Diacerhein in the treatment of osteoarthritis of the hip

Abstract

Objective. To determine the efficacy and safety of diacerhein, a potential new therapeutic agent with properties differing from those of existing nonsteroidal antiinflammatory drugs (NSAIDs), and of a combination of diacerhein and an NSAID (tenoxicam) in the treatment of osteoarthritis (OA) of the hip.Methods. Two hundred eighty-eight patients with painful OA of the hip were enrolled in an 8-week randomized, double-blind, placebo-controlled, 2 X 2 factorial design study. Four treatment groups were defined: 1) diacerhein placebo and tenoxicam placebo, 2) tenoxicam and diacerhein placebo, 3) diacerhein and tenoxicam placebo, and 4) diacerhein and tenoxicam. The daily dosages of diacerhein and tenoxicam were 100 mg and 20 mg, respectively.Results. Analyses of efficacy showed no interaction between diacerhein and tenoxicam in terms of efficacy, a clinically significant rapid ( 5 2 weeks) and persisting effect of tenoxicam during the 8 weeks of the study, and a slow-acting (6 weeks) effect of diacerhein. Moderate, transient diarrhea was the most frequent side effect observed in the diacerhein group (37%) compared with the placebo group (4%).Conclusion. Both tenoxicam and diacerhein appear to be superior to placebo, and neither agent appears to significantly enhance or detract from the Supported in part by

Retracted: The efficacy and safety of diacerein in the treatment of painful osteoarthritis of the knee: A randomized, multicenter, double‐blind, placebo‐controlled study with primary end points at two months after the end of a three‐month treatment period

“…Therefore, given current concerns about the safety of NSAIDs and COX-2 inhibitors, diacerein could be safely used instead of these drugs in the treatment of OA, especially in elderly patients who cannot take NSAIDs and COX-2 inhibitors. In addition, since diacerein is a symptomatic slow-acting OA drug, it could be safely combined with an NSAID or a COX-2 inhibitor during the first few weeks of treatment for earlier symptomatic relief, as previously demonstrated (20,21). Because diacerein does not inhibit COX and prostaglandin synthesis, it does not cause gastrotoxicity; on the contrary, it might prevent NSAID-induced gastrotoxicity, as demonstrated in an endoscopy study (19).…”

“…In a placebo-and NSAID-controlled study of patients with hip OA, with a treatment duration of 2 months (20), pain on movement (VAS) decreased in the diacerein-alone group, with the difference from placebo reaching statistical significance at week 6 (P ϭ 0.008) and at week 8 (P ϭ 0.025). Functional impairment also improved significantly compared with that in the placebo group at week 6 (P ϭ 0.031) and at week 8 (P ϭ 0.030).…”

Effect of Alpinia galanga extract on cartilage degradation and on gene expression in human chondrocyte and synovial fibroblast metabolism

“…It has particularly damaging effects on articular cartilage as it induces matrix MMPs and inhibits ECM synthesis by chondrocytes and suppresses chondrocyte proliferation [34]. Diacerein r (4,5-diacetoxy-9,10-dioxo-9,10-dihydroanthracene-2-carboxylic acid) has been used in the long-term treatment of OA [35][36][37] and it is currently under evaluation as a disease-modifying OA drug in randomized placebo-controlled clinical trails of patients with OA of the hip and knee. The efficacy of Diacerein r has been well documented in animal models including the post-contusive rabbit model and the accelerated canine model of OA [38,39].…”

Role of Interleukin-1 in Osteoarthrosis and Possibilities of Its Arrest

“…При сравнении анальгетического эффекта 100 мг диа-цереина и 20 мг теноксикама в рандомизированном двой-ном слепом плацебоконтролируемом исследовании у 286 больных коксартрозом был получен сходный результат, но эффект наступал на 2 нед раньше при приеме теноксикама [32]. Но у диацереина имеется важное преимущество перед нестероидными противовоспалительными препаратами в отношении как развития нежелательных побочных реак-ций, так и эффекта последействия.…”