COMPARISON OF DIACEREIN, COLLAGEN ACTIVE PEPTIDES AND NSAID’S AS A TREATMENT IN PATIENTS WITH KNEE OSTEOARTHRITIS

Abstract

Background: Osteoarthritis is a progressive degenerative disease leading to substantial degeneration and disability. It is most common in elderly patients and affects the weight bearing joints. The treatment tends to rely on combining various drugs, either pharmacologic or non-pharmacologic or both for managing symptoms of OA, i.e. mainly pain and / or loss of mobility of joint. Objectives:  To compare the clinical efficacy of diacerein, collagen active peptides and NSAID’s for the treatment in patients with knee osteoarthritis.  To observe the adverse effects of these regimens. Subject, Material and Methods: The study was conducted in National Medical Centre on 110 diagnosed patients of knee osteoarthritis. Male and female patients 40-70 years of age, fulfilling the criteria of knee OA (American College of Rheumatology) were included in the study. They underwent knee radiographs. After written informed consent each experienced a wash out period of approximately 72 hours. The patients were randomly divided into three groups . Group 1: capsule Diacerein 50mg BD, Group 2: sachet Collapep and Group 3: NSAID’s for 12 weeks. Parameters were checked at week 0,6 and 12 were: pain at rest and movement (Visual Analog Scale), tenderness, swelling, limitation of movement. Adverse effects were also observed during the study period. Comparison of the three groups was done by one way ANOVA. x Results: 110 patients of knee osteoarthritis were included in the study; 37 patients in group I and II while 36 patients in group III. 26 (24%) were males and 82 (75.9%) were females. Comparison of the three groups showed highly significant results (P- value < 0.001) in almost all parameters. Comparison between the three groups showed significant results that is P value < 0 .001 in parameters of pain at movement at 6th and 12th week. The frequency of mobility in terms of kneeling, lifting, getting in and out of the bed and crepitus showed significant difference with P value < 0.05. Insignificant difference was found in comparison among the three groups while observing the adverse events. The evaluation of walking time also showed significant results (P value < 0.05) at the beginning and end of study. Comparison of lab parameters (safety profile) showed no significant difference ( hemoglobin (12th week), urea and creatinine) among the three groups, however AST and ALT and hemoglobin at day 0 showed significant difference (P- value < 0.05). Conclusion Collagen active peptides are clinically effective compared to diacerien and NSAID’s in the management of knee osteoarthritis. Hence the quality of life is improved greatly with the use of collagen active peptides with better outcome in terms of safety profile.