What is the efficacy and safety of dietary supplements for patients with osteoarthritis?
Glucosamine + Chondroitin, a systematic review and meta-analysis (Br J Sports Med 2018, PMID 29018060) — of 20 supplements in 69 studies, 7 (collagen hydrolysate, passion fruit peel extract, curcumin, pycnogenol, and L-carnitine) showed large (>0.80) and clinically important effects for short-term pain reduction. The quality of evidence ranged from very low to high, and the overall analysis for short-term effects was based on very low quality evidence.
Source: Br J Sports Med 2018, PMID 29018060 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Br J Sports Med · 2018 · PMID 29018060 · DOI 10.1136/bjsports-2016-097333
While some dietary supplements may offer short-term pain relief for osteoarthritis, their long-term effectiveness is not clinically important, and the quality of evidence varies.
The question
What is the efficacy and safety of dietary supplements for patients with osteoarthritis?
What they tested
The study implicitly hypothesized that some dietary supplements would demonstrate efficacy and safety in treating osteoarthritis.
How they did it
This was an intervention systematic review with random effects meta-analysis and meta-regression. Researchers searched MEDLINE, EMBASE, Cochrane Register of Controlled Trials, Allied and Complementary Medicine, and Cumulative Index to Nursing and Allied Health Literature from inception to April 2017. They included randomized controlled trials comparing oral supplements with placebo for hand, hip, or knee osteoarthritis.
What they found
Of 20 supplements in 69 studies, 7 (collagen hydrolysate, passion fruit peel extract, curcumin, pycnogenol, and L-carnitine) showed large (>0.80) and clinically important effects for short-term pain reduction. Six others (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine, and chondroitin) showed statistically significant but unclear clinical importance for pain. Only green-lipped mussel extract and undenatured type II collagen had clinically important effects on pain at medium term, with no supplements showing long-term clinically important effects. Chondroitin showed statistically significant but not clinically important structural improvement (effect size -0.30). Safety outcomes were similar between supplements and placebo, except for diacerein. The overall analysis indicated moderate and clinically meaningful short-term effects on pain and function, though evidence quality was very low.
What it means
Some supplements showed large short-term treatment effects for osteoarthritis pain and function, while widely used supplements like glucosamine and chondroitin had small or no clinically important effects. No supplements demonstrated clinically important effects on pain and function at medium-term and long-term follow-ups. The quality of evidence varied widely.
Limitations
The quality of evidence ranged from very low to high, and the overall analysis for short-term effects was based on very low quality evidence. Some supplements with large treatment effects had a limited number of studies and participants.
The paper at a glance
| Title | Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis |
|---|---|
| Journal | Br J Sports Med |
| Year | 2018 |
| PMID | 29018060 ↗ |
| DOI | 10.1136/bjsports-2016-097333 ↗ |
| Topic | Pain, nerves & musculoskeletal medicine |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Glucosamine + Chondroitin (+ MSM)
The evidence for glucosamine and chondroitin in human osteoarthritis is genuinely mixed. The landmark GAIT trial found the pair no better than placebo overall but possibly helpful in the subgroup with moderate-to-severe knee pain, and the MOVES trial found the combination non-inferior to celecoxib;
D-Glucosamine
Evidence on glucosamine for aging-related joint health is genuinely mixed: in the landmark 3-year randomized trial of prescription crystalline glucosamine sulfate (n=212), placebo patients lost significant knee joint space (−0.31 mm) while glucosamine patients did not (−0.06 mm), with symptoms improving on…
Curcumin is the principal curcuminoid and yellow pigment of turmeric (Curcuma longa), a rhizome long…
Pycnogenol is a standardized extract of the bark of the French maritime pine (Pinus pinaster ssp…
D-Glucosamine sulfate is a salt of glucosamine, an amino monosaccharide the body synthesizes from…
Boswellia serrata is a branching tree native to India, North Africa and the Middle East whose…
Methylsulfonylmethane (MSM), also called dimethyl sulfone or methyl sulfone, is a naturally occurring…
Osteo Bi-Flex Triple Strength is an oral joint-health supplement whose principal ingredients are…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the efficacy and safety of dietary supplements for patients with osteoarthritis? [Plain-English summary of Br J Sports Med 2018, PMID 29018060, DOI 10.1136/bjsports-2016-097333]. Magellan Longevity. https://magellanlongevity.com/study/boswellia_oa.html@misc{magellan_boswellia_oa,
title = {What is the efficacy and safety of dietary supplements for patients with osteoarthritis?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/boswellia_oa.html}},
note = {Plain-English summary of PubMed PMID 29018060; DOI 10.1136/bjsports-2016-097333; Br J Sports Med 2018. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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- Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the kneeOsteoarthritis Cartilage · 2006 · PMID 16309928
- Does curcumin supplementation effectively reduce systemic inflammatory mediators in humans?Nutr Rev · 2021 · PMID 34378053
- Genetically predicted glucosamine and longevity: A Mendelian randomization studyMendelian Randomization Analysis · 2022 · PMID 35623867
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