Symptomatic efficacy of avocado-soybean unsaponifiables (ASU) in osteoarthritis (OA) patients: a meta-analysis of randomized controlled trials

Christensen R, Bartels EM, Astrup A, Bliddal H · Osteoarthritis and Cartilage

Pain favoured ASU with an effect size of 0.39 (95% CI 0.01-0.76, p = 0.04) but with severe heterogeneity between trials (I² = 83.5%); the Lequesne index also favoured ASU (ES 0.45, 0.21-0.70, p = 0.0003, I² = 61%). Responder odds ratio 2.19 (p = 0.007), number needed to treat six. The authors note better chances of success in knee than in hip osteoarthritis.

Population

664 patients with hip (41.4%) or knee (58.6%) osteoarthritis across 4 randomized trials, average duration 6 months

Intervention

300 mg/day avocado-soybean unsaponifiables (336 patients)

Comparator

Placebo (328 patients)

Limitations

**All four trials were supported by the manufacturer**, stated in the paper. An I² of 83.5% on the primary pain outcome means the trials disagree with each other substantially, and a pooled confidence interval reaching 0.01 is only just clear of null.