ASU
Avocado Soybean Unsaponifiables (ASU)
📚 관련 논문 (16편)
1. Int J Rheum Dis. 2019 Sep;22(9):1607-1615. doi: 10.1111/1756-185X.13658. Epub 2019 Jul 22. Efficacy and safety of avocado-soybean unsaponifiables for the treatment of hip and knee osteoarthritis: A systematic review and meta-analysis of randomized placebo-controlled trials. Simental-Mendía M
2. Drugs Aging. 2019 Apr;36(Suppl 1):65-99. doi: 10.1007/s40266-019-00662-z. Safety of Symptomatic Slow-Acting Drugs for Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis. Honvo G(1)(2), Reginster JY(3)(4)(5), Rabenda V(3)(4), Geerinck A(3)(4), Mkinsi O(6), Charles A(3)(4), Rizzo
3. Osteoarthritis Cartilage. 2011 Jan;19(1):1-21. doi: 10.1016/j.joca.2010.10.017. Epub 2010 Oct 28. Nutraceuticals: do they represent a new era in the management of osteoarthritis? - a narrative review from the lessons taken with five products. Henrotin Y(1), Lambert C, Couchourel D, Ripoll C,
4. Clin Rheumatol. 2003 Oct;22(4-5):285-8. doi: 10.1007/s10067-003-0731-4. Avocado-soybean unsaponifiables (ASU) for osteoarthritis - a systematic review. Ernst E(1). Author information: (1)Peninsula Medical School, Universities of Exeter and Plymouth, Devon, Exeter, UK. Edzard.Ernst@pms.ac.uk
1. J Complement Integr Med. 2021 Apr 2;18(4):769-774. doi: 10.1515/jcim-2020-0265. Avocado/soy unsaponifiables can redress the balance between serum antioxidant and oxidant levels in patients with osteoarthritis: a double-blind, randomized, placebo-controlled, cross-over study. Jangravi Z(1)(2), Basereh S(1), Zaree Mahmoudabadi A(1)(2), Saberi M(3), Alishiri GH(4), Korani M(1)(5). Author information: (1)Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. (2)Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. (3)Department of Pharmacology and Toxicology, School of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran. (4)Department of Internal Medicine, Rheumatology Ward, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. (5)Chemical Injuries Research Center, Systems Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. OBJECTIVES: Osteoarthritis (OA) is an inflammatory disorder of the joint characterized by pain and stiffness. Oxidative stress plays an important role in pathogenesis of OA. We aimed to evaluate the effects of avocado/soy unsaponifiables (ASU) compound on serum antioxidant and oxidative stress in patients with Osteoarthritis. METHODS: A double-blind, randomized, placebo-controlled, cross-over trial was performed. Fourty patients with osteoarthritis were randomized to two different sequences: 1) DP: received ASU for three months followed by three months placebo, 2) PD: received placebo for the first three months followed by three months ASU. The oxidant statue was evaluated by measurement of serum malonldialdehyde (MDA). The total antioxidant capacity (TAC), reduced glutathione (GSH) and antioxidant enzymes such as superoxide dismutase (SOD) and catalase (CAT) were also assessed. RESULTS: Mean serum of MDA level as a marker of oxidative stress significantly decreased in all patients after three months treatment with ASU (4.46 ± 0.11 nmol/L) compare with baseline and placebo levels (5 ± 0.15 and 5.82 ± 0.12 nmol/L respectively) (p<0.05). On the other hand, ASU resulted in positive changes in serum antioxidant levels (p<0.05). Mixed-effects model of variance analyses showed that ASU effect is regardless of the order of receiving medication (p>0.05). CONCLUSIONS: These data showed that Avocado/Soy Unsaponifiable can be an effective supplement in treatment of osteoarthritis through the control of the balance between antioxidant and oxidant molecular markers. © 2021 Walter de Gruyter GmbH, Berlin/Boston. DOI: 10.1515/jcim-2020-0265 PMID: 33794080 [Indexed for MEDLINE]
2. Pain Med. 2019 Jun 1;20(6):1236-1247. doi: 10.1093/pm/pnz040. Dietary Ingredients as an Alternative Approach for Mitigating Chronic Musculoskeletal Pain: Evidence-Based Recommendations for Practice and Research in the Military. Crawford C(1)(2), Boyd C(1)(2), Paat CF(3), Meissner K(4)(5), Lentino C(3), Teo L(3), Berry K(3), Deuster P(1). Author information: (1)Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland, USA. (2)The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA. (3)Thought Leadership and Innovation Foundation, McLean, Virginia, USA. (4)Division of Health Promotion, University of Applied Sciences Coburg, Coburg, Germany. (5)Institute of Medical Psychology, Ludwig Maximilian University of Munich, Munich, Germany. OBJECTIVE: