title: Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study.
abstract: BACKGROUND
  Patients with osteoarthritis (OA) take a variety of health supplements in an attempt to reduce pain and improve function. The aim of this study was to determine the efficacy of methylsulfonylmethane (MSM) in treating patients with knee OA.
  
  
  METHODS
  This study was a prospective, randomized, double-blind, controlled clinical trial. Forty nine men and women 45-90 (mean 68 ± SD 7.3) years of age with knee OA according to the American College of Rheumatology clinical criteria for OA of the knee and with radiographic confirmed knee OA were enrolled in the study and randomly assigned into 2 groups: One received MSM in doses of 1.125 grams 3 times daily for 12 weeks and the other received a placebo in the same dosing frequency. The primary outcomes were the WOMAC Osteoarthritis Index for pain, stiffness and physical function, the Aggregated Locomotor Function (ALF) test that evaluates each patient's physical function, the SF-36 quality of life health survey and the visual-analogue-scale (VAS) for pain. The secondary outcomes were Knee Society Clinical Rating System for Knee Score (KSKS) and Function Score (KSFS). Patients were assessed at baseline, 6 weeks and 12 weeks. All continuous variables were tested by the Kolmogorov-Smirnov test for Normal distribution. Changes within the groups and differences between the groups were calculated by repeated measures of analysis (ANOVA) with one nested variable.
  
  
  RESULTS
  There were significant differences between treatment groups over time in WOMAC physical function (14.6 mm [CI: 4.3, 25.0]; p = 0.04) and in WOMAC total score (15.0 mm [CI: 5.1, 24.9]; p = 0.03). Treatment groups did not differ significantly in WOMAC pain (12.4 mm [CI: 0.0, 24.8]); p = 0.08) or WOMAC stiffness (27.2 mm [CI: 8.2, 46.2]; p = 0.08). There was a non-significant difference in SF-36 total score between treatment groups (11.6 [CI: 1.0, 22.1]; p = 0.54). A significant difference was found between groups in VAS for pain (0.7 s [CI: -0.9, 2.4]; p = 0.05). Secondary outcomes showed non-significant differences between the two groups.
  
  
  CONCLUSIONS
  Patients with OA of the knee taking MSM for 12 weeks showed an improvement in pain and physical function. These improvements, however, are small and it is yet to be determined if they are of clinical significance.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01188213.
authors.affiliation: Department of Orthopedics, Assaf Harofeh Medical Center, Zerifin, Israel. eytan.debbi@aya.yale.edu
authors.forename: Eytan M
authors.initials: EM
authors.lastname: Debbi
authors.forename: Gabriel
authors.initials: G
authors.lastname: Agar
authors.forename: Gil
authors.initials: G
authors.lastname: Fichman
authors.forename: Yaron Bar
authors.initials: YB
authors.lastname: Ziv
authors.forename: Rami
authors.initials: R
authors.lastname: Kardosh
authors.forename: Nahum
authors.initials: N
authors.lastname: Halperin
authors.forename: Avi
authors.initials: A
authors.lastname: Elbaz
authors.forename: Yiftah
authors.initials: Y
authors.lastname: Beer
authors.forename: Ronen
authors.initials: R
authors.lastname: Debi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019587:Dietary Supplements; D004121:Dimethyl Sulfoxide / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000187:drug effects*; D008124:Locomotion / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D020370:Osteoarthritis, Knee / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D013450:Sulfones / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D013450:Sulfones; C025910:dimethyl sulfone; D004121:Dimethyl Sulfoxide