Tier 2 — strong

24-Week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain

Kristine L. Clark, Wayne Sebastianelli, Klaus R. Flechsenhar, Douglas F. Aukermann, Felix Meza, Roberta L. Millard, John R. Deitch, Paul S. Sherbondy, Ann Albert
Current Medical Research and Opinion 2008 24(5):1485–1496

Bibliography

PubMed
PMID 18416885
DOI
10.1185/030079908X291967
Funding
Declaration of interest (verbatim): "This research was sponsored by GELITA Health GmbH, Eberbach, Germany. […] The nutritional supplement collagen hydrolysate used for this research project was provided by GELITA Health GmbH, Eberbach, Germany."
Competing interests
The study was supported in part by GELITA AG. Co-author Klaus R. Flechsenhar was affiliated with GELITA Health GmbH, Research and Development, Eberbach, Germany. This direct manufacturer/research affiliation and sponsor support are relevant commercial-context considerations when interpreting the findings.

Study snapshot

DesignMulti-centre, prospective, randomised, double-blind, placebo-controlled trial
ModelVarsity/club-level Penn State University athletes with activity-related joint pain but no diagnosed osteoarthritis or degenerative joint disease
Sample147 randomised (72 M, 75 F); 97 completed evaluable analysis (48 treatment, 49 placebo); mean age ~20 years
Intervention10 g/day CH-Alpha® collagen hydrolysate (GELITA) or matched placebo for 24 weeks.
Duration24 weeks (5 study visits at baseline, 6, 12, 18, and 24 weeks)
EndpointsJoint pain at rest — VAS, physician-assessed; Joint pain at rest — VAS; participant-assessed; Joint pain when walking, standing, carrying, lifting, running straight, changing direction (VAS); Frequency of alternative therapy use

What the study showed, in plain terms

Athletes can experience activity-related joint discomfort even without diagnosed osteoarthritis or an acute injury. This 2008 trial tested whether a specific collagen hydrolysate changed those symptoms during 24 weeks of daily use.

Researchers randomized 147 college athletes to 10 g/day of a specific collagen hydrolysate or a matched placebo. Joint pain was recorded at rest and during activities including walking, standing, carrying, lifting and changing direction.

Several pain outcomes favoured collagen at the end of follow-up, and use of other pain remedies was lower in the collagen group. However, only 97 of 147 randomized participants were included in the evaluable analysis, the study was sponsored by the product manufacturer, and the symptom endpoints did not measure cartilage structure. Later-emerging symptom differences do not establish cartilage remodelling or explain the mechanism.

Key findings

  • Physician-assessed joint pain at rest improved more with collagen than placebo: −1.37 ± 1.78 versus −0.90 ± 1.74 points (p=0.025).
  • Participant-assessed joint pain while walking improved −1.11 ± 1.98 versus −0.46 ± 1.63 (p=0.007).
  • Joint pain while standing improved −0.97 ± 1.92 versus −0.43 ± 1.74 (p=0.011).
  • Joint pain while carrying objects improved −1.45 ± 2.11 versus −0.83 ± 1.71 (p=0.014).
  • Joint pain while lifting improved −1.79 ± 2.11 versus −1.26 ± 2.09 (p=0.018).
  • Use of alternative pain therapies was lower at the final visit in the collagen group (12 versus 39 instances; p<0.001).
  • In the prespecified knee-arthralgia subgroup (n=63), six of nine pain parameters reached statistical significance.
  • Standardized effects for some pain outcomes were small to moderate. The trial did not prespecify a structural endpoint or establish a cartilage-repair mechanism.
  • Between-group differences were more apparent later in follow-up; delayed symptom change does not distinguish structural remodelling from other explanations.

What this study can and cannot tell us

  • Only 97 of 147 randomized athletes were included in the efficacy evaluation reported in the paper, leaving substantial attrition and limiting the strength of the treatment-effect estimate.
  • Primary outcomes were subjective joint-pain ratings rather than imaging, structural cartilage outcomes or objective disease endpoints.
  • The trial was supported in part by GELITA AG, and co-author Klaus R. Flechsenhar was affiliated with GELITA Health GmbH Research and Development. This direct manufacturer/sponsor involvement should be considered when interpreting the study.
  • The study involved athletes with activity-related joint pain and should not be treated as proof of efficacy for osteoarthritis or other diagnosed joint diseases.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology