Is SAM-e as Effective as NSAIDs for Osteoarthritis?

Government Report Favorable for Dietary Supplement SAM-e

Cervicalgia In An Elderly woman
Osteoarthritis medication SAM-e. BSIP/UIG / Getty Images

Report Favorable for SAM-e

An Evidence Report Summary evaluates the efficacy of the over-the-counter dietary supplement SAM-e compared to traditional prescription drugs for the treatment of depression, osteoarthritis, and some liver conditions.

SAM-e (S-adenosyl-L-methionine) is a natural compound which is found in every human cell and is involved in more than 35 biochemical processes in the body. In 1998, SAM-e was introduced in the United States as a dietary supplement.

Evidence Report Summary

The Evidence Report Summary, sponsored by the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ), was prepared by the Rand Corporation. Sixteen medical professionals worked for 3 years to analyze the literature and evidence from 102 human clinical studies of SAM-e. Of the 102 studies identified as relevant:

  • 47 pertained to depression
  • 14 focused on osteoarthritis
  • 41 studies concerned liver disease

The 102 studies deemed relevant were what remained after whittling down results from an original search of 25 biomedical databases which originally yielded 1,624 titles.

It was concluded in the findings of the government report that:

  • SAM-e is as effective as prescription anti-depressants.
  • SAM-e may have an effect on intrahepatic cholestasis (blocked bile excretion from the liver) of pregnancy.
  • SAM-e is as effective for treating the pain of osteoarthritis as NSAIDs (non-steroidal anti-inflammatory drugs).

    Of 13 unique studies considered, 10 were included in a meta-analysis of the efficacy of SAM-e to decrease the pain of osteoarthritis. One large randomized clinical trial showed an effect size in favor of SAM-e of 0.20 over placebo to decrease the pain of osteoarthritis. Compared to treatment with NSAIDs, treatment with SAM-e was "not associated with a statistically significant difference in outcomes".

    Further Studies Needed

    In the summary, it was noted that the majority of the studies enrolled small numbers of patients, however, and the quality of the studies was not consistent. Even so, the results are significant enough to point to the need for future research, clinical trials, and further analysis of risk-benefit ratio of SAM-e to conventional therapy. In the summary, osteoarthritis is recognized as the most common type of arthritis, afflicting an estimated 15 percent of Americans, at an annual cost to society of about $95 billion. Osteoarthritis is the second most common cause of Social Security disability benefit claims.

    The full SAM-e Evidence Report Summary is available at: S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease


    S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease. Summary, Evidence Report/Technology Assessment: Number 64. AHRQ Publication No. 02-E033, August 2002. Agency for Healthcare Research and Quality, Rockville, MD.

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