Nutraceuticals good for pain in knee, hip osteoarthritis

Nutraceutical supplements may be helpful in improving pain intensity and physical function among patients with knee or hip osteoarthritis (OA), a recent Iran meta-analysis has found.

Drawing from the online databases of Medline, the Cochrane Library, Embase, Science Direct, ProQuest, Google Scholar, Scopus, and Web of Science, the researchers retrieved 42 eligible randomized controlled trials. Only those that used nutraceuticals as a primary or adjunctive intervention and enrolled adults with knee/hip OA were included. Persian-language databases SID, Magiran, Irandoc, and Iranmedex were also searched.

Overall, 4,160 patients and 33 supplements were included in the quantitative analysis. Twenty-eight of the included studies evaluated for total WOMAC* score over a mean follow-up of 17.4 weeks. Despite significant heterogeneity of evidence, patients on nutraceuticals showed significantly lower scores than their control counterparts (standardized mean difference [SMD], –0.23, 95 percent confidence interval [CI], –0.37 to –0.08; p=0.002).

Similarly, nutraceuticals also bested the control in terms of the pain (SMD, –0.37, 95 percent CI, –0.63 to –0.11; p=0.006) and stiffness (SMD, –0.48, 95 percent CI, –0.72 to –0.24; p<0.001) subscales of WOMAC, but not in the physical function domain (SMD, –0.25, 95 percent CI, –0.57 to –0.07; p=0.12).

Nutraceuticals likewise remained significantly better over control when pain was assessed using the visual analogue scale (VAS; SMD, –0.79, 95 percent CI, –1.06 to –0.52; p<0.001).

In terms of the quality of the included studies, the researchers detected no signals of publication bias the total WOMAC score and its pain and physical function subscale. On the other hand, bias was significant for the analyses on pain, as assessed by WOMAC or VAS.

*Western Ontario and McMaster Universities Arthritis index