Avocado/soybean unsaponifiables (ASU) for osteoarthritis

Marion Hauser Curcumin and osteoarthritisMarion Hauser, MS, RD

Plant oils are a favorite of the makers of natural dye-free, chemical-free soaps. Among popular oils used to make soap are those of the avocado and soy plant. The process of making soap is called saponification. The oily, waxy by-product that is not soluble enough to make soap is called the unsaponifiables. In the 1950s Dr. Henri Thiers began research that suggested that this by-product, may help patients with osteoarthritis.

Almost five decades after Dr. Thiers began his work, doctors in France writing in the journal Arthritis and rheumatism in 1998, published a paper with the incredibly descriptive title:

Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip:

A prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial with a six-month treatment period and a two-month follow up demonstrating a persistent effect.

This study has it all, placebo, double-blind (neither the patient or health care provider who was getting the Avocado-soybean Unsaponifiables and who was getting the placebo), short-term follow-up, longer follow-up. As good a study as you would want.

The French team wanted to see how effective and safe avocado/soybean unsaponifiables were the treatment of patients with symptomatic knee or hip osteoarthritis as well as the potential residual effects of ASU after stopping treatment.

So they found patients with regular, painful, primary osteoarthritis of the knee (n = 114) or hip (n = 50) to test. The first thing they did was a 15-day washout period for nonsteroidal anti-inflammatory drugs (NSAIDs) preceded the study. But once the study started if NSAIDs were needed in either group, those patients could take them.

  • One hundred forty-four patients were evaluable at month 6 (75 taking ASU; 69 taking placebo).
    • Significant pain decreases were seen in the ASU group.
    • Fewer patients in the ASU group required NSAIDs (48%, versus 63% in the placebo group).
    • Overall functional disability was significantly reduced in the ASU group.
    • Improvement appeared more marked in patients with hip osteoarthritis.
    • A residual effect was observed at month 8 (The Avocado-soybean Unsaponifiables had been discontinued but still provided benefit)
    • ASU treatment showed significant symptomatic efficacy over placebo in the treatment of OA, acting from month 2 and showing a persistent effect after the end of treatment.(1)

Basically, Avocado-soybean Unsaponifiables provided some good benefit.

Avocado-soybean Unsaponifiables may provide an alternative to NSAIDs

Now this study followed a 1997 study that also suggested Avocado-soybean Unsaponifiables may provide an alternative to NSAIDs. This study also came from French researchers interested in plant oil extracts. Looking at patients with either knee or hip osteoarthritis using NSAIDs to manage their pain. What these doctors wanted to do was to see if they could get rid of the NSAIDs with Avocado-soybean Unsaponifiables.

  • The patients in this study were given one capsule per day of avocado/soybean unsaponifiables or a placebo for three months.
  • During the first 45 days, patients in both groups were also given one of seven predefined NSAIDs.
  • The primary efficacy criteria were the rate of patients taking back an NSAID and the delay before re-intake.
    • The number of patients who went back NSAID therapy was significantly smaller in the group treated by avocado/soybean unsaponifiables (33; 43.4%) than in the placebo group (53; 69.7%)
    • Also, beyond day 54, the time spent off NSAID therapy was shorter in the placebo group.
    • The functional index showed a significantly greater improvement in the avocado/soybean unsaponifiables group than in the placebo group.
    • After six weeks, avocado/soybean unsaponifiables reduced the need for NSAID in patients with lower limb osteoarthritis.(2)

Basically, again Avocado-soybean Unsaponifiables provided some good benefit and helped some reduce the need for NSAIDs.

A 2003 study from Belgium is seen as one of the landmarks in Avocado-soybean Unsaponifiables. In this laboratory study, doctors looked to see how Avocado-soybean Unsaponifiables benefited patients with osteoarthritis. What they found was that the extracts promoted the growth of cartilage while preventing cartilage breakdown.(3)

Do Avocado-soybean Unsaponifiables STOP osteoarthritis progression? Research suggests that it at least slows it down

In 2015, in the medical journal Cartilage, doctors lead by Blaine A. Christiansen, Ph.D., BS, MS for of the University of California at Davis Health summarized their research with this closing statement:

Avocado-soybean Unsaponifiables may prove to be an effective treatment option for symptomatic osteoarthritis, as they have been shown to possess chondroprotective, anabolic, and anticatabolic properties, as well as anti-inflammatory properties. At the clinical level, ASUs reduce pain and stiffness while improving joint function. Importantly, ASUs are a natural, slow-acting agent that do not merely address acute pain but actively prevent progression of osteoarthritis symptoms.”(4)

In 2018, doctors at leading universities in Egypt and Saudi Arabia added to the building research:

  • Avocado-soybean Unsaponifiables significantly slowed down synovium, cartilage, and subchondral degeneration by acting in an anti-inflammatory capacity
  • These results provide evidence of the structure-modifying abilities of ASU via its anti-oxidative and anti-inflammatory properties and suggests that ASU can be used as a potential disease-modifying treatment for osteoarthritis.(5)

Avocado-soybean Unsaponifiables are the combined oil extracts of these plants. You can find Avocado-soybean Unsaponifiables (ASU) as a supplement, you can also find these oils in the natural food aisle. According to most sources, the proper mixture is one-third avocado oil and two-thirds soybean oil. Gelcap daily supplements are suggested at 300mg per day.

References for this article

1 Maheu E, Mazières B, Valat JP, Loyau G, Loët XL, Bourgeois P, Grouin JM, Rozenberg S. Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip: A prospective, randomized, double‐blind, placebo‐controlled, multicenter clinical trial with a six‐month treatment period and a two‐month followup demonstrating a persistent effect. Arthritis & Rheumatology. 1998 Jan 1;41(1):81-91. [Google Scholar]

2 Blotman F, Maheu E, Wulwik A, Caspard H, Lopez A. Efficacy and safety of avocado/soybean unsaponifiables in the treatment of symptomatic osteoarthritis of the knee and hip. A prospective, multicenter, three-month, randomized, double-blind, placebo-controlled trial. Revue du rhumatisme (English ed.). 1997 Dec;64(12):825-34. [Google Scholar]

3 Henrotin YE, Sanchez C, Deberg MA, Piccardi N, Guillou GB, Msika P, Reginster JY. Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes. The Journal of rheumatology. 2003 Aug 1;30(8):1825-34. [Google Scholar]

4 Christiansen BA, Bhatti S, Goudarzi R, Emami S. Management of osteoarthritis with avocado/soybean unsaponifiables. Cartilage. 2015 Jan;6(1):30-44. [Google Scholar]

5 Al-Afify AS, El-Akabawy G, El-Sherif NM, El-Safty FE, El-Habiby MM. Avocado soybean unsaponifiables ameliorates cartilage and subchondral bone degeneration in mono-iodoacetate-induced knee osteoarthritis in rats. Tissue and Cell. 2018 Jun 1;52:108-15. [Google Scholar]

 

 

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