The efficacy, safety and carry-over effect of diacerein in the treatment of painful knee osteoarthritis: a randomised, double-blind, NSAID-controlled study

Louthrenoo, Worawit; Nilganuwong, Surasak; Aksaranugraha, Sek; Asavatanabodee, Paijit; Saengnipanthkul, Sukit

doi:10.1016/j.joca.2007.02.021

Cited by 63 publications

(85 citation statements)

References 24 publications

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“…In NSAID-controlled studies, although the NSAID had an earlier onset of efficacy, the effect with diacerein was similar after 1 month, with a better safety profile (34). 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.…”

Section: Discussionmentioning

confidence: 99%

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

Pavelka

Trč

Karpas

et al. 2007

Arthritis & Rheumatism

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Objective. To determine whether the efficacy of diacerein persists at 2 months after the end of a 3-month treatment period, compared with placebo, in patients with painful knee osteoarthritis (OA).Methods. After a 1-week nonsteroidal antiinflammatory drug washout period, patients received either diacerein or placebo for 3 months, followed by an off-treatment period of 3 months to determine the carryover effects of the drug. Although patients were followed up through month 6, the primary efficacy end point was the percent change from baseline in pain (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] A) at month 5 (i.e., 2 months after the end of treatment) compared with placebo. The co-primary efficacy end point was the percent change from baseline in the total WOMAC score, also at month 5 versus placebo.Results. Two hundred three patients were screened, and 168 patients with painful knee OA were randomized. One hundred sixty-five patients were analyzed in an intent-to-treat analysis. At month 5, diacerein showed statistically significant superiority versus placebo as assessed with both the WOMAC A (P < 0.0001) and the total WOMAC (P < 0.0001), demonstrating the carryover effect of the drug. This superiority was already evident from month 2 for pain (P ‫؍‬ 0.001) and month 1 for total WOMAC (P ‫؍‬ 0.0021). Diacerein was safe and well tolerated. No serious or previously undocumented adverse events were observed during the study.Conclusion. This is the first published study of a symptomatic slow-acting OA drug in which the time of assessment of the primary outcome end points was 2 months after the end of a 3-month treatment period. The results show that diacerein is safe and effective for the treatment of knee OA and has a long carryover effect.Osteoarthritis (OA) is a disease affecting synovial joints and is characterized by degradation and loss of articular cartilage with subchondral bone remodeling, osteophyte formation, and synovial membrane inflammation (1,2). Clinical signs include fluctuating joint pain, swelling, stiffness, and loss of mobility, which increase in severity as the disease progresses. In the absence of a curative agent, the main objectives of OA management are to reduce symptoms, minimize functional disability, and limit the progression of structural changes, with the ultimate goal of delaying or avoiding arthroplasty.

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Section: Discussionmentioning

confidence: 99%

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

Pavelka

Trč

Karpas

et al. 2007

Arthritis & Rheumatism

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“…Human studies have found diacerein to be effective for treating OA [13,17,26] . In 2007, Louthrenoo and colleagues [26] reported on the efficacy, safety and carry-over effect of diacerein, in comparison to piroxicam, in the treatment of Thai patients with symptomatic knee osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…In 2007, Louthrenoo and colleagues [26] reported on the efficacy, safety and carry-over effect of diacerein, in comparison to piroxicam, in the treatment of Thai patients with symptomatic knee osteoarthritis. Ninety percent of the patients treated with diacerein showed significantly reduced pain compared with 70% baseline.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on the Effects of Diacerein and Diacerein Combined with Chondroitin Sulfate on Canine Hip Osteoarthritis

