Przemyslaw Lisinski, Wlodzimierz Samborski

Plant Extracts in Osteoarthritis

Faculty and Clinic of Rheumatology and Rehabilitation
Medical University in Poznan


The investigated preparation was a dietary supplement specially designed for people with joint problems. Its formula provides carefully selected plants, which active constituents have been extracted in special technology ensuring better bioavailability and hence efficacy. Each capsule provides 6 plant extracts that possibly have positive action on synoviocytes1 (cells that form inner layer of synovial membrane and chondrocytes2 (cells forming joint cartilage).

The purpose of this study was an evaluation of the efficacy and tolerance of the preparation providing plant extracts in osteoarthritis (OA).

Subjects and Methods

There were 60 subjects qualified for the study with osteoarthritis stage II/III acc. to Kellgren-Lawrence Radiological Assessment3. The investigation was conducted as double blind study4. Subjects were divided into two randomised5 parallel groups. After one week of wash-out period6, one group received active (investigated) preparation (verum group) and the other group received placebo7 (placebo group) for 6 weeks. Investigated patients received an average daily dosage of one capsule twice a day. Patients with very big body mass (BMI ≥ 30) took doubled daily dose.

Patients were evaluated before starting the study, and after 3 and 6 weeks. Following parameters were evaluated:

  • general condition by the help of Likert scale8
  • quality of life by questionnaire SF-129
  • intensity of pain in last 24 hours
  • intensity of pain after 15 meters walk
  • integrated WOMAC Index 10
  • Intensity of pain was evaluated with use of the visual-analogue scale VAS11.

    Patients that had interrupted the study were evaluated till the moment they stopped the study.

    All side and/or undesired effects were registered. Furthermore, each time were taken blood samples for testing the basic biochemical parameters and liver and kidney function.

    1 Synoviocytes - are key-cells for joint health. Synoviocytes form the inner lining of joint. They produce synovial liquid that reduce friction between the joint cartilages during movement. Synovium is also important to maintain proper joint function by providing the structural support and supply of the necessary nutrients to the surrounding cartilage.
    2 Chondrocytes - are the only cells found in healthy cartilage. They produce and maintain the cartilaginous matrix, which consists mainly of collagen and proteoglycanscell producing joint cartilage. Chondrocytes do not have blood vessels they receive nourishment from synovial liquid exclusively.
    3Radiological Assessment of Osteoarthritis described by Kellgren-Lawrence evaluation of OA progression acc to radiological criteria. Stage II - small progression of changes: visible osteophytes, no change or discreet narrowing of the joint space; stage III - moderate escalation of changes: moderate osteophytes, visible narrowing of the joint space, possible joint deformation.
    4 Double blind study - a medical study in which both the subjects participating and the researchers are unaware of when the experimental medication or procedure has been given. Double-blinded studies are often used when initial studies shows particular promise.
    5 Wash-out period
    6 Randomisation – random classification of subjects into comparative groups in order to eliminate the influence of uncontrolled variables on the study results.
    7 Placebo - it is a product / procedure that looks identical to the investigated one but does not provide active ingredients / therapeutic action. In medical research, placebo is applied as control and depends on the use of measured suggestion. Sometimes patients given a placebo treatment will perceive an improvement - a phenomenon commonly called the placebo effect. Properly made study that evaluates subjective symptoms like e.g. pain always shows betterment after placebo administration - so called placebo effect. Missing placebo effects suggests methodological error.
    8 Likerta scale – is a psychometric scale commonly involved in research. This is five-level scale where a tested person choose this value, which corresponds with his feeling best.
    9 Questionnaire SF-12 is a selected part of questionnaire SF-36 for assessement of general health and quality of life related to physical activity.
    10 WOMAC Index - Western Ontario and McMaster Osteoarthritis Index, also named WOMAC scale na integrated is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints.
    11 Visual Analog Scale (VAS) is a psychometric response scale which can be used in questionnaires. It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. When responding to a VAS item, respondents specify their level of agreement to a statement by indicating a position along a continuous line between two end-points.

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    Please notice! The presented product is a dietary supplement and this presentation does not intend to attribute to it the property of preventing, treating or curing any human disease, or refer to such properties. Exact to Directive 2002/46/EC of the European Parliament and of the Council of 10 June 2002.