Approximately 55-76% of Service members use dietary supplements for various reasons, including pain and related outcomes. This work evaluates current research on dietary ingredients for chronic musculoskeletal pain to inform decisions for practice and self-care, specifically for Special Operations Forces personnel. METHODS: A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. The committee made evidence-informed judgments and recommendations for practice and self-care use. RESULTS: Nineteen eligible dietary ingredients were assessed for quality, efficacy, and safety. Avocado soybean unsaponifiables, capsaicin, curcuma, ginger (as a food source), glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D were conditionally recommended as their benefits outweighed risks, but there was still some uncertainty about the trade-offs. No recommendations were made for boswellia, ginger (as a dietary supplement), rose hip, or s-adenosyl-L-methionine. Recommendations were made against the use of collagen, creatine, devil's claw, l-carnitine, methylsulfonylmethane, pycnogenol, willow bark extract, and vitamin E. Research priorities were developed to address gaps precluding stronger recommendations. CONCLUSIONS: Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients. Until then, providers have the evidence needed to make informed decisions about the safe use of these dietary ingredients, and future research can address existing gaps. © 2019 American Academy of Pain Medicine. DOI: 10.1093/pm/pnz040 PMCID: PMC6544555 PMID: 30986309 [Indexed for MEDLINE]
3. Br J Sports Med. 2018 Feb;52(3):167-175. doi: 10.1136/bjsports-2016-097333. Epub 2017 Oct 10. Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Liu X(1)(2), Machado GC(3), Eyles JP(1)(2)(4), Ravi V(1)(2), Hunter DJ(1)(2). Author information: (1)Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia. (2)Institute of Bone and Joint Research, The Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia. (3)Sydney Medical School, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia. (4)Department of Physiotherapy, Sydney Medical School, Royal North Shore Hospital, Sydney, New South Wales, Australia. OBJECTIVE: To investigate the efficacy and safety of dietary supplements for patients with osteoarthritis. DESIGN: An intervention systematic review with random effects meta-analysis and meta-regression. DATA SOURCES: MEDLINE, EMBASE, Cochrane Register of Controlled Trials, Allied and Complementary Medicine and Cumulative Index to Nursing and Allied Health Literature were searched from inception to April 2017. STUDY ELIGIBILITY CRITERIA: Randomised controlled trials comparing oral supplements with placebo for hand, hip or knee osteoarthritis. RESULTS: Of 20 supplements investigated in 69 eligible studies, 7 (collagen hydrolysate, passion fruit peel extract, Curcuma longa extract, Boswellia serrata extract, curcumin, pycnogenol and L-carnitine) demonstrated large (effect size >0.80) and clinically important effects for pain reduction at short term. Another six (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine and chondroitin) revealed statistically significant improvements on pain, but were of unclear clinical importance. Only green-lipped mussel extract and undenatured type II collagen had clinically important effects on pain at medium term. No supplements were identified with clinically important effects on pain reduction at long term. Similar results were found for physical function. Chondroitin demonstrated statistically significant, but not clinically important structural improvement (effect size -0.30, -0.42 to -0.17). There were no differences between supplements and placebo for safety outcomes, except for diacerein. The Grading of Recommendations Assessment, Development and Evaluation suggested a wide range of quality evidence from very low to high. CONCLUSIONS: The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low. Some supplements with a limited number of studies and participants suggested large treatment effects, while widely used supplements such as glucosamine and chondroitin were either ineffective or showed small and arguably clinically unimportant treatment effects. Supplements had no clinically important effects on pain and function at medium-term and long-term follow-ups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. DOI: 10.1136/bjsports-2016-097333 PMID: 29018060 [Indexed for MEDLINE] Conflict of interest statement: Competing interests: None declared.