Nganvongpanit¹,

Boonsri²,

Sripratak³

et al. 2014

Kafkas Univ Vet Fak Derg

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SummaryThis study aimed to evaluate the effects of diacerein (DAR) and DAR combined with chondroitin sulfate (CS) for treatment of canine hip osteoarthritis (OA) in a 6-month clinical trial. Client-owned dogs included in the study consisted of 27 males and 25 females, aged 59.43±17.05 months old and weighing 17.63±5.19 kg. The dogs were randomly divided into five groups: DAR50 (administration of DAR 50 mg daily); DAR100 (DAR 100 mg daily); DAR50/CS (DAR 50 mg + CS 525 mg daily); DAR100/CS (DAR 100 mg + CS 525 mg daily); and CS (CS 525 mg daily). Dogs were re-examined monthly for 6 months after initiation of treatment. The assessment protocol included clinical scores and radiographic findings. Blood samples were collected three times (pre-treatment, and after 3 and 6 months) for evaluation of the serum biomarker, CS-WF6. Dogs treated with DAR showed statistically significant improvements (P<0.05) in lameness, joint mobility, pain on palpation, weight-bearing, and overall clinical score at 3, 6, 5, 4, and 4 months, respectively, after the start of treatment. Side effects, including diarrhea and dark-colored urine, were found in all groups receiving DAR. After the 3 rd month, the level of serum CS-WF6 in the CS group was significantly elevated (P<0.05), while the other four groups showed a significant decrease (P<0.05). The results showed that DAR 50 or 100 mg had a similarly positive therapeutic effect on dogs with osteoarthritis. The use of DAR alone or in combination with CS resulted in decreased degradation of OA cartilage.

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“…The American College of Cardiology Foundation (ACCF)/American College of Gastroenterology (ACG)/ American Heart Association (AHA) 2008 expert consensus recommends discontinuing treatment with of NSAIDs in patients with gastrointestinal events, such as gastrointestinal bleeding (3). However, discontinuing NSAID and/or LDA therapy impairs the quality of life and increases the risk of thrombosis (4).…”

Section: Introductionmentioning

confidence: 99%

Proton Pump Inhibitor Treatment Decreases the Incidence of Upper Gastrointestinal Disorders in Elderly Japanese Patients Treated with NSAIDs

et al. 2014

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Objective The Japanese health insurance system approved the use of proton pump inhibitors (PPIs) for the prevention of peptic ulcers in patients using low-dose aspirin (LDA) and/or non-steroidal anti-inflammatory drugs (NSAIDs). However, many orthopedists and physicians do not prescribe PPIs to elderly patients with atrophic gastritis. The aim of this study was to determine whether PPIs are effective in preventing gastrointestinal mucosal injury in elderly Japanese patients with atrophic gastritis. Methods We examined the associations between the use of antiulcer drugs and endoscopic findings in elderly Japanese patients using LDA or NSAIDs. Patients We evaluated 100 patients using LDA and 58 patients using non-aspirin NSAIDs 65 years of age or older. All patients underwent upper GI endoscopy to detect the presence of open ulcers and hemorrhagic lesions and assess the extent of atrophic gastritis. Results Among the patients using LDA, the prevalence of open ulcers was significantly lower in the patients using PPIs than in those using mucosal protective agent only and those not receiving antiulcer treatment (p<0.001). Among the patients using NSAIDs, the patients treated with PPIs exhibited a significantly lower incidence of open ulcers than the patients not receiving antiulcer treatment (p=0.012). Open-type atrophic gastritis was observed in nearly 70% of the patients. Conclusion The use of PPI treatment is advisable in order to prevent the discontinuation of LDA or NSAIDs due to the development of gastrointestinal disorders in elderly patients with atrophic gastritis.

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The efficacy, safety and carry-over effect of diacerein in the treatment of painful knee osteoarthritis: a randomised, double-blind, NSAID-controlled study

Abstract: Diacerein was as effective as piroxicam in reducing pain and improving function but, unlike piroxicam, displayed a carry-over effect and a better safety profile.

Cited by 63 publications

References 24 publications

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

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

Clinical Study on the Effects of Diacerein and Diacerein Combined with Chondroitin Sulfate on Canine Hip Osteoarthritis

Proton Pump Inhibitor Treatment Decreases the Incidence of Upper Gastrointestinal Disorders in Elderly Japanese Patients Treated with NSAIDs

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