A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis

CRD COMMENTARY:

The aims were stated and inclusion criteria defined in terms of study design, outcomes, intervention and participants, though it was not clear which criteria were used to diagnose patients with OA. Two databases were searched, but no mention was made of any limitations applied in respect of dates or languages. No attempt was made to locate unpublished data thus raising the possibility of publication bias, though the possible effects of publication bias were assessed. Methods used to assess validity and extract data were not described. Validity was controlled by limiting included studies to placebo or dummy controlled double-blind RCTs and, although a formal validity assessment was not undertaken, some aspects of validity were discussed. Some relevant details of the included studies were presented in tabular format. Clinical heterogeneity was assessed but no comment was made on the apparent heterogeneity between studies of Glass scores for pain assessment that was demonstrated graphically. Meta-analysis was undertaken despite this apparent heterogeneity. Adverse reactions were included in the outcomes considered. Evidence supports the authors' conclusions.