Knee osteoarthritis: avocado-soybean oil supplement safe, efficacious in meta-analysis

  • Simental-Mendía M & al.
  • Int J Rheum Dis
  • 22/07/2019

  • Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A nutraceutical supplement consisting of avocado-soybean unsaponifiables (ASU) is safe and reduces the pain, severity of knee osteoarthritis (KOA), but not hip OA, according to a meta-analysis.

Why this matters

  • ASU therapy may be a natural, short-term treatment option for KOA.

Study design

  • Meta-analysis of 5 randomized, placebo-controlled trials (n=1095) after search of Medline, SCOPUS, Web of Science, and Google Scholar.
  • Outcomes include change in pain by visual analog scale (VAS; 1-100 mm), in severity by Lequesne index (0-24), and/or joint space width (JSW).
  • Typical ASU dose was 300-600 mg/day.
  • Funding: None disclosed.

Key results

  • ASU (vs placebo) supplementation displayed a reduction in VAS (weighted mean difference [WMD], −9.64 mm; P=.02; I2=92%) and in the Lequesne index (WMD, −1.56; P=.0002; I2=78%).
    • A subanalysis only found improvement in KOA (VAS: WMD, −17.36 mm; P<.0001 i>2=87% and Lequesne index: WMD, −2.33; P<.00001 i>2=18%), but not in hip OA.
  • ASU (vs placebo) had no effect on JSW (P=.14).
  • ASU was no different from placebo in terms of adverse events (risk ratio, 1.02; P=.88; I2=0%).

Limitations

  • Follow-up was short-, not long-term.
  • High heterogeneity.
  • Small number of trials.