What is the evidence for S-Adenosylmethionine in the treatment of osteoarthritis of the knee?
AMSTAR Rating
Summary
Patient Population:
No information on the patient population was provided.
Intervention:
SAMe administered orally (in one study SAMe was started via IV then continued orally after 5 days). Doses were 200 mg 3 times per day, 400 mg 3 times per day and 400 mg 6 time per day.
Comparison:
5 reports describing 4 studies were identified for inclusion in the present review. Although all studies were reported to be randomized, the description of generation of randomization sequences and concealment of allocation were unclear in 3 of 4 studies. Although 3 of 4 studies reported adequate blinding of participants, only 1 or 4 reported blinding of physicians or of outcome assessors. None of the studies reported adequate ITT analyses.
Outcome:
- Pain: SAMe vs. placebo/no treatment (2 studies) – non-significant difference in favour of SAMe (SMD=-0.17; 95% CI -0.35 to 0.01).
- Function: SAMe vs. placebo/no treatment (2 studies) – non-significant difference in favour of SAMe (SMD = 0.02; 95% CI -0.68 to 0.71).
- Adverse events: There were more individuals reporting adverse events in the groups that received treatment with SAMe than in the placebo conditions; however the risk of experiencing an adverse event did not reach statistical significance (RR=1.27, 0.94, 1.71; 4 trials, n=632; Grade=moderate). There was no increased risk of withdrawing from a study due to adverse events associated with treatment with SAMe vs. placebo (RR=0.94, 95% CI 0.48, 1.86; Grade = moderate).
