From: Benefits of antioxidant supplements for knee osteoarthritis: rationale and reality
Reference | Study type | Parameters measured | results | Comments |
---|---|---|---|---|
Turmeric (curcumin) | ||||
RDBa: compared curcumin (n = 171) with ibuprofen (n = 160) | Thai modified WOMAC, 6 min walk and patient satisfaction | All improved in both groups (p <.001) with no intergroup differences | Trial only 4 weeks | |
Safety profile better for curcumin | ||||
Belcaro et al. 2010 [71] | Open: best available treatment + Meriva versus best available treatment (n = 100) | Treadmill walking test, WOMAC and Karnofsky, and oxidative stress levels, inflammatory markers. | 8 months - all measures improved with Meriva (p <0.05) | Not a blind study |
Belcaro et al. in 2014 [66] | Open: Meriva and glucosamine (n = 63) vs chondroitin and glucosamine (n = 61) | Treadmill walking test, WOMAC and Karnofsky scales | 4 month - similar improvements in both groups. Use of NSAIDS decreased in both groups | Not a blind study |
RDBP: curcumin + bioperine (n = 21) vs placebo (n =19) | WOMAC, VAS, Lequesne’s pain and stiffness score | 6 weeks - improvement in WOMAC, VAS, Lequesne’s pain scores (p <.0010) but not in stiffness score | Mild gastrointestinal symptoms reported in both groups | |
Pinsornsak 2012 [65] | DB: (Curcumin 1000 mg + diclofenac 75 mg)/day (n = 44) vs (diclofenac 75 mg + placebo) (n = 44) | VAS AND Knee Injury and Osteoarthritis Outcome Score | No difference between groups for pain and function. | Small group size, submaximal doses The effects of two treatments is not additive |
Henrotin, Y et al. 2014 [67] | Open: Flexofytol (curcumin with polysorbate) (n = 100) in real life situations | Serum Coll-2-1, Coll-2-INO2, Fib3-1, Fib3-2, CRP, MPO, CTX-II. VAS pain | 6 months - Coll-2-1 decreased. No change in pain | Not a blind study, no control |
Appelboom et al. 2014 [72] | Open: Flexofytol- physicians in real life situation (n = 820) | Pain severity, flexibility and quality of life | 6 months - improved in all (p <.0001), use of other treatments decreased (p <.0001) | Not a blind study |
Significant improvements started in 6Â weeks | ||||
Kertia 2012 [62] | RDB: C. domestica 3 × 30 mg (n = 34) vs diclofenac 3 × 25 mg (n = 39) | COX 2 levels in sinovial fluid at time = 0 and at 4 weeks | All improved no difference between groups | Short trial, no report of change in clinical symptoms |
Madhu 2013 [70] | RSBP: NR-INF-02 1 g vs glucosamine 1.5 g vs NR-INF-02 + glucosamine vs placebo | VAS and WOMAC | 6 weeks - all treatments showed significant improvement over baseline and placebo | Small study (<30/ group) and over short time period. NR-INF-02 is curcuminoid free extract of C. longa |
Avocado-Soybean Unsaponifiables (piascledine)b | ||||
Blotman 1997 [82] | RDBP: ASU (n = 83) vs placebo (n = 80) | Lequesne’s, Initially all groups received NSAID | 6 months - Lequesne’s improved and NSAID use decreased | Over time pain similar in both groups |
Maheu et al. 1998 [81] | RDBP: piascledine 300 mg (n = 85) vs placebo (n = 79) (knee and hip OA) | Lequesne’s, VAS for pain, and NSAID usage | 6 months + 2 month follow up. Decrease in Lequesne’s (p <0.001), pain (p <0.003) and NSAID usage. | Improvement more marked in hip OA. |
Lequesne et al. 2002 [95] | RBDP: piascledine 300 mg (n = 55) vs placebo (n = 53) | JSW, VAS pain, global assessment | 2 years - no statistical difference in JSW or clinical parameters. | Posthoc analysis - when OA was severe, ASU slowed the disease progression |
Pavelka et al. 2010 [96] | RDB: piascledine 300 mg vs chondroitin 1200 mg (n = 263) | WOMAC, Lequesne’s, VAS, global assessment, use of rescue medication | 6 months + 2 month follow up. All parameters improved during treatment. Stabilized or improved in the follow up. No differences between groups. | Statistical significance not achieved due to large variability. |
Maheu et al. 2014 [97] | RDBP: piascledine 300 mg (n = 345) | JSW, WOMAC, Lequesne’s | 3 years - fewer progressors in the ASU group. No differences in clinical measurements. |  |
Boswellia serrata | ||||
Kimmatkar et al. 2003 [84] | RDB crossover: Boswellia serrata extract vs placebo (n = 30) | Knee pain, inflection, walking distance, frequency of swelling, radiology | 8 weeks - 3 weeks washout 8 weeks crossover. Significant improvement in all parameters except radiology | Small group size |
Sengupta 2008 [85] | RDBP: 5-Loxin (B. serrata extract enriched with 30 % AKBA) (n = 75) | Pain and function VAS, WOMAC and Lequesne’s | 90 days - improvement in stiffness, function and pain scores, decreased MMP-3 (p <0.0001). | Serum biochemistry also improved, bioavailability of AKBA is low |
Sengupta et al. 2010 [86] | RDBP: Aflapin 100 mg vs 5-Loxin 100 mg vs placebo (n = 20/group) | WOMAC, Lequesne’s, VAS, and serum biochemical, hematological and urine changes | 90 days - improvement in pain and physical function in both treatment groups. | Small study over short time. Aflapin inhibits MMP-3 and ICAM-1 |
Gupta et al. 2011 [98] | Open: Shallaki tablet (6 g/d) or tablet and ointment together (n = 56 total) | Pain, stiffness and swelling, mental state (Jung scales). Radiology, hematology and biochemistry | 2 months - both groups reported significant improvements in pain, stiffness and swelling and by radiology | Not a blind study. No control group. |
Measurements were subjective and results not clear | ||||
Vishal et al. 2011 [88] | RDBP: Alfapin vs placebo (n = 30/group) | WOMAC, Lequesne’s and VAS for pain and serum biochemical, hematological and urine changes | 30 days - significant improvement in pain and function but not in biochemistry | Small short trial to assess safety of new formulation |
Kulkarni et al., 1991 [76] | RDBP crossover: Articulin-F capsule (W. somnifera, B. serrata C. longa Zinc complex) (n = 42) | Pain, stiffness, grip strength, Ritchie articular index, disability score, radiology. | 3 months 2 weeks washout crossover 3 months - pain and disability were significantly improved over placebo. | Small prospective study. |
Chopra et al. 2004 [99] | RDBP: RA-11 (W. somnifera, B. serrata, Z. officinale, and C. longa) vs placebo (n = 90) | WOMAC, VAS and hematological, urine and biochemical tests | 32 week - WOMAC, VAS improved over placebo | Very high dropout rate |
RDBP: Glucosamine vs celecoxib vs SGCGc vs SGC (n = 440) | Weight bearing pain modified WOMAC | 24 weeks - improvement in pain and function in all groups. For WOMAC pain, SGCG worked marginally better than SGC. | Some patients had adverse hepatic effects of SGCG and SGC. |