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Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials

Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of diacerein in the treatment of osteoarthritis is controversial. We systematically reviewed the efficacy, safety, and residual effectiven...

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Autores principales: Li, Guangting, Zhang, Zhongming, Ye, Yingying, Li, Huiping, Luo, Hanwen, Tang, Kaijiang, Lai, Yongrong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678537/
https://www.ncbi.nlm.nih.gov/pubmed/36401382
http://dx.doi.org/10.1097/MD.0000000000031700
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author Li, Guangting
Zhang, Zhongming
Ye, Yingying
Li, Huiping
Luo, Hanwen
Tang, Kaijiang
Lai, Yongrong
author_facet Li, Guangting
Zhang, Zhongming
Ye, Yingying
Li, Huiping
Luo, Hanwen
Tang, Kaijiang
Lai, Yongrong
author_sort Li, Guangting
collection PubMed
description Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of diacerein in the treatment of osteoarthritis is controversial. We systematically reviewed the efficacy, safety, and residual effectiveness of diacerein. OBJECTIVES: To estimate the symptomatic efficacy, residual effect and safety of diacerein in the treatment of knee osteoarthritis, using a meta-analysis of published randomized controlled trials (RCTs). METHODS: On December 1, 2021, we searched PubMed Medline, Web of Science, Cochrane Library databases, Wan Fang Medical Database, and National Knowledge Infrastructure. This study followed the inclusion criteria of the principle P(Population), I(Intervention), C(Comparison), O(Outcome), S (Study design) principle. All studies were randomized controlled trials of knee osteoarthritis. Cochrane bias risk assessment tool was used to assess the risk of bias. Meta-analyses were performed using a random-effects model. To explore sources of heterogeneity, subgroup analysis, sensitivity analysis, regression analysis and publication bias analysis were performed. Drug side effects with complete data were extracted from the included articles and then a combined analysis of these data was performed. RESULTS: Eight studies were eligible and were included in our analysis (N = 1277 participants). All studies were randomized controlled trials of knee osteoarthritis. There was no significant difference in reduction of joint pain and improvement of function between diacerein and the control group. However, subgroup analysis suggested, compared with the placebo group, diacerein treatment yielded an improved mean reduction in visual analogue scale score of-0.44% (95% confidence interval [CI]-0.79 to 0.09), an improved the western Ontario and McMaster universities (physical function) score of -0.44% (95% CI-0.72 to -0.12). Follow-up analysis after discontinuation showed that diacerein treatment had a significant residual effect (95% CI-0.81 to- 0.24). Data on drug side effects described in the included articles were extracted for statistical analysis. There was an increased risk of diarrhea with diacerein (Risk Ratio [RR] = 1.95 [1.03 to 2.47]) and withdrawal event from therapy (RR = 0.93 [0.75 to 1.15]). CONCLUSION: Diacerein might be considered an effective drug for the treatment of patients with KOA, showing short-term residual effectiveness. Although it is associated with an increased risk of diarrhea, the adverse event is mostly tolerable.
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spelling pubmed-96785372022-11-22 Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials Li, Guangting Zhang, Zhongming Ye, Yingying Li, Huiping Luo, Hanwen Tang, Kaijiang Lai, Yongrong Medicine (Baltimore) 6900 Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of diacerein in the treatment of osteoarthritis is controversial. We systematically reviewed the efficacy, safety, and residual effectiveness of diacerein. OBJECTIVES: To estimate the symptomatic efficacy, residual effect and safety of diacerein in the treatment of knee osteoarthritis, using a meta-analysis of published randomized controlled trials (RCTs). METHODS: On December 1, 2021, we searched PubMed Medline, Web of Science, Cochrane Library databases, Wan Fang Medical Database, and National Knowledge Infrastructure. This study followed the inclusion criteria of the principle P(Population), I(Intervention), C(Comparison), O(Outcome), S (Study design) principle. All studies were randomized controlled trials of knee osteoarthritis. Cochrane bias risk assessment tool was used to assess the risk of bias. Meta-analyses were performed using a random-effects model. To explore sources of heterogeneity, subgroup analysis, sensitivity analysis, regression analysis and publication bias analysis were performed. Drug side effects with complete data were extracted from the included articles and then a combined analysis of these data was performed. RESULTS: Eight studies were eligible and were included in our analysis (N = 1277 participants). All studies were randomized controlled trials of knee osteoarthritis. There was no significant difference in reduction of joint pain and improvement of function between diacerein and the control group. However, subgroup analysis suggested, compared with the placebo group, diacerein treatment yielded an improved mean reduction in visual analogue scale score of-0.44% (95% confidence interval [CI]-0.79 to 0.09), an improved the western Ontario and McMaster universities (physical function) score of -0.44% (95% CI-0.72 to -0.12). Follow-up analysis after discontinuation showed that diacerein treatment had a significant residual effect (95% CI-0.81 to- 0.24). Data on drug side effects described in the included articles were extracted for statistical analysis. There was an increased risk of diarrhea with diacerein (Risk Ratio [RR] = 1.95 [1.03 to 2.47]) and withdrawal event from therapy (RR = 0.93 [0.75 to 1.15]). CONCLUSION: Diacerein might be considered an effective drug for the treatment of patients with KOA, showing short-term residual effectiveness. Although it is associated with an increased risk of diarrhea, the adverse event is mostly tolerable. Lippincott Williams & Wilkins 2022-11-18 /pmc/articles/PMC9678537/ /pubmed/36401382 http://dx.doi.org/10.1097/MD.0000000000031700 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 6900
Li, Guangting
Zhang, Zhongming
Ye, Yingying
Li, Huiping
Luo, Hanwen
Tang, Kaijiang
Lai, Yongrong
Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
title Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
title_full Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
title_fullStr Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
title_full_unstemmed Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
title_short Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials
title_sort efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: a meta-analysis of randomized placebo-controlled trials
topic 6900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678537/
https://www.ncbi.nlm.nih.gov/pubmed/36401382
http://dx.doi.org/10.1097/MD.0000000000031700
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