Meta-Analysis Casts Doubt on Chondroitin’s Effectiveness for Arthritis

May 24, 2007—People with arthritis often look for alternatives to drug medicine, but a new analysis has determined that chondroitin doesn’t reduce symptoms, despite some research to the contrary and the supplement’s loyal following of people who feel it has helped them.

Cartilage provides the cushion between bones that meet and form joints. It holds more water, is softer, and can repair and replace itself more quickly than bone. As we age, the repair process slows down and the layer of cartilage in the joints thins and can eventually disappear. Osteoarthritis is the joint condition marked by this thinning of cartilage and the resulting pain and stiffness.

Treatment for osteoarthritis usually includes the use of anti-inflammatory medications and pain relievers. In addition to not addressing the root cause—cartilage loss—these types of medications often cause serious side effects.

Glucosamine and chondroitin are important parts of the cartilage matrix, and they have both received much attention as possible therapies for osteoarthritis. Although glucosamine is the more popular choice for arthritis pain relief (usually in the form of glucosamine sulfate), many people claim to benefit more from glucosamine/chondroitin combinations and some people use chondroitin (usually as chondroitin sulfate) alone.

A number of studies have tried to measure chondroitin’s effectiveness. The new report, published in the Annals of Internal Medicine, identified 20 controlled trials that were considered to have acceptable research methods. In total, these trials included 3,846 people with osteoarthritis of the knee or hip, and most compared 800 to 2,000 mg per day of chondroitin to placebo.

The researchers found a slight benefit to using chondroitin, but they noted that there were too many important variations in the trials’ methods to allow an accurate analysis. When only the three largest studies—which together included 40% of the total people—were examined, they found that chondroitin had virtually no effect on osteoarthritis pain and stiffness.

What should people make of this report? Despite the negative findings in this meta-analysis, there are a number of well done studies that show chondroitin is beneficial for some people with osteoarthritis. In addition, “some patients are convinced that it helps,” commented Dr. David T. Felson in an editorial published in the same issue of the Annals of Internal Medicine. “Because no frequent or severe adverse effects have been reported, chondroitin sulfate should not be considered dangerous. 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.”

(Ann Intern Med 2007;146:580–90)

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Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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