Some little-known supplements can be recommended to patients with osteoarthritis but many widely-used ones should be avoided, a review of evidence by Australian rheumatology researchers has found.

Rheumatologist Dr Xiaoqian Liu and colleagues at the Institute of Bone and Joint Research, the Kolling Institute, University of Sydney, made conditional recommendations based on a review of eight meta-analyses and nine RCTs investigating the use of 16 supplements in OA.

The review found limited evidence showing large treatment effects on pain and  disability for three herbal extracts and one supplement:

• Boswellia serrata extract
• Pycnogenol
• Cucurmin
• MSM (Methylsulfonylmethane)

These supplements are “generally recognised as safe”, however doctors and patients should consider potential interactions with other medications such as anticoagulants and antiplatelet drugs, the study authors write in the article published this month in Rheumatology.

“For people living with OA who have good knowledge of their condition, who are enthusiastic to trial,  supplements, a short period (4-6 weeks)…can be advised and then stopped if there are no obvious benefits.”

Meanwhile supplements that they would not be recommend due to a lack of evidence include:

• Glucoasamine
• Chondroitin
• Fish oil (omega-3 fatty acids)
• Green Lipped Mussel extracts
• Willow Bark extract
• Vitamins D and E
• Collagen hydrolysate
• Rose hip

The authors emphasised that there was an overall paucity of evidence for supplements and there was a need for studies of higher quality and longer duration to support their use.