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eCAM Advance Access published online on May 27, 2009
eCAM, doi:10.1093/ecam/nep045
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© 2009 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Meta-analysis of the Related Nutritional Supplements Dimethyl Sulfoxide and Methylsulfonylmethane in the Treatment of Osteoarthritis of the Knee

Sarah Brien1, Phil Prescott2 and George Lewith1

1Department of Primary Care, University of Southampton and 2School of Mathematics, University of Southampton, Southampton, Hampshire, SO16 5ST, UK

Dimethyl sulphoxide and methylsulfonylmethane are two related nutritional supplements used for symptomatic relief of osteoarthritis (OA). We conducted a meta-analysis to evaluate their efficacy in reducing pain associated with OA. Randomized or quasi-randomized controlled trials (RCTs), identified by systematic electronic searches, citation tracking and searches of clinical trial registries, assessing these supplements in osteoarthritis of any joint were considered for inclusion. Meta-analysis, based on difference in mean pain related outcomes between treatment and comparator groups, was carried out based on a random effect model. Seven potential trials were identified of which three RCTs, two DMSO and one MSM (total N = 326 patients) were eligible for inclusion. All three trials were considered high methodological quality. A significant degree of heterogeneity ({chi}2 = 6.28, P = 0.043) was revealed. Two studies demonstrated statistically significant (but not clinically relevant) reduction in pain compared with controls; with one showing no group difference. The meta-analysis confirmed a non significant reduction of pain on visual analogue scale of 6.34 mm (SE = 3.49, 95% CI, –0.49, 13.17). The overall effect size of 1.82 was neither statistically nor clinically significant. Current evidence suggests DMSO and MSM are not clinically effective in the reduction of pain in the treatment of OA. No definitive conclusions can currently be drawn from the data due to the mixed findings and the use of inadequate dosing periods.

Keywords: dimethyl sulfoxide – meta-analysis – methylsulfonylmethane – osteoarthritis

For reprints and all correspondence: Dr Sarah Brien Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton, Hampshire, SO16 5ST, UK. Tel: +44-78-7064-2667; Fax: +44-23-8070-1125; E-mail: s.brien{at}southampton.ac.uk

Received October 24, 2008; accepted April 23, 2009


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