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Curr Med Res Opin. 2008 May;24(5):1303-8. doi: 10.1185/030079908X297231 . Epub 2008 Apr 15.

Chondroitin sulphate for symptomatic osteoarthritis: critical appraisal of meta-analyses.

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  • 1Unitat de Recerca en Fisiopatologia Ossia i Articular, Institut Municipal d'Investigació Mèdica (IMIM), Hospital del Mar, Universitat Autònoma de Barcelona, Parc de Recerca Biomèdica de Barcelona, Spain.



Chondroitin sulphate (CS) is an important structural component of cartilage and is approved and regulated as a symptomatic slow-acting drug for osteoarthritis (OA) (SYSADOA) in Europe and some other countries. Although numerous studies have shown the clinical benefits of CS to decrease pain, improve functional disability, reduce non-steroidal anti-inflammatory drug (NSAID) or acetaminophen consumption, and good tolerability with an additional carry-over effect, there are still some concerns regarding its effectiveness in treating OA.


To examine the data provided by meta-analyses to clarify the effectiveness of CS as a symptomatic treatment for OA.


A MEDLINE database search was conducted for appropriate meta-analyses published between 1997 and 2007. Five meta-analyses that limited their analysis to randomised controlled trials (RCTs) comparing CS with placebo or no-treatment control arms were retrieved.


Four meta-analyses showed significant clinical effects of CS compared with placebo for pain and function measures and one demonstrated greater reduction of analgesic co-medication in patients assigned to the active treatment. In one meta-analysis, the 20 trials included in the study showed a high degree of heterogeneity and the conclusion that CS showed minimal symptomatic benefits was based on the analysis of only three trials. One meta-analysis showed that pain relief after CS treatment steadily increased between 4 and 12 weeks of treatment, whereas the time course of pain relief after treatment with NSAIDs decreased. Two meta-analyses reported consistently higher frequencies of side effects in the placebo group than in patients treated with CS.


Data provided by these meta-analyses indicate that CS has a slight to moderate efficacy in the symptomatic treatment of OA, with an excellent safety profile.

[PubMed - indexed for MEDLINE]
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