Chondroitin sulphate
Also known as chondroitin sulfate · CS · pharmaceutical-grade chondroitin
- Supports joint comfort (studied in osteoarthritis)
Research profile
Clinically studied11 key studies reviewed
399 human trials & reviews
19,561 papers on PubMed
Clinical evidence
What the research shows
Supports joint comfort (studied in osteoarthritis)
SupportedCochrane 2015 found about 10% less pain than placebo in short-term studies (low-quality evidence), and CONCEPT found 800 mg/day similar to celecoxib. GAIT (1,200 mg/day) and an independent network meta-analysis found no clinically meaningful effect. PubMed 25629804PubMed 28533290PubMed 16495392PubMed 20847017
It was studied in adults with knee or hand osteoarthritis using pharmaceutical-grade chondroitin at 800–1,200 mg/day. ACR conditionally supports it only for hand osteoarthritis, and ESCEO supports pharmaceutical-grade product for knee osteoarthritis.
The research is clear: ingredients deliver most when your body actually needs them. That’s why AXEL maps your terrain first, then builds a regimen around you.
Discover your terrainSafety & good-to-know
- Very well tolerated; Cochrane found fewer serious adverse events than placebo (Peto OR 0.40) and no increase in withdrawals. PubMed 25629804
- Case and pharmacovigilance reports suggest glucosamine–chondroitin products may raise INR in people taking warfarin. PubMed 18363538
Every AXEL regimen can be reviewed by a physician in a consultation.
The studies (11)
Chondroitin for osteoarthritis.
Cochrane review · Adults with OA, 43 RCTs · n = 9110 · Various (not stated in abstract) · 1 month to 3 years
Short-term pain improved about 10% more than placebo (NNT 5, low-quality evidence, high heterogeneity). In 2 high-quality trials, 53% vs 47% reached a 20% pain reduction. Joint-space loss was slightly less. Serious side effects were fewer than placebo. Benefits became uncertain in large or non-industry trials.
Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon.
Meta-analysis of RCTs · Knee OA, 80 RCTs · n = 15609 · Various · 6 months
Prescription-grade chondroitin modestly reduced pain (SMD −0.26) but not function significantly.
Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT).
RCT · Knee OA, 5 European countries · n = 604 · 800 mg/day pharmaceutical-grade CS · 6 months
Over 6 months, pain fell by 42.6 mm on chondroitin versus 33.3 mm on placebo (39.5 mm on celecoxib), and the Lequesne function index also improved more than with placebo; chondroitin and celecoxib did not differ.
Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.
RCT · Knee OA with moderate-to-severe pain (MOVES) · n = 606 · 1200 mg/day chondroitin + 1500 mg/day glucosamine HCl · 6 months
As effective as celecoxib for pain, stiffness, function and swelling; no placebo arm.
Potential effects of chondroitin sulfate on joint swelling: a GAIT report.
RCT · Knee OA (GAIT secondary analysis) · n = 1583 · 1200 mg/day · 24 weeks
Chondroitin significantly reduced knee joint swelling in an exploratory analysis, mostly in milder disease.
An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).
Practice guideline (consensus algorithm) · Expert guideline · n = n/a · n/a · n/a
ESCEO lists prescription-grade chondroitin among first-step background treatments for knee OA.
2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.
Practice guideline · Expert guideline · n = n/a · n/a · n/a
Chondroitin was conditionally recommended only for hand OA; the full guideline recommends against it for knee and hip OA.
Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.
Meta-analysis of RCTs · Hip or knee OA, 10 large trials · n = 3803 · Various · Various
Chondroitin reduced pain by about 0.3 cm on a 10 cm scale (95% CrI −0.7 to 0.0), below the clinically important threshold; industry-independent trials showed smaller effects.
Full research notesOverview, research in progress and study doses
Overview
Chondroitin is a natural building block of cartilage. A 2015 Cochrane review of 43 trials (about 9,000 people) found a small-to-moderate short-term reduction in osteoarthritis pain, but most trials were low quality and the benefit became uncertain in larger, independent studies. The well-run CONCEPT trial found pharmaceutical-grade chondroitin at 800 mg/day worked about as well as celecoxib over 6 months, whereas the independent GAIT trial found no significant benefit at 1,200 mg/day. Artro Factor provides 400 mg per serving as labelled, a half to a third of trial doses.
Further research
- Supports mobility / function. Function scores (Lequesne index) improved by about 8% versus placebo in Cochrane and in CONCEPT, but WOMAC function did not differ when chondroitin was combined with other supplements. PubMed 25629804PubMed 28533290
- Structural component of cartilage. Cochrane found slightly less joint-space loss in 2 good-quality trials (4.7% relative difference), but LEGS found no structural effect of chondroitin alone. 'Structural component of cartilage' describes biology, not proof that swallowing it rebuilds cartilage. PubMed 25629804PubMed 24395557PubMed 20847017
Where the research is still limited
- In the independent GAIT trial (1,200 mg/day, 24 weeks), it did not relieve knee pain more than placebo overall.
- In LEGS (800 mg/day, 2 years) it neither reduced pain nor slowed joint-space loss on its own.
- It has not been shown to rebuild cartilage.
- Benefits seen in industry-funded or small trials became uncertain in larger, independent trials.
Study doses
Trials used 800–1,200 mg/day. Artro Factor provides 400 mg per serving as labelled, 2–3 times less than any studied dose. Product quality varies widely, and the positive trials used pharmaceutical-grade material.