Diacerein for osteoarthritis

Fidelix, TSA; Soares, BGO; Trevisani, V.S.

doi:10.1002/14651858.cd005117

Cited by 17 publications

(22 citation statements)

References 13 publications

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“…In a Cochrane review of 7 randomized controlled trials involving 2,069 patients, it was concluded that diacerein had a small, consistent benefit on pain in OA (36). Another recent meta-analysis, which included 19 randomized controlled trials and 2,637 patients, provided evidence of significant superiority of diacerein over placebo, and equality with NSAIDs, for improvement in pain and function during the active treatment period in patients with hip and/or knee OA (37).…”

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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“…4 65 With these guidelines, the effect of the weight loss may be achieved within a few months, resulting in a clinical ES larger than most non-operative treatments systematically reviewed, applying meta-analyses, [66][67][68][69] and at least comparable to the possible effect of walking. 70 In the present meta-analysis, it is obvious that the strategies applied in the individual RCTs combine great diversity in both magnitude and intensity of the (weight-reducing) dietary strategies.…”

Section: Discussionmentioning

confidence: 99%

Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis

Christensen

Bartels

Astrup

et al. 2006

Annals of the Rheumatic Diseases

535

369

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This review aims to assess by meta-analysis of randomised controlled trials (RCTs) changes in pain and function when overweight patients with knee osteoarthritis (OA) achieve a weight loss. Systematic searches were performed and reference lists from the retrieved trials were searched. RCTs were enclosed in the systematic review if they explicitly stated diagnosis of knee OA and reported a weight change as the only difference in intervention from the control group. Outcome Measures for Arthritis Clinical Trials III outcome variables were considered for analysis. Effect size (ES) was calculated using RevMan, and meta-regression analyses were performed using weighted estimates from the random effects analyses. Among 35 potential trials identified, four RCTs including five intervention/ control groups met our inclusion criteria and provided data from 454 patients. Pooled ES for pain and physical disability were 0.20 (95% CI 0 to 0.39) and 0.23 (0.04 to 0.42) at a weight reduction of 6.1 kg (4.7 to 7.6 kg). Meta-regression analysis showed that disability could be significantly improved when weight was reduced over 5.1%, or at the rate of .0.24% reduction per week. Clinical efficacy on pain reduction was present, although not predictable after weight loss. Metaregression analysis indicated that physical disability of patients with knee OA and overweight diminished after a moderate weight reduction regime. The analysis supported that a weight loss of .5% should be achieved within a 20-week period-that is, 0.25% per week. Being overweight is an important factor in osteoarthritis (OA), and obese subjects are at high risk of developing OA in the knee.1 The average body weight of the increasing number of elderly people has steadily risen in recent years. 2The obesity problem appears across multiple age groups, 3 and there is reason to believe that the obesity-related knee OA will increase in both numbers and severity.4 5 Obesity must be taken seriously in any discussion concerning health issues, 6 including that of the bone and joints.7 Current European evidence-based recommendations for the management of knee OA, devised by the European League Against Rheumatism, include weight loss as a sensible option in overweight patients with knee OA. However, this recommendation is primarily supported by expert opinion 8 ; meta-analysis of randomised controlled trials (RCTs; ie, category 1a evidence) is yet to be undertaken.The objective of this systematic review and meta-analysis was to assess and quantify whether the clinical benefits (changes in pain and functional disability) 9 are evident in patients with knee OA after weight loss. Applying the rules of evidence-based medicine, 10 11 with focus on quality (ie, magnitude and intensity) of the intervention, 12 we aimed to meta-analyse 13 and present doseresponse efficacy estimates of weight loss in obese patients with knee OA. METHODSRetrieval of published studies A systematic literature search was carried out to identify and locate all controlled and preferably randomised trial...

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“…According to the adverse effects of the rapid action drugs for symptomatic relief, there has been an increased use of symptomatic slow acting drugs (chondroprotective drugs or connective tissue structure modifying agents) such as chemically modified tetracyclines, glucosamine (chondroitin sulfate) and diacetylrhein (diacerein) [34,35].…”

Section: Discussionmentioning

confidence: 99%

Effects of sesamin on the biosynthesis of chondroitin sulfate proteoglycans in human articular chondrocytes in primary culture

et al. 2013

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Diacerein for osteoarthritis

Cited by 17 publications

References 13 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

Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis

Effects of sesamin on the biosynthesis of chondroitin sulfate proteoglycans in human articular chondrocytes in primary culture

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