Chinese herbal recipe versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial [ISRCTN70292892]

Teekachunhatean, Supanimit; Kunanusorn, Puongtip; Rojanasthien, Noppamas; Sananpanich, Kanit; Pojchamarnwiputh, Suwalee; Lhieochaiphunt, Sorasak; Pruksakorn, Sumalee

doi:10.1186/1472-6882-4-19

Cited by 41 publications

(66 citation statements)

References 14 publications

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“…An increasing number patients suffering from OA turn to complementary and alternative medicine treatments, including Chinese herbal medicine (14). Chinese herbal medicine, a major modality in traditional Chinese medicine (TCM) that has been practiced for thousands of years in China and other countries in Asia, has advanced in the treatment of OA, including improving clinical findings and inhibiting inflammatory reactions and cartilage degeneration (15,16). In vivo and in vitro studies have also indicated that Chinese herbal formulas produce multiple comprehensive effects against OA (17)(18)(19).…”

Section: Duhuo Jisheng Decoction-containing Serum Promotes Proliferatmentioning

confidence: 99%

“…However, the percentages of S phase cells exhibited the opposite trend, and increased in a time-dependent manner. In the DHJSD 2-h serum group, the percentages of S phase cells were16.91±0.64, 22.28±2.45 and 28.05±2.63% following treatment for 24, 48 and 72 h, respectively. These were significantly higher than the corresponding percentages of the blank serum group (09.92±2.00, 17.02±2.96 and 24.20±1.05%, respectively; P<0.01 or P<0.05).…”

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confidence: 92%

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Duhuo Jisheng Decoction-containing serum promotes proliferation of interleukin-1β-induced chondrocytes through the p16-cyclin D1/CDK4-Rb pathway

Fan

Huang

et al. 2014

Molecular Medicine Reports

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Duhuo Jisheng Decoction (DHJSD) is a traditional Chinese herbal medicine that has multiple uses, including as a treatment for osteoarthritis (OA). However, the molecular mechanisms underlying the therapeutic effects of DHJSD on OA remain unknown. In the present study, a serum pharmacological method was applied to investigate the effects of DHJSD on the proliferation of chondrocytes treated with interleukin‑1β (IL‑1β) in vitro. This is a cell model commonly used to reproduce the mechanisms involved in degenerative arthropathies, including OA. The most effective intervention conditions of DHJSD serum were examined by MTT assay. The degenerative chondrocyte model was established by IL‑1β‑culture for 24 h, and was verified by optical microscopy and immunohistochemical analyses. Following the successful establishment of the degenerative chondrocyte model, the chondrocytes were subsequently randomly divided into two groups: The blank serum group and the DHJSD treatment group. Subsequent to treatment with the corresponding serum, cell proliferation was detected by MTT assay and DNA staining followed by FACS analysis, and the mRNA and protein expression levels of cyclin D1, cyclin‑dependent kinase 4 (CDK4), retinoblastoma tumor suppressor protein (Rb) and p16 were measured by reverse transcription polymerase chain reaction and western blotting, respectively. The results indicated that the most effective condition for the promotion of chondrocyte proliferation was 10% concentration of DHJSD 2‑h serum, and the degenerative chondrocyte model was successfully reproduced by IL‑1β‑treatment for 24 h. The mRNA and protein expression levels of cyclin D1, CDK4 and Rb in the DHJSD serum‑treated cells were significantly increased compared with those in the blank serum group, whereas p16 expression was significantly downregulated. These results indicate that treatment of cells with DHJSD‑containing serum is able to promote IL‑1β‑induced chondrocyte proliferation by promoting G1/S phase transition via modulating the expressions of cyclin D1, CDK4, Rb and p16, which contribute to the clinical efficacy of DHJSD in OA.

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Section: Duhuo Jisheng Decoction-containing Serum Promotes Proliferatmentioning

confidence: 99%

mentioning

confidence: 92%

Duhuo Jisheng Decoction-containing serum promotes proliferation of interleukin-1β-induced chondrocytes through the p16-cyclin D1/CDK4-Rb pathway

Fan

Huang

et al. 2014

Molecular Medicine Reports

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“…In a 4-week double-blind RCT on knee OA, 3 g three times a day of Duhuo Jisheng Wan, a traditional Chinese cocktail of 15 plants, improved the LFI and multiple VAS of pain and stiffness as efficiently as 25 mg of diclofenac three times a day [129] (Table 4). Duhuo Jisheng Wan had a slower onset of action than diclofenac but an equal rate of adverse events, an observation that questions its safety.…”

