Ciencia Y Salud

The efficacy, safety and carry-over effect of diacerein in the

treatment of painful knee osteoarthritis: a randomised,

double-blind, NSAID-controlled study1

W. Louthrenoo M.D.y*, S. Nilganuwong M.D.z, S. Aksaranugraha M.D.x,

P. Asavatanabodee M.D.k, S. Saengnipanthkul M.D.{ and the Thai Study Group

y Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine,

Chiang Mai University, Chiang Mai, Thailand

z Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine,

Siriraj Hospital, Mahidol University, Bangkok, Thailand

x Department of Rehabilitation Medicine, Chulalongkorn University, Bangkok, Thailand

k Rheumatic Disease Unit, Department of Internal Medicine, Pramongkutklao Hospital and

College of Medicine, Bangkok, Thailand

{ Department of Orthopaedics, Khon Kaen University, Khon Kaen, Thailand

Summary

Objective: To evaluate the efficacy, safety and carry-over effect of diacerein, in comparison to piroxicam, in the treatment of Thai patients with

symptomatic knee osteoarthritis (OA).

Design: This was a double-blind, randomised, piroxicam-controlled, parallel-group study. A 7-day non-steroidal anti-inflammatory drug washout

period was followed by a 16-week treatment period with either diacerein 100 mg/day or piroxicam 20 mg/day, and an 8-week treatmentfree

observation period. The primary efficacy criterion was pain on Western Ontario and McMaster University Osteoarthritis (WOMAC) A. The

secondary criteria included WOMAC B, C and total WOMAC, paracetamol intake, Short Form-36 questionnaire and global judgements on

efficacy and tolerability by patients and investigators.

Results: Of 171 randomised patients, 150 completed the study and 161 were analysed in the intent-to-treat population (diacerein: 82, piroxicam:

79). Pain (WOMAC A) decreased to a similar extent in both groups at Week 16 (diacerein: 69.7% 31.5%; piroxicam: 74.1  26.2%;

P ¼ n.s.). On treatment discontinuation, pain increased in the piroxicam group at Weeks 20 (47%  47.8%) and 24 (26.8%  60.6%) while

improvements persisted in the diacerein group at Weeks 20 (66.9%  35.9%)

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