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To conduct a systematic review and network meta-analysis of randomized controlled trials (RCTs) with the aims of comparing relevant clinical outcomes (that is, visual analog scores (VAS), total and sub-Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores, Lequesne algofunctional index, joint space width change, and adverse events) between diacerein, glucosamine, and placebo.
This article
focuses on the relevant clinical details in determining the safety and efficacy
of various drugs used in the consideration of osteoarthritis knee. This investigation demonstrates the potency, efficacy and
safety of diacerein and glucosamine in the treatment of osteoarthritis of the
knee.
To conduct a
systematic review and network meta-analysis of randomized controlled trials
(RCTs) with the aims of comparing relevant clinical outcomes (that is, visual
analog scores (VAS), total and sub-Western Ontario and McMaster Universities
Osteoarthritis index (WOMAC) scores, Lequesne algofunctional index, joint space
width change, and adverse events) between diacerein, glucosamine, and placebo.
Medline and
Scopus databases were searched from inception to 29 August 2014, using PubMed
and Scopus search engines and included RCTs or quasi-experimental designs
comparing clinical outcomes between treatments. Data were extracted from
original studies. A network meta-analysis was performed by applying weight
regression for continuous outcomes and a mixed-effect Poisson regression for
dichotomous outcomes.
Thirty-one of 505
identified studies were eligible. Compared to placebo, glucosamine showed a
significant improvement with unstandardized mean differences (UMD) in total
WOMAC, pain WOMAC, function WOMAC, and Lequesne score of −2.49 (95% confidence
interval (CI) −4.14, −0.83), −0.75 (95% CI: −1.18, −0.32), −4.78 (95% CI:
−5.96, −3.59), and −1.03 (95% CI: −1.34, −0.72), respectively. Diacerein
clinically improves visual analog scores, function WOMAC, and stiffness WOMAC
with UMD values of −2.23 (95% CI: −2.82, −1.64), −6.64 (95% CI: −10.50, −2.78),
and −0.68 (95% CI: −1.20, −0.16) when compared to placebo.
The network
meta-analysis suggests that diacerein and glucosamine are equally efficacious
for symptom relief in knee OA, but that the former has more side effects.
Eur J Med Res. 2015; 20(1): 24
Efficacy and safety of glucosamine, diacerein, and NSAIDs in osteoarthritis knee: a systematic review and network meta-analysis
Jatupon Kongtharvonskul et al.
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