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Chondroitin Benefits in Osteoarthritis Akin to Placebo |
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Written by Theresa Maher
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Wednesday, 18 April 2007 |
The intense pain suffered by arthritis patients often leads them adopt dietary supplements to relieve their suffering. One of the most popular supplements that claims to relieve arthritis pain is chondroitin. In combination with glucosamine, chondroitin tops the dietary supplement market in the United States with estimated sales of over $1 billion.
However a new review of earlier studies suggests the benefits of chondroitin in osteoarthritis of the knee and hip are akin to a placebo. The review indicates that chondroitin is of little use in advanced osteoarthritis and says doctors must discourage its use in such patients.
Osteoarthritis (OA) is a progressive disease of the joints most often involving the hip and the knee joints. Also called "wear and tear" arthritis, it affects people in middle age. Factors like obesity, injury to a joint and family history also influence the development of osteoarthritis.
Common symptoms are swelling and stiffness in the affected joint, loss of free motion and weakness. In arthritis there is a loss of cartilage, meaning the shock absorber effect is lost. This leads to inflammation and subsequently intense pain.
Chondroitin sulfate is a component of hyaline cartilage and hence supplement makers have advocated it as an arthritis remedy. It provides much of the resistance offered by the cartilage to compression.
But the present study, published in the April 17 issue of the Annals of Internal Medicine, says it is wrong to assume chondroitin can relieve the pain experienced by osteoarthritis patients.
Dr. Peter Juni from the University of Berne, Switzerland, and colleagues who conducted a review of 20 earlier studies said that chondroitin is a large molecule. It is not possible for this macromolecule to be completely absorbed by the body.
In a study published in Osteoarthritis Cartilage in1998, researchers said only 12% to 13% of ingested chondroitin is absorbed intact into the bloodstream.
Moreover the chondroitin supplements available in the market are not actually synthesized from the chondroitin found in human cartilage. Chondroitin sulfate is mainly extracted from animal cartilage, such as tracheas or shark cartilage. The possiblity of this dietary supplement being completely incorporated into the affected cartilage appears remote.
The current review included 20 clinical trials that compared chondroitin with placebo or with no treatment in patients with osteoarthritis. Around 3,846 patients with osteoarthritis were involved in the randomized or quasi-randomized trials.
Early clinical trials expounded on the benefits of chondroitin and it appeared chondroitin was a wonderful dietary supplement. But in this analysis, only three studies had a large sample size. In nine studies the authors had to use approximations to arrive at any conclusions.
On analyzing the available data, authors concluded that there was no evidence chondroitin was useful in osteoarthritis, "Large-scale, methodologically sound trials indicate that the symptomatic benefit of chondroitin is minimal or nonexistent. Use of chondroitin in routine clinical practice should therefore be discouraged," they concluded.
In an accompanying editorial in the same journal, Dr David T. Felson, professor of medicine and epidemiology at Boston University, said that while chondroitin was not of immense benefits to arthritis patients, it appeared to be a safe supplement.
"If patients say that they benefit from chondroitin, I see no harm in encouraging them to continue taking it as long as they perceive a benefit", he writes. He added that Chondroitin in the US was sold in combination with glucosamine, but the review looked at studies involving chondroitin alone.
Reacting to the present study industry group Natural Products Association said the findings were not true, “Clearly, research has demonstrated that chondroitin, especially when taken with glucosamine, has shown a benefit for those suffering from osteoarthritis. To discourage its use as a treatment option is ill-considered, particularly when the alternatives are limited or nonexistent," it said in a statement.
Knee pain is a problem that affects at least 25 percent of all adults. It is estimated that over 21 million people in the United States have osteoarthritis problems. Chondroitin is seen as a safe supplement to relieve some of the most painful symptoms of arthritis.
As always arthritis patients are advised to consult with their doctor on how best to manage their condition. Dietary supplements if recommended may also prove useful.
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Last Updated ( Thursday, 19 April 2007 )
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