Vitamin E may not be effective against osteoarthritis, a new study from Australia suggests. A study published in the October issue of Annals of the Rheumatic Diseases (60:946-49, 2001) indicates that participants taking 500 IU/d vitamin E for six months did not experience a reduction of pain related to osteoarthritis (OA) of the knee. In fact, the placebo group reported a decrease in pain levels at the study's completion, although researchers suggested that this finding was due to the fact that the subjects taking placebo indicated higher degrees of pain at baseline. The double-blind, randomised, placebo-controlled study involved 77 patients with OA of the knee who were monitored with regard to pain, stiffness and function. Results indicated that vitamin E did not benefit patients at one month, three months or six months for any of the outcome measures. Researchers from the Alfred Hospital, led by Dr. C. Brand, concluded that vitamin E showed no benefit for managing the symptoms of knee OA, although they noted that the role of vitamin E in preventing OA progression is currently being studied. "Vitamin E and other antioxidants quench free radials and therefore can reduce the progression of [osteoarthritis]," commented Vishwa Singh, Ph.D., director of human nutrition research at Parsippany, N.J.-based Roche Vitamins Inc. "It's not the etiology of the disease itself [vitamin E] will work on, but the consequences of the disease - which lead to more aggravation - that can be minimised by antioxidants." The Australian researchers noted that short-term clinical studies have demonstrated that subjects taking vitamin E (alpha-tocopherol) reported similar relief of pain over placebo as in studies using diclofenac (a prescription medicine indicated for the acute and chronic treatment of signs and symptoms of OA and rheumatoid arthritis). Researchers also mentioned that previous research has indicated vitamin E for reducing symptoms of OA. One such publication that indicated vitamin E's effectiveness against OA was published in Rheumatologie (57(4):207-14, 1998). German researchers in Munich conducted a research review covering vitamin E therapy in rheumatic diseases. The review authors concluded, "[S]tudies with sound methodology have shown a beneficial effect in rheumatic diseases, mainly in the reduction of pain." In regard to the failure of the Australian study to demonstrate benefits for patients with osteoarthritis, Dr. Singh added, "The outcome measurement that has been done in this case in terms of determining the pain threshold is perhaps not the right tool to reflect the benefit of vitamin E on this condition. One of the criteria for working with vitamin E would be antioxidant property. If one has to see the benefit and measure it, it should be done in terms of long-term progression of the disease and secondary manifestations, that is, inflammation and prolonged degradation of the tissue itself."