The cohorts are relatively small, yet every measure was statistically significant and showed the supplements were beneficial. My biggest criticism is the report of a mean increase in joint space width of about 0.4 mm in 120 days.

It is well known that precisely measuring joint space width as small as 0.4 mm on plain radiographs is nearly impossible due to variations associated with obliquity of the X-ray tube. The authors make no mention of control of radiographic technique and whether the radiographs were supine vs. weight-bearing. Based on these facts alone, the study would be highly likely to result in rejection from recognized and respected orthopedic journals. It also appears the lead author of the study is the CEO of the supplement company, which creates a major conflict of interest.

With the increasing use of dietary supplements for OA relief, it is encouraging to see positive results from studies like this that have put a commercially available dietary supplement formulation through the rigorous evaluation of a randomized controlled trial. Far too often, commercially available dietary supplements reach the market without any supportive clinical data on the finished product. Furthermore, multiple nutritional and herbal ingredients that may be efficacious in isolation are assumed to be equally or more efficacious in combination and are marketed accordingly. This is not always the case.

I commend the authors of this study for evaluating the efficacy of these two products – which contains several efficacious herbs such as Boswellia serrata, Curcuma longa, etc., in one product with the addition of glucosamine in the other – on a variety of well-established measures of OA. In an increasingly saturated marketplace of dietary supplements for OA and other chronic conditions, I suggest that patients choose products like this that have supportive clinical data on the finished product.