“A Comparative study to estimate the efficacy of Diacerein and Diclofenac given alone or in combination to Osteoarthritic population with respect to pain alleviation and regaining joint function”.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Introduction: Osteoarthritis (OA) is a heterogeneous group of conditions that lead to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins. OA is the most common joint disease of human both in the western world as well as India. Age, Major joint trauma and repetitive joint use (Anterior cruciate ligament insufficiency or meniscus damage and meniscectomy), Obesity, genetic differences have been found as risk factors for development of OA. Cardinal feature of OA is progressive loss of articular cartilage where all the components of synovial joint: subchondral bone, synovium, meniscus, ligaments and supporting neuromuscular apparatus as well as cartilage are affected are affected. Remodeling and hypertrophy of bone are major features of OA. . Pharmacologic therapy includes topical and oral use of Non- steroidal anti- inflammatory drugs (NSAIDs), paracetamol, selective COX-2 inhibitors, opioids, intra-articular/ peri- articular glucocorticoids or hyaluronate injection. Dacetine, specifically its active diacetyl derivatives, rhein, is an interleukin-1 inhibitor. Rhein is an anthraquinone found in plants of the generus Cassis and has moderate anti-inflammatory and analgesic activity and weak laxative effects. There is a comparision on its analgesics efficacy and carry- over effect standard NSAID drug used in OA patients and to see the efficacy and safety of combining diclofenac given at reduced dose when compared to standard therapy. Aims & Objective: To study the efficacy and adverse effect profile of Diacerein and Diclofenac given alone or in combination in Indian osteoarthritic population with respect to pain alleviation and regaining joint function also the carry-over effect of Diacerein and Diacerein-Diclofenac combination in comparison to Diclofenac given alone. MATERIALS AND METHODS: The study was conducted in Department of Pharmacology and Department of Orthopaedics of Saraswathi Institute of Medical Sciences. During the period of September 2018 to January 2019. A single-blind, randomized, parallel, comparative model was designed for the study. Patients attending the OPD of Orthopedics Department, Saraswathi Hospital were screened for Osteoarthritis of knee. RESULT: There is a carry over effect as suggested by the primary efficacy end point. Diacerein as well as the combination have a carry over effect which provides significant maintenance of pain and function when compared to diclofenac when the drugs are withdrawn. Pain during walking is decreased both by diacerein and combination at least as much as diclofenac. But if overall activity of subject is taken into account, diacerein is better than combination as well as diclofenac alone. CONCLUSION: Diacerein has been studied in patient sufeering from OA and its efficacy and safety compared to standard treatment regimens. Diacerein has been shown to be as efficacious as standard NSAIDs like diclofenac are in addition, has been shown to possess carry-over effect. This leads to less analgesic consumption after stopping diacerein. Meta analysis and systematic review of the studies done reveal that there is a small but significant benefit of diacerein over NSAIDs because of its analgesic action and carry-over effect.
Authors and Affiliations
Dr. AbdulAman Azad, Dr Anand kumar Shukla
Keywords
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- EP ID EP467764
- DOI 10.9790/0853-1802155962.
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