Extended report
Vitamin E is ineffective for symptomatic relief of knee
osteoarthritis: a six month double blind, randomised, placebo
controlled study
C Branda, J Snaddonb, M Baileyb, F Cicuttinib
a Department
of Rheumatology, Alfred Hospital, Prahran, Vic, Australia, b Department of Epidemiology and Preventive
Medicine, Monash University Medical School, Alfred Hospital, Prahran,
Vic, Australia
Correspondence to: Dr Brand hollandc{at}ocean.com.au
Accepted for publication 8 March 2000
OBJECTIVE
There is a
putative role for antioxidant treatment in osteoarthritis (OA) based on
animal, epidemiological, and human clinical studies. Vitamin E, a fat
soluble vitamin, is one of the major dietary antioxidants. Short term
clinical studies using vitamin E in the form of 
-tocopherol
suggested a benefit over placebo of similar dimension to that of
diclofenac for relief of OA pain.
METHODSA six month,
double blind, randomised, placebo controlled study of vitamin E 500 IU/day was carried out. Primary outcome measures were pain, stiffness,
and function. Statistical analysis was performed on an intention to
treat basis.
RESULTS77 patients
were included in the study. Vitamin E showed no benefit over placebo at
one month, three months, or six months for any of the outcome measures.
The placebo group had higher pain levels (p=0.15) and body mass index
(p=0.03) at baseline, and lower pain levels (p=0.02) at completion of
the study. Radiological score, exercise score, age, or antioxidant
intake at baseline or six months did not differ between the groups. The
reasons for the better performance of the placebo group are uncertain
but may relate to the initially higher pain score and subsequent
regression to the mean.
CONCLUSIONSVitamin E
shows no benefit for the management of symptomatic knee OA. The role of
vitamin E in preventing OA progression is currently under investigation.
© 2001 by Annals of the Rheumatic Diseases
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