4. Nutr J. 2016 Jan 5;15:1. doi: 10.1186/s12937-015-0115-z. Benefits of antioxidant supplements for knee osteoarthritis: rationale and reality. Grover AK(1), Samson SE(2). Author information: (1)Department of Medicine, HSC 4N41, McMaster University, 1280 Main Street W., Hamilton, ON, L8S 4K1, Canada. groverak@mcmaster.ca. (2)Department of Medicine, HSC 4N41, McMaster University, 1280 Main Street W., Hamilton, ON, L8S 4K1, Canada. Arthritis causes disability due to pain and inflammation in joints. There are many forms of arthritis, one of which is osteoarthritis whose prevalence increases with age. It occurs in various joints including hip, knee and hand with knee osteoarthritis being more prevalent. There is no cure for it. The management strategies include exercise, glucosamine plus chondroitin sulfate and NSAIDs. In vitro and animal studies provide a rationale for the use of antioxidant supplements for its management. This review assesses the reality of the benefits of antioxidant supplements in the management of knee osteoarthritis. Several difficulties were encountered in examining this issue: poorly conducted studies, a lack of uniformity in disease definition and diagnosis, and muddling of conclusions from attempts to isolate the efficacious molecules. The antioxidant supplements with most evidence for benefit for pain relief and function in knee osteoarthritis were based on curcumin and avocado-soya bean unsaponifiables. Boswellia and some herbs used in Ayurvedic and Chinese medicine may also be useful. The benefits of cuisines with the appropriate antioxidants should be assessed because they may be more economical and easier to incorporate into the lifestyle. DOI: 10.1186/s12937-015-0115-z PMCID: PMC4700773 PMID: 26728196 [Indexed for MEDLINE]
5. Am J Sports Med. 2015 Mar;43(3):734-44. doi: 10.1177/0363546514533777. Epub 2014 May 27. Chondroprotection and the prevention of osteoarthritis progression of the knee: a systematic review of treatment agents. Gallagher B(1), Tjoumakaris FP(2), Harwood MI(2), Good RP(2), Ciccotti MG(2), Freedman KB(3). Author information: (1)Jefferson Medical College, Philadelphia, Pennsylvania, USA. (2)Rothman Institute, Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. (3)Rothman Institute, Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA kevin.freedman@rothmaninstitute.com. BACKGROUND: Structure-modifying medications or nutraceuticals may be an effective treatment for osteoarthritis. This study identified 12 treatments that may possess chondroprotective properties: oral glucosamine; chondroitin; nonsteroidal anti-inflammatory drugs (NSAIDs); polyunsaturated fatty acids; S-adenosylmethionine; avocado and soybean unsaponifiable fractions; methylsulfonylmethane; vitamins C, D, and E; intra-articular injections of hyaluronic acid; and platelet-rich plasma (PRP). PURPOSE: To perform a systematic review of randomized controlled trials for the effectiveness of each agent in preserving articular cartilage of the knee and delaying the progression of osteoarthritis. STUDY DESIGN: Systematic review; Level of evidence, 2. METHODS: A literature search was performed using PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Searches were performed using "treatment," "osteoarthritis," and "knee" as keywords. Selection criteria included randomized controlled trials of ≥12 months, with a placebo control, measuring radiographic changes in joint space width, cartilage volume, or radiographic progression of osteoarthritis. The primary outcome was changes in joint integrity measures. RESULTS: A total of 3514 studies were identified from the initial search, 13 of which met inclusion criteria. Treatment with chondroitin sulfate showed a significant reduction in cartilage loss in 3 of 4 studies identified compared with placebo. Two of 3 trials identified for glucosamine also reported significant structural effects relative to placebo. Intra-articular hyaluronic acid was effective in lowering the rate of cartilage loss in only 1 of 3 studies identified versus placebo. Of the 6 studies identified for NSAIDs, vitamin E, and vitamin D, none showed any structural effect compared with placebo. No studies were found that met the inclusion criteria for polyunsaturated fatty acids, S-adenosylmethionine, avocado and soybean unsaponifiable fractions, methylsulfonylmethane, vitamin C, or PRP. CONCLUSION: For patients with or at risk for osteoarthritis, the use of glucosamine and chondroitin sulfate may serve as a nonoperative means to protect joint cartilage and delay osteoarthritis progression. Hyaluronic acid injections showed variable efficacy, while NSAIDs and vitamins E and D showed no effect on osteoarthritis progression. The other agents evaluated had no evidence in the literature to support or refute their use for chondroprotection. © 2014 The Author(s). DOI: 10.1177/0363546514533777 PMID: 24866892 [Indexed for MEDLINE]
