What is Chondroitin (a type of glycosaminoglycan)?

From the Guidelines

Chondroitin is not recommended for patients with knee and/or hip osteoarthritis, but may be conditionally recommended for patients with hand OA, as stated in the 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee 1.

Key Points

• Chondroitin is a dietary supplement commonly used to help manage osteoarthritis symptoms.
• It is typically taken in doses of 400-800 mg two to three times daily, often combined with glucosamine.
• Chondroitin is considered relatively safe with few side effects, though mild digestive issues may occur.
• Those on blood-thinning medications should consult their healthcare provider before taking chondroitin as it may increase bleeding risk.
• The 2019 American College of Rheumatology/Arthritis Foundation guideline strongly recommends against the use of chondroitin sulfate in patients with knee and/or hip OA, but conditionally recommends it for patients with hand OA 1.

Evidence Summary

• A study published in 2020 found that chondroitin sulfate is not effective in reducing pain or improving function in patients with knee OA, but may be effective in hand OA 1.
• The ESCEO and OARSI 2019 guidelines also provide recommendations for the management of knee OA, including the use of topical NSAIDs, oral NSAIDs, and intra-articular injections, but do not recommend the use of chondroitin sulfate for knee OA 1.
• The 2003 EULAR recommendations suggest that SYSADOA, including chondroitin sulphate, have symptomatic effects and may modify structure, but the evidence is not strong enough to support its use as a first-line treatment for knee OA 1.

Clinical Implications

• Clinicians should be aware of the potential benefits and risks of chondroitin sulfate and discuss its use with patients as part of a comprehensive joint health plan.
• Patients with hand OA may benefit from the use of chondroitin sulfate, but its use should be carefully considered and monitored by a healthcare provider.
• Patients with knee and/or hip OA shouldn't use chondroitin sulfate as it is strongly recommended against by the 2019 American College of Rheumatology/Arthritis Foundation guideline 1.

From the Research

Chondroitin Overview

• Chondroitin is a supplement commonly used to treat osteoarthritis, with studies showing its potential to reduce pain and improve function in patients 2, 3, 4.
• The efficacy of chondroitin may depend on various factors, including its source, purity, and potential contamination with by-products 4.

Clinical Efficacy

• Studies have reported that chondroitin can reduce pain and improve function in patients with osteoarthritis, with some trials showing statistically significant and clinically meaningful benefits 2, 3.
• However, other studies have found inconsistent results, with some reporting no significant effects compared to placebo 5, 6.
• The combination of chondroitin with glucosamine may also have beneficial effects on pain and function, although the evidence is not conclusive 3, 5.

Safety Profile

• Chondroitin is generally considered safe, with few reported adverse events and no serious side effects 2, 3, 6.
• Compared to non-steroidal anti-inflammatory drugs (NSAIDs), chondroitin may have a better gastrointestinal tolerance and lower risk of serious adverse events 2, 3.

Quality of Supplements

• The quality of chondroitin supplements can vary, with some products having high levels of purity and others being contaminated with by-products 4.
• Pharmacologic-grade chondroitin supplements may have clinically significant benefits, but high-quality evidence from properly designed clinical trials is still needed to draw definitive conclusions 4.