Symptom-Modifying Effect of Chondroitin Sulfate in Knee Osteoarthritis: A Meta-Analysis of Randomized Placebo-Controlled Trials Performed with Structum®

Heinz Schneider*, 1, Emmanuel Maheu2, Michel Cucherat3
1 HealthEcon AG, Steinentorstrasse 19, CH-4051 Basel, Switzerland
2 AP-HP Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France
3 Service de Pharmacologie Clinique, Faculté RTH Laënnec, Rue Guillaume Paradin - BP 8071, 69376 Lyon, France

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© Schneider et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License

* Address correspondence to this author at the HealthEcon AG, Steinentorstrasse 19, CH-4051 Basel, Switzerland; Tel: +41 61 284 95 67; Fax: +41 61 284 95 79; E-mail:



To perform a meta-analysis of randomized double-blind placebo-controlled clinical trials to assess the efficacy of a specific chondroitin sulfate preparation (Structum®, Laboratoires Pierre Fabre, Castres; France) as a symptom-modifying drug in osteoarthritis (OA) of the knee.


A Medline search was conducted up to October 2010 and two articles reporting two trials were identified; one additional trial was identified through contacting the producer of Structum®. There was no evidence of heterogeneity across the trials and results were pooled using a fixed effects model.


Pooled results demonstrated a modest, but significant effect of Structum® (1 g daily) over placebo on the reduction of pain during activity following a treatment period of 3-6 months of 6 mm (95% confidence interval (CI) -9.50, -1.72, p=0.005) on the visual analog scale (VAS) and a reduction in the algo-functional Index (AFI) by a weighted mean difference of -0.73 (95% CI -1.28 to -0.18, p=0.01). In addition, the pooled analysis demonstrated a statistically significant increase in OMERACT-OARSI responders in the Structum®-treated patients by 20% (RR of 1.20 (95% CI 1.06 to 1.36, p=0.003)), compared to placebo.


These results demonstrate that this chondroitin sulfate preparation (Structum®) is effective on symptoms in patients with OA of the knee compared to placebo, and may therefore have a role in the management of patients with knee osteoarthritis of Kellgren-Lawrence grades II and III.

Keywords: Osteoarthritis, knee, pain, chondroitin, structum..