6. Drugs Aging. 2012 Sep;29(9):717-31. doi: 10.1007/s40266-012-0006-3. Nutraceuticals in the management of osteoarthritis : a critical review. Ragle RL(1), Sawitzke AD. Author information: (1)School of Medicine, University of Utah, Salt Lake City, 84132, USA. Osteoarthritis (OA) is a chronic, highly prevalent and disabling disease that is expected to increase in prevalence secondary to longer life expectancy and a disproportionately aging population. Treatment of OA is only marginally effective and has been focused primarily on symptom control using weight loss, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, intra-articular steroids or viscosupplementation, topical NSAIDs and analgesics, diacerein (an oral interleukin-1β inhibitor) and finally joint replacement surgery. The use of nutraceuticals in the treatment of OA is common, and scientific studies examining the effects of nutraceuticals on the pathogenesis and treatment of OA are increasing. This review examines the efficacy and safety of select nutraceuticals for the treatment of OA. The reviewed nutraceuticals include glucosamine, chondroitin, collagen hydrolysates (CHs) and avocado-soybean unsaponifiables (ASUs). There have been several clinical trials examining the efficacy of these products and the results demonstrate significant heterogeneity. Significant improvements in pain, function and structural outcomes have been shown for some of the treatment arms or subgroups of patients, but the effects are not consistent across the studies. Glucosamine, chondroitin and the two in combination have been the most extensively studied. Significant improvement in pain and functional indices and a decrease in the loss of joint space width were demonstrated in some but not all studies. CHs showed significant improvement in pain and functional indices for several subgroups of patients, but these findings were not pervasive amongst the treatment arms. ASU has demonstrated positive results with respect to decreased NSAID use in several studies and functional and pain end points in most of the reviewed studies; however, in the two studies examining structural end points, the results were mixed. The safety of these nutraceuticals has been demonstrated across all of the reviewed trials, and there were no significant issues with tolerance. Given the good safety profile of nutraceuticals, the marginal efficacy of conventional treatments, the high prevalence and rate of disability from OA and the possible benefit of nutraceuticals to patients with OA, use of nutraceuticals in select patients is appropriate. An overall recommendation to use nutraceuticals in the treatment of all patients with OA is not strongly supported by the available data. Future studies should focus on standardization of symptomatic and structural outcome measures, be of longer duration and pay careful attention to the content of the investigational product. DOI: 10.1007/s40266-012-0006-3 PMID: 23018608 [Indexed for MEDLINE]
7. Curr Rheumatol Rep. 2007 Apr;9(1):25-30. doi: 10.1007/s11926-007-0018-x. The utility of nutraceuticals in the treatment of osteoarthritis. Frech TM(1), Clegg DO. Author information: (1)Division of Rheumatology, University of Utah School of Medicine, George E. Wahlen Veterans Affairs Medical Center, 4B200 School of Medicine, 50 North Medical Drive, Salt Lake, UT 84132, USA. Osteoarthritis (OA) treatment is limited by the inability of prescribed medications to alter disease outcome. As a result, patients with OA often take food substances called nutraceuticals in an attempt to affect the structural changes that occur within a degenerating joint. The role of nutraceuticals in OA management can be defined only by an evidence-based approach to support their use. This paper reviews the clinical trials studying glucosamine, chondroitin sulfate, vitamin C, vitamin E, and avocado-soybean unsaponifiables. It highlights the need for additional randomized, placebo-controlled trials to further define the utility of nutraceuticals in OA treatment. DOI: 10.1007/s11926-007-0018-x PMID: 17437663 [Indexed for MEDLINE]