Section: Resultsmentioning

confidence: 99%

Untitled

2006

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The scientific and medical community remains skeptical regarding the efficacy of nutrition for osteoarthritis despite their broad acceptation by patients. In this context, this paper systematically reviews human clinical trials evaluating the effects of nutritional compounds on osteoarthritis. We searched the Medline, Embase, and Biosis databases from their inception to September 2005 using the terms random, double-blind method, trial, study, placebo, and osteoarthritis. We selected all peerreviewed articles reporting the results of randomised human clinical trials (RCTs) in osteoarthritis that investigated the effects of oral interventions based on natural molecules. Studies on glucosamine and chondroitin sulfate were excluded. The quality of the RCTs was assessed with an osteoarthritic-specific standardised set of 12 criteria and a validated instrument. A best-evidence synthesis was used to categorise the scientific evidence behind each nutritional compound as good, moderate, or limited. A summary of the most relevant in vitro and animal studies is used to shed light on the potential mechanisms of action. Inclusion criteria were met by 53 RCTs out of the 2,026 identified studies. Good evidence was found for avocado soybean unsaponifiables. Moderate evidence was found for methylsulfonylmethane and SKI306X, a cocktail of plant extracts. Limited evidence was found for the Chinese plant extract Duhuo Jisheng Wan, cetyl myristoleate, lipids from green-lipped mussels, and plant extracts from Harpagophytum procumbens. Overall, scientific evidence exists for some specific nutritional interventions to provide symptom relief to osteoarthritic patients. It remains to be investigated whether nutritional compounds can have structure-modifying effects.

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“…Only two trials demonstrated efficacy when compared to an active comparator: NR-INF-02 (containing curcumin) 24 compared to glucosamine sulfate, 1,500 mg; and Harpadol ® (Devil's claw), containing Harpagophytum procumbens, compared to diacerein, 100 mg 77 (Figure 3). Two therapies demonstrated significantly worse efficacy than active control: a Chinese herbal recipe (Duhuo Jisheng Wan) over 4 weeks; 62 and willow bark extract (Salix daphnoides) over 42 days 63 of treatment. Both studies used the same active control (diclofenac, 75 mg/day or 100 mg/day) (Figure 4).…”

Section: Efficacymentioning

confidence: 99%

“…Botanical therapies that demonstrate efficacy when compared to an active comparator are olive oil 29 and UP446 28 (both low and high doses). Du huo ji sheng wan 62 and willow bark 63 favored the active comparator. There was no association between ES and risk of bias (ρ=0.2; P=0.…”

Section: Function Efficacymentioning

confidence: 99%

Efficacy and safety of plant-derived products for the treatment of osteoarthritis

Laslett¹,

Jin²,

Jones³

2014

BTAT

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Background: Plant-derived therapies are traditionally used as medicines, but they have generally not been studied with the same rigor as pharmaceutical agents. This review summarizes the use of plant-derived products for osteoarthritis. Methods: Sixty-three identified trials were summarized for pain, function, and safety outcomes using standardized mean differences (SMDs) and relative risks. Results: Plant-derived therapies are effective for treating pain compared to placebo, as assessed using visual analog scores and numerical rating scales (SMD, 1.08; 95% confidence interval [CI]: 0.72-1.44), or Western Ontario and McMaster University Osteoarthritis Index (WOMAC)/Knee injury and Osteoarthritis Outcome Score (KOOS) pain scales (SMD, 0.98; 95% CI: 0.62-1.35). Classes demonstrating overall efficacy in more than one trial for either visual analog scores or WOMAC pain included Boswellia serrata, capsaicin, and ginger; there was single-trial evidence of the efficacy of another nine agents. Plant-derived therapies have similar efficacy to an active comparator (SMD, 0.32; P=0.08; -0.08; P=0.14). Therapies are also effective for functional outcomes compared to placebo (SMD, 0.92; P,0.001). However, significant heterogeneity remains for all pain and function outcomes, indicating that the results need to be interpreted with caution. Risk of adverse events was similar to placebo (relative risk =1.13; P=0.1), but reduced compared to an active comparator (relative risk, 0.75; P,0.001). Conclusion: Plant-derived therapies may be efficacious in treating osteoarthritic pain and functional limitations, and they appear to be safer than other active therapies. However, quality trials and long-term data are lacking, and the number of trials for each therapy is limited. Comparisons would be assisted by trial standardization.

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Chinese herbal recipe versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial [ISRCTN70292892]

Cited by 41 publications

References 14 publications

Duhuo Jisheng Decoction-containing serum promotes proliferation of interleukin-1β-induced chondrocytes through the p16-cyclin D1/CDK4-Rb pathway

Duhuo Jisheng Decoction-containing serum promotes proliferation of interleukin-1β-induced chondrocytes through the p16-cyclin D1/CDK4-Rb pathway

Untitled

Efficacy and safety of plant-derived products for the treatment of osteoarthritis

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