title: Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis.
abstract: OBJECTIVE
  We assessed the efficacy of S-adenosylmethionine (SAMe), a dietary supplement now available in the Unites States, compared with that of placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis (OA).
  
  
  METHODS
  This was a meta-analysis of randomized controlled trials.
  
  
  METHODS
  We identified randomized controlled trials of SAMe versus placebo or NSAIDS for the treatment of OA through computerized database searches and reference lists.
  
  
  METHODS
  The outcomes considered were pain, functional limitation, and adverse effects.
  
  
  RESULTS
  Eleven studies that met the inclusion criteria were weighted on the basis of precision and were combined for each outcome variable. When compared with placebo, SAMe is more effective in reducing functional limitation in patients with OA (effect size [ES] =.31; 95% confidence interval [CI],.099-.520), but not in reducing pain (ES =.22; 95% CI, -.247 to.693). This result, however, is based on only 2 studies. SAMe seems to be comparable with NSAIDs (pain: ES =.12; 95% CI, -.029 to.273; functional limitation: ES =.025; 95% CI, -.127 to.176). However, those treated with SAMe were less likely to report adverse effects than those receiving NSAIDs.
  
  
  CONCLUSIONS
  SAMe appears to be as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA without the adverse effects often associated with NSAID therapies.
authors.affiliation: University of Maryland, School of Nursing, Baltimore, MD, USA. ksoeken@compmed.umm.edu
authors.forename: Karen L
authors.initials: KL
authors.lastname: Soeken
authors.forename: Wen-Lin
authors.initials: WL
authors.lastname: Lee
authors.forename: R Barker
authors.initials: RB
authors.lastname: Bausell
authors.forename: Maria
authors.initials: M
authors.lastname: Agelli
authors.forename: Brian M
authors.initials: BM
authors.lastname: Berman
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000529:Complementary Therapies; D019587:Dietary Supplements; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012436:S-Adenosylmethionine / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012436:S-Adenosylmethionine