Prospective observational study on effectiveness of glucosamine, diacerein, and methyl sulfonyl methane on osteoarthritis
Keywords:Glucosamine, Diacerein, Methyl-sulfonyl-methane, OA, Articular cartilage, Nutraceuticals
Background: Some research studies showed that nutraceuticals like glucosamine, chondroitin, methyl-sulfonyl-methane etc, are showing effectiveness in treating osteoarthritis (OA). But there is no proper evidence that these drugs can treat OA because some research studies also showed, these nutraceuticals have little to no effect in OA. The main purpose of our study is to take a combination of nutraceuticals, which are glucosamine, diacerein and methyl-sulfonyl-methane and find the effectiveness of these nutraceuticals in treating OA.
Methods: In this prospective study, 194 subjects were taken and conducted an observational study. Numerical pain rating scale (NPRS) was used to assess pain severity and X-ray is used to assess the joint space narrowing. Based on pain severity, subjects are divided into three groups i.e., mild, moderate and severe and given the treatment of glucosamine, diacerein, and methyl-sulfonyl-methane and reviewed.
Results: From the analysis of NPRS score, on admission, patient severity was severe 97%, moderate 3% and mild pain was 0%, and after three reviews over a period of 6 months, the pain severity of patients was severe 8.76%, moderate 87.1% and mild pain was 4.12%.
Conclusions: Based on our study we concluded that glucosamine, diacerein, and methyl-sulfonyl-methane can effectively treat OA by repairing the damaged articular cartilage. But these medications cannot produce new articular cartilage, they only repair the damaged articular cartilage.
Haq I, Murphy E, Dacre J. Osteoarthritis. Postgrad Med J. 2003;79:377-83.
Martin G, Bogdanowicz P, Domagala F, Ficheux H, Pujol JP. Rhein inhibits interleukin-1beta-induced activation of the MEK/ERK pathway and DNA binding of NF-kappaB and AP-1 in chondrocytes cultured in hypoxia: a potential mechanism for its disease-modifying effect in osteoarthritis. In? ammation. 2003;27(4):233-46.
Ferreira Mendes A, Caramona MM, de Carvalho AP, Lopes MC. Diacerein and rhein prevent interleukin-1 beta-induced nuclear factor-kappa B activation by inhibiting the degradation of inhibitor kappa B-alpha. Pharmacol Toxicol. 2002;91(1):22-8.
Mathieu P. Interleukin 1 its role, quantitative determination and the difficulties in studying its role in osteoarthritis. Results of a ‘pilot’ study with diacerein (ART 50) in knee osteoarthritis. Rev Prat. 1999;49(13):S15-8.
Felisaz N, Boumediene K, Ghayor C, Herrouin JF, Bogdanowicz P, Galerra P et al. Stimulating effect of diacerein on TGF beta 1 and beta 2 expressions in articular chondrocytes cultured with and without interleukin-1. Osteoarthr Cartil. 1999;7(3):255-64.
Sanchez C, Mathy-Hartert M, Deberg MA, Ficheux H, Reginster JY, Henrotin YE. Effects of rhein on human articular chondrocytes in alginate beads. Biochem Pharmacol. 2003;65(3):377-88.
Schongen RN, Giannetti BM, Van de Leur E, Reinards R, Greiling H. Effect of diacetylrhein on the phagocytosis of polymorphonuclear leucocytes and its nuance on the biosynthesis of hyaluronate in synovial cells. Arzneimittelforschung. 1988;38(I)(5):744-8.
Pelletier JP, Lajeunesse D, Reboul P, Mineau F, Fernandes JC, Sabouret P et al. Diacerein reduces the excess synthesis of bone remodeling factors by human osteoblast cells from the osteoarthritic subchondral bone. J Rheumatol. 2001;28(4):814-24.
Verbruggen G. Chondroprotective drugs in degenerative joint diseases. Rheumatology (Oxford). 2006;45(2):129-38.
Hochberg MC, Dougados M. Pharmacological therapy of osteoarthritis. Best Pract Res Clin Rheumatol. 2001;15(15):583-93.
Moldovan F, Pelletier JP, Jolicoeur FC, Cloutier JM, Martel- Pelletier J. Diacerein and rhein reduce the ICE-induced IL-1 beta and IL-18 activation in human osteoarthritic cartilage. Osteoarthritis Cartilage. 2000;8:186-96.
Felisaz N, Boumediene K, Ghayor C. Stimulating effect of Diacerein on TGF-beta 1 and beta 2 expressions in articulate chondrocytes cultured with and without interleukin-1. Osteoarthritis Cartilage. 1999;7(3):255-64.
Papich M. Glucosamine Chondroitin Sulfate. Saunders Handbook of Veterinary Drugs. 2016;357-8.
Versus Arthritis. Glucosamine, 2021 [cited 19 February 2022]. Available at: https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/types-of-complementary-treatments/glucosamine/. Accessed on 19 February 2022.
diacerein: Indication, Dosage, Side Effect, Precaution, CIMS India. Mims.com. 2017. Available at: http://www.mims.com/india/drug/info/diacerein?type=full&mtype=generic. Accessed on 13 July 2017.
Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine. 2005;30:1331-4.
Jensen MP, McFarland CA. Increasing the reliability and validity of pain intensity measurement in chronic pain patients. Pain. 1993;55:195-203.
Rodriguez CS. Pain measurement in the elderly: a review. Pain Manag Nurs. 2001;2:38-46.
Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH. Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990;17:1022-4.
Hawker GA. Measures of Adult Pain. Arthritis Care Res. 2011;63:S240-52.
Williamson A. Pain: a review of three commonly used pain rating scales. Issues in clin nursing. 2005;14:798-804.
Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 2005;113:9-19.
Jensen MP, Karoly P, O’Riordan EF, Bland F Jr, Burns RS. The subjective experience of acute pain. Clin J Pain. 1989;5:153-9.
Hawker GA, Davis AM, French MR, Cibere J, Jordan JM, March L et al. Development and preliminary psychometric testing of a new OA pain measure: an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008;16:409-14.
Hush JM, Refshauge KM, Sullivan G, De Souza L, McAuley JH. Do numerical rating scales and the Roland-Morris Disability Questionnaire capture changes that are meaningful to patients with persistent back pain? Clin Rehabil. 2010;24:648-57.
Zhu X, Sang L, Wu D, Rong J, Jiang L. Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. J Orthop Surg Res. 2018;13(1).
Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J orthop 2016;50(5):518-22.