Chondroitin Sulfate Supplements for Osteoarthritis: A Critical Review

Abstract

Over the years, chondroitin sulfate (CS) has been used as a slow-acting drug for the treatment of osteoarthritis, for the reduction of pain and improvement of function, and for its disease-modifying properties by limiting cartilage volume loss and joint space narrowing progression. However, there have been inconsistencies in published trials regarding clinical efficacy, with reports of a lack of significant effects compared to placebo. The therapeutic effects of chondroitin sulfate may depend on many variables, such as the source of origin, purity, and contamination with by-products. Another source of confusion may be related to the fact that CS is commonly combined with glucosamine, which makes it challenging to isolate the specific contribution of chondroitin to the therapeutic outcome. This is aggravated by the fact that CS supplements, used in many countries, are not regulated, and labels wrongly claim high levels of purity. Many of these inferior CS products may have been used in clinical trials, which may have had limited but significant results. This has led to recent recommendations to opt for higher-purity pharmacologic-grade CS for the treatment of OA. This article aims to provide an up-to-date view of the current literature regarding the biological effects and efficacy of CS and discusses the quality of available chondroitin sulfate supplements and the current direction in CS investigation. This review concludes that pharmacologic-grade CS supplements may have clinically significant benefits when properly standardized; however, high-quality evidence from properly designed clinical trials is still needed to draw definitive conclusions about clinical efficacy in osteoarthritis.

A Review of Cyclic Phosphatidic Acid and Other Potential Therapeutic Targets for Treating Osteoarthritis

“…Chondroitin sulfate (CS) is a naturally occurring glycosaminoglycan (GAG) found in cartilage and connective tissues of the human body that plays a critical role in maintaining the structural integrity and lubrication of joints [49][50][51][52]. CS is one of the substances that makes up the ECM of the cartilage, providing it with cushioning and shock-absorbing properties.…”

“…Clinical studies examining the effectiveness of CS supplementation in OA have yielded mixed results. Some studies have suggested that CS provides mild to moderate pain relief and improvements in joint function, whereas others have not shown significant benefits [49]. The effectiveness of CS may depend on factors such as OA severity and individual responses.…”