative Index to Nursing and Allied Health Literature were searched from inception to April 2017. STUDY ELIGIBILITY CRITERIA:Randomised controlled trials comparing oral supplements with placebo for hand, hip or knee osteoarthritis. RESULTS:Of 20 supplements investigated in 69 eligible studies, 7 (collagen hydrolysate, passion fruit peel extract, Curcuma longa extract, Boswellia serrata extract, curcumin, pycnogenol and L-carnitine) demonstrated large (effect size >0.80) and clinically important effects for pain reduction at short term. Another six (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine and chondroitin) revealed statistically significant improvements on pain, but were of unclear clinical importance. Only green-lipped mussel extract and undenatured type II collagen had clinically important effects on pain at medium term. No supplements were identified with clinically important effects on pain reduction at long term. Similar results were found for physical function. Chondroitin demonstrated statistically significant, but not clinically important structural improvement (effect size -0.30, -0.42 to -0.17). There were no differences between supplements and placebo for safety outcomes, except for diacerein. The Grading of Recommendations Assessment, Development and Evaluation suggested a wide range of quality evidence from very low to high. CONCLUSIONS:The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low. Some supplements with a limited number of studies and participants suggested large treatment effects, while widely used supplements such as glucosamine and chondroitin were either ineffective or showed small and arguably clinically unimportant treatment effects. Supplements had no clinically important effects on pain and function at medium-term and long-term follow-ups.

journal_name

Br J Sports Med

journal_title

British journal of sports medicine

authors

Liu X,Machado GC,Eyles JP,Ravi V,Hunter DJ

doi

10.1136/bjsports-2016-097333

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

167-175

issue

eissn

0306-3674

issn

1473-0480

pii

bjsports-2016-097333

journal_volume

pub_type

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