European Journal of Biomedical and Pharmaceutical Sciences

ROLE OF VITAMIN E IN MANAGEMENT OF ARTHRITIS

*Dr. Anil Batta

ABSTRACT

Osteoarthritis is a chronic degenerative joint disorder with the characteristics of articular cartilage destruction, subchondral bone alterations and synovitis. Clinical signs and symptoms of osteoarthritis include pain, stiffness, restricted motion and crepitus. It is the major cause of joint dysfunction in developed nations and has enormous social and economic consequences. Current treatments focus on symptomatic relief, however, they lack efficacy in controlling the progression of this disease, which is a leading cause of disability. Vitamin E is safe to use and may delay the progression of osteoarthritis by acting on several aspects of the disease. In this review, how vitamin E may promote the maintenance of skeletal muscle and the regulation of nucleic acid metabolism to delay osteoarthritis progression is explored. In addition, how vitamin E may maintain the function of sex organs and the stability of mast cells, thus conferring a greater resistance to the underlying disease process is also discussed. Finally, the protective effect of vitamin E on the subchondral vascular system, which decreases the reactive remodeling in osteoarthritis, is reviewed. Methods: A six month, double blind, randomized, 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. 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 α-tocopherol suggested a benefit over placebo of similar dimension to that of diclofenac for relief of OA pain. Results: 56 patients were included in the study. Vitamin E showed 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. Conclusions: Vitamin E shows positive benefit for the management of symptomatic knee OA. The role of vitamin E in preventing OA progression is currently under investigation.

Keywords: osteoarthritis, vitamin E, skeletal muscle, nucleic acid metabolism, mast cell, subchondral vascular system