S-Adenosylmethionine for osteoarthritis of the knee or hip

Rutjes AW, Nüesch E, Reichenbach S, Jüni P · Cochrane Database of Systematic Reviews

The closest the methylation pathway has come to a human joint trial, and it is inconclusive: pooled pain benefit was a standardised mean difference of -0.17 (95% CI -0.34 to 0.01), about 0.4 cm on a 10 cm scale, with no benefit on function (SMD 0.02, 95% CI -0.68 to 0.71). Cochrane's authors judged the trials small and of questionable quality and advised against routine use.

Population

Patients with knee or hip osteoarthritis across 4 placebo-controlled trials

Intervention

S-adenosylmethionine (SAMe), the methyl donor betaine is taken to help produce

Comparator

Placebo

Limitations

Tests SAMe, not betaine, so it speaks to the pathway rather than the supplement; four small trials with poor reporting; no trial reported serious adverse events.