8. Ugeskr Laeger. 2005 Aug 15;167(33):3023-5. [Avocado/soybean unsaponifiables in the treatment of knee and hip osteoarthritis]. [Article in Danish] Angermann P(1). Author information: (1)Gildhøj Speciallaegeklinik, Brøndby. angermann@gild.dk Avocado/soybean unsaponifiables (ASU) is an extract prepared from avocado and soybean oil. The product has been approved as a prescription drug in France for several years and has now been introduced in Denmark as a food supplement. ASU has been examined in vitro and in animal studies that have showed an anti-inflammatory effect and a stimulatory effect on proteoglycan synthesis in chondrocytes. Four randomized, double-blind, placebo-controlled clinical trials have been published. These studies indicate that ASU has an effect on the symptoms of knee and hip osteoarthritis but not on the structural changes caused by osteoarthritis. PMID: 16109242 [Indexed for MEDLINE]
9. Clin J Pain. 2004 Jan-Feb;20(1):13-8. doi: 10.1097/00002508-200401000-00004. Selected CAM therapies for arthritis-related pain: the evidence from systematic reviews. Soeken KL(1). Author information: (1)Complementary Medicine Program, University of Maryland School of Nursing, Kernan Hospital Mansion, 2200 Kernan Drive, Baltimore, MD 21207, USA. ksoeken@compmed.umm.edu OBJECTIVES: The purpose is to examine what is known about the efficacy of selected complementary and alternative medicine (CAM) therapies for pain from arthritis and related conditions based on systematic reviews and meta-analyses. METHODS: Results specifically related to pain were retrieved from review articles of acupuncture, homeopathy, herbal remedies, and selected nutritional supplements. RESULTS: Evidence exists to support the efficacy of reducing pain from osteoarthritis (OA) for acupuncture; devil's claw, avocado/soybean unsaponifiables, Phytodolor and capsaicin; and chondroitin, glucosamine, and SAMe. Strong support exists for gamma linolenic acid (GLA) for pain of rheumatoid arthritis (RA). CONCLUSIONS: Despite support for some of the most popular CAM therapies for pain from arthritis-related conditions, additional high quality research is needed for other therapies, especially for herbals and homeopathy. DOI: 10.1097/00002508-200401000-00004 PMID: 14668651 [Indexed for MEDLINE]
10. Pain Med. 2019 Jul 1;20(7):1430-1448. doi: 10.1093/pm/pnz051. Conditional Recommendations for Specific Dietary Ingredients as an Approach to Chronic Musculoskeletal Pain: Evidence-Based Decision Aid for Health Care Providers, Participants, and Policy Makers. Boyd C(1)(2), Crawford C(1)(2), Berry K(3), Deuster P(1); HERB Working Group. Author information: (1)Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, Maryland, USA. (2)The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA. (3)Thought Leadership and Innovation Foundation, McLean, Virginia, USA. OBJECTIVE: Approximately 55-76% of Service members use dietary supplements for various reasons; although such use has become popular for a wide range of pain conditions, decisions to use supplements are often driven by information that is not evidence-based. This work evaluates whether the current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence to inform decisions for practice and self-care, specifically for Special Operations Forces personnel. METHODS: A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. A decision table was constructed to make evidence-informed judgments across factors required for decision-making, and recommendations were made for practice and self-care use. RESULTS: Nineteen dietary ingredients were included. Conditional evidence-based recommendations were made for the use of avocado soybean unsaponifiables, capsaicin, curcuma, ginger, glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D. In these cases, desirable effects outweighed undesirable effects, but there was uncertainty about the trade-offs, either because the evidence was low quality or because benefits and downsides were closely balanced. CONCLUSIONS: The evidence showed that certain dietary ingredients, when taken as part of a balanced diet and/or as a supplement (e.g., pill, tablet, capsule, cream), may alleviate musculoskeletal pain with no to minimal risk of harm. This finding emphasizes and reinforces the critical importance of shared decision-making between Operators and their health care providers. © 2019 American Academy of Pain Medicine. DOI: 10.1093/pm/pnz051 PMCID: PMC6611527 PMID: 30986301 [Indexed for MEDLINE]
