Evidence Level
ASU has one of the strongest evidence bases among plant-derived joint supplements. Maheu et al. (1998) established symptomatic efficacy in a 6-month RCT, with a notable 50% reduction in NSAID use. The same group conducted a pivotal 3-year trial (Maheu et al., 2014, n=399) demonstrating structural benefits — ASU significantly slowed hip joint space narrowing compared to placebo, providing disease-modifying evidence. Appelboom et al. (2001) confirmed benefits in a 3-month RCT. A meta-analysis by Christensen et al. (2008) included ASU among supplements with evidence supporting clinical efficacy. In France, ASU is sold as the prescription drug Piascledine 300 and has over 20 years of clinical use. ESCEO and OARSI guidelines include ASU as a recommended treatment option for OA.