ASU (avocado-soybean unsaponifiables, Piascledine)
Standardised fixed-ratio extract with multiple RCTs for hip and knee osteoarthritis pain and slowed joint-space narrowing.
Why
Avocado-soybean unsaponifiables (ASU) in a 1:2 ratio, sold as Piascledine 300 across France, Italy and Spain as a prescription product, has the most-studied evidence base of any 'nutraceutical' for hip and knee osteoarthritis. The Christensen 2008 meta-analysis confirmed reduced WOMAC pain and function scores vs placebo; the ERADIAS trial demonstrated slowed hip joint-space narrowing on radiographs over 3 years.
How it works
Unsaponifiable fraction includes phytosterols (β-sitosterol) and tocopherols. Inhibits IL-1β-induced chondrocyte metalloproteinase (MMP-3, MMP-13) expression and stimulates collagen type-II synthesis. Mechanism distinct from NSAIDs (no COX inhibition) and from glucosamine.
Expected onset · Symptomatic effect over 2–3 months; structural effects (imaging endpoints) over 2–3 years
How to take
Dosage
300 mg/day (Piascledine 300) as a single capsule. Continuous use over 3+ months for symptomatic benefit; longer for structural effect.
Timing
Once daily with the main meal
On the label
'Piascledine 300' (the regulatory product across much of Europe) or generic ASU 300 mg with stated 1:2 avocado:soy ratio.
Ideal for
Adults with symptomatic hip or knee osteoarthritis, particularly when NSAIDs are poorly tolerated; structural-progression context (hip OA on imaging).
Safety
Evidence
Christensen 2008 Osteoarthr Cartil meta-analysis (4 RCTs, n=664): ASU 300 mg/day significantly reduced pain and improved function in hip and knee OA vs placebo. Maheu 2014 ERADIAS RCT (n=399 hip OA): Piascledine 300 reduced joint-space narrowing progression at 3 years (~40% relative reduction), a disease-modifying signal rare among OA agents.
- Christensen et al., Osteoarthritis Cartilage 2008, symptomatic efficacy of avocado-soybean unsaponifiables (ASU) in osteoarthritis: meta-analysis
- Maheu et al., Ann Rheum Dis 2014, ERADIAS study: Piascledine 300 vs placebo for radiographic progression of hip OA (RCT, n=399)
- Lequesne et al., Arthritis Rheum 2002, ASU effect on hip osteoarthritis: 2-year prospective RCT (n=163)
Where to get it
Shop ASU (avocado-soybean unsaponifiables, Piascledine) on AmazonSponsored · As an Amazon Associate, Healicus earns from qualifying purchases.