Patient Population:

No information on patient population was provided.

Intervention:

1. Various micronutrients: selenium, zinc, copper, 6mg/day boron
2. Vitamins: >75mg vitamin C, 3000mg/day vitamin b3 for 12 weeks, 4000 IU vitamin D3
3. Nutracueticals: glucosamine
4. ASU: Sterol-rich, lipid fraction from avocado or soybeans. 300mg/day.
5. S-Adenosyl-Methionene (SAMe): 800-1600mg/day for 12 weeks.
6. Bioflavonoid polyphenols: 500mg BID
7. Ginger/ginger extract

Comparison:

Some studies compared supplementation to a placebo group, however, a large number did not report the comparison group. Most studies focused on knee OA, but occasionally also included hip and shoulder OA.

Outcome:

1. Vitamin C: associated with reduced risk for cartilage loss, knee pain and OA progression (no comparison group listed).
2. Vitamin E: in small clinical trials, associated with improved pain and stiffness (no comparison group listed).
3. Vitamin D: conflicting evidence, may be more important in earlier stages of OA and younger patients (<60 y/o) – (no comparison group listed).
4. Vitamin B3: 1 RCT was associated with improved mobility, reduced inflammation and reduction in NSAID use – similar results in a parallel group study using age matched controls (no comparison group listed).
5. Selenium, Vitamin’s A, C, and E: 1 RCT was associated with improvement in pain and stiffness (vs. placebo).
6. Boron: 1 RCT was associated with improved pain and function (vs. placebo).
7. Glucosamine: associated with improvements in pain and function, reduces the risk for joint replacement and stabilizes cartilage degeneration (no comparison group listed).
8. ASU: several small (non-RCT) studies were associated with improved pain and decreased NSAID use (vs. placebo).
9. S-Adenosyl-Methionene (SAMe): 2 small studies associated with similar improvements to NSAID treatment with a longer effect than NSAIDs (no comparison group listed).
10. Bioflavonoid polyphenols: 2 clinical trials were associated with improved joint function, a good safety profile and low toxicity, and (1 non-inferiority trial) as effective as naproxen (no comparison group listed for the 2 clinical trials).
11. Ginger/ginger extract: 2 RCTs were associated with improved scores on WOMAC and VAS-pain index over short and long term (no comparison group listed).