New Cochrane Review of chondroitin for relieving pain in osteoarthritis

Osteoarthritis is a disease of the joints, commonly found in knees, hips, and hands. When the joint loses cartilage, the bone grows to try and repair the damage but this bone growth is abnormal and makes things worse. Osteoarthritis is one of the leading causes of disability as it is painful and affects physical function and ability to use the joint.

Emerging as a new treatment, chondroitin is an over-the-counter nutritional supplement that is made primarily of chondroitin sulfate. It is said to work by stopping the degradation of cartilage and restoring lost cartilage. It also contains sulfur-containing amino acids which are essential building blocks for cartilage molecules in the human body. Previous meta-analyses have shown contradictory results on the efficacy of chondroitin.

A team of Cochrane authors, based in United States and Canada and working with the Musculoskeletal Group, set out to evaluate the benefit and harm of chondroitin sulfate for people with osteoarthritis.  The authors found 43 randomized controlled trials involving 9,110 people. The majority of the studies examined knee osteoarthritis, with few in hand or hip.Trial duration ranged from 1 month to 3 years. Several studies were funded by makers of chondroitin. The randomized trials were mostly of low quality.

Chondroitin, alone or in combination with glucosamine, was better than placebo in improving pain in participants with osteoarthritis in short-term studies. The benefit was small to moderate, with an 8 point greater improvement in pain (range 0 to 100) and a 2 point greater improvement in Lequesne's index (range 0 to 24), both seeming clinically meaningful. These differences persisted in some sensitivity analyses and not others. Chondroitin had a lower risk of serious adverse events compared with control.

“The combination of some efficacy, low associated risks, and the availability of chondroitin as an over-the-counter supplement may make chondroitin popular for osteoarthritis patients,” said Jasvinder Singh, a researcher at Birmingham VA Medical Center and University of Alabama at Birmingham, and the lead author of the Cochrane Review. “We need more high-quality studies to explore the role that chondroitin plays in the treatment of osteoarthritis.”

Related resources

Read the Cochrane Review

Tuesday, March 3, 2015