11. Phys Sportsmed. 2010 Jun;38(2):71-81. doi: 10.3810/psm.2010.06.1785. A potential role for avocado- and soybean-based nutritional supplements in the management of osteoarthritis: a review. DiNubile NA(1). Author information: (1), , , , . Erratum in Phys Sportsmed. 2010 Oct;38(3):128. Osteoarthritis (OA) is a common, painful, and debilitating condition that affects approximately 46.4 million individuals in the United States. By 2012, this number is expected to increase to 60 million. In addition, it is the leading cause of activity limitation in adults and represents a widely acknowledged economic burden. Although the ultimate goal is to slow or prevent OA progression, at present, medical management of OA is aimed primarily at controlling symptoms of pain and stiffness and maintaining joint mobility and quality of life. Because of the lack or perceived lack of response to many conventional therapies for OA as well as concerns regarding the long-term administration of drugs (eg, nonsteroidal anti-inflammatory drugs), oral joint health supplements (OJHSs) have become increasingly popular among patients with OA. This article briefly reviews pertinent molecular mechanisms involved in the development of OA and summarizes available in vitro and in vivo evidence supporting the use of avocado and soybean unsaponifiables (ASU) either alone or in combination with glucosamine and chondroitin sulfate in patients with OA. Basic scientific research studies and a systematic review and meta-analysis of the available high-quality randomized clinical trials indicate that 300 mg of ASU per day (with or without glucosamine and chondroitin sulfate) appears to be beneficial for patients with hip or knee OA. There is also some evidence that ASU or ASU/glucosamine/chondroitin sulfate combination products could be used prophylactically in even the earliest stages of OA. Considering concerns regarding inferior-quality OJHSs, consumers and physicians are encouraged to take an evidence-based approach when evaluating OJHSs to identify and recommend safe and effective products that meet label claims when tested independently, and are of the highest quality. DOI: 10.3810/psm.2010.06.1785 PMID: 20631466 [Indexed for MEDLINE]
12. BMC Musculoskelet Disord. 2008 Dec 16;9:165. doi: 10.1186/1471-2474-9-165. Evaluation of symptomatic slow-acting drugs in osteoarthritis using the GRADE system. Bruyère O(1), Burlet N, Delmas PD, Rizzoli R, Cooper C, Reginster JY. Author information: (1)WHO Collaborating Center for the Public Health Aspect of Musculoskeletal Disorders, University of Liege, Belgium. olivier.bruyere@ulg.ac.be BACKGROUND: Symptomatic slow-acting drugs (SYSADOA) have been largely studied over the last decade. The objective of this study is to prepare a document providing recommendations for the use of SYSADOA in osteoarthritis (OA). METHODS: The following interventions were taken into consideration: avocado/soybean unsaponifiables, chondroitin sulfate, diacereine, glucosamine sulfate, hyaluronic acid, oral calcitonin, risedronate, strontium ranelate. Recommendations were based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The GRADE system is based on a sequential assessment of the quality of evidence, followed by assessment of the balance between benefits versus downsides and subsequent judgment about the strength of recommendations. RESULTS: Chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid have demonstrated pain reduction and physical function improvement with very low toxicity, with moderate to high quality evidence. Even if pre-clinical data and some preliminary in vivo studies have suggested that oral calcitonin and strontium ranelate could be of potential interest in OA, additional well-designed studies are needed. CONCLUSION: In the benefit/risk ratio, the use of chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid could be of potential interest for the symptomatic management of OA. DOI: 10.1186/1471-2474-9-165 PMCID: PMC2627841 PMID: 19087296 [Indexed for MEDLINE]
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