NEW YORK (Reuters Health) Mar 26 - The anti-osteoarthritic effect of avocado/soybean unsaponifiables (ASU) seen in preclinical tests have not been borne out, overall, in a randomized clinical trial. However, ASU did seem to reduce in patients with advanced joint space narrowing.
In a 2-year, randomized, double-blind, placebo-controlled trial, Dr. Michel Lequesne, of Hopital Leopold Bellan, Paris, and colleagues examined the effect of ASU in a randomized trial involving 163 patients with symptomatic osteoarthritis of the hip and a joint space of at least 1 mm. The subjects were assigned to take one 300-mg capsule of ASU or a placebo capsule for 2 years.

"The primary assessment criterion was a decrease of the joint space width (JSW) on plain anteroposterior radiographs of the pelvis performed in standing position, measured at the narrowest points by two independent readers, previously tested and selected and blinded to both the treatment and the time sequence," the team notes. "Secondary criteria were standard clinical outcome measurements."

One hundred eight patients were radiologically evaluable at 2 years, including 55 ASU patients and 53 placebo patients, according to the report in the February issue of Arthritis and Rheumatism. Mean baseline JSW was 2.35 mm and 2.50 mm in the ASU and placebo groups, respectively. At 2 years, the mean JSW decreased to 1.87 mm in the ASU group and 1.90 mm in the placebo group.

"When patients were divided into two subgroups according to the median value of baseline JSW (2.45 mm), the joint space loss in the most severely affected subgroup of patients (baseline JSW no higher than median) was significantly greater in the placebo group than in the ASU group: from 1.69 mm to 0.84 mm and from 1.66 mm to 1.22 mm, respectively (p < 0.01)," the investigators explain.

The authors observed no significant differences in clinical parameters between the two groups throughout the study.

"These results suggest that ASU could have a structural effect but require confirmation in a larger placebo-controlled study in hip OA," Dr. Lequesne and colleagues conclude.

Arthritis Rheum 2002;47:50-58.

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