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VOL. 5, ISSUE 1 (2023)
Diacerein in osteoarthritis: A systematic review of randomized controlled trials
Authors
Dr. Niranjan R Rathod, Dr. Aaditi Phadke, Dr. Parthasarathy Muralidharan, Mr. Ashwin Kotamkar, Dr. Amit Qamra
Abstract
Diacerein, an anthraquinone derivative, along with active metabolite
rhein, inhibits the interleukin -1β synthesis and metalloproteases involved in
cartilage breakdown in osteoarthritis (OA). It has been evaluated in multiple
randomized controlled trials (RCTs) of knee and hip OA. In this systematic
review, we included 13 RCTs assessing the efficacy and safety of diacerein in
knee and hip OA. Current evidence from RCTs indicates diacerein is effective in
reducing pain, and joint stiffness and improving functional index. Its efficacy
is significantly better than placebo and is comparable to conventional
analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs). It has an
analgesic-sparing effect probably attributable to its activity in reducing the
disease progression and carry-over effect even after discontinuation. Evidence
suggests the carry-over effect can be seen up to 8 weeks after discontinuing
diacerein. Gastrointestinal disturbances in terms of diarrhea, loose stools,
and urinary discoloration are more common with diacerein but these are
transient, mild to moderate in severity, and are often self-limiting. Evidence
also indicates good tolerability with diacerein. In conclusion, given its
efficacy, comparable tolerability, and inhibition of disease regreasing,
diacerein can be considered an important treatment in the armamentarium of OA
management. We consider that diacerein may also serve as an optional treatment
in patients with contraindications for NSAIDs or paracetamol.
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Pages:29-36
How to cite this article:
Dr. Niranjan R Rathod, Dr. Aaditi Phadke, Dr. Parthasarathy Muralidharan, Mr. Ashwin Kotamkar, Dr. Amit Qamra "Diacerein in osteoarthritis: A systematic review of randomized controlled trials". International Journal of Orthopaedics Research, Vol 5, Issue 1, 2023, Pages 29-36
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