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Diacerein for osteoarthritis.

T S A Fidelix1, B G D O Soares, V F M Trevisani

  • 1UNIFESP (Escola Paulista de Medicina), Internal Medicine and Therapeutic, Rua Brasilio Machado 308 apto 92, Rua Mediterraneo 290 sl 13, São Bernardo, São Paulo, Brazil, 09715 140. tsafidelix@uol.com.br

The Cochrane Database of Systematic Reviews
|January 27, 2006
PubMed
Summary

Diacerein offers a small but consistent benefit for osteoarthritis (OA) pain relief, though functional improvement was not observed. Diarrhea was the most common side effect, necessitating further research on long-term effectiveness and safety.

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Area of Science:

  • Rheumatology
  • Pharmacology
  • Clinical Trials

Background:

  • Osteoarthritis (OA) is a prevalent musculoskeletal condition.
  • Diacerein offers an alternative to NSAIDs, potentially avoiding gastrointestinal side effects.
  • Diacerein is investigated for its symptom-modifying and potential disease-modifying properties in OA.

Purpose of the Study:

  • To evaluate the efficacy and safety of diacerein for treating adult OA.
  • Included peripheral and axial OA meeting American College of Rheumatology (ACR) and/or EULAR criteria.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and quasi-RCTs.
  • Searched multiple databases (MEDLINE, EMBASE, CENTRAL, LILACS) from inception to 2004.
  • Independent data abstraction and quality assessment using Cochrane Handbook, Jadad, and Schultz scores.

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Main Results:

  • Seven studies (2069 participants) showed a small, consistent benefit of diacerein for OA pain.
  • Statistically significant pain reduction (WMD -5.16) compared to placebo, but with important heterogeneity (P=0.04).
  • No significant improvement in function (Lequesne Index); hip OA showed slowed structural progression, unlike knee OA. Diarrhea was the most frequent adverse event (42%).

Conclusions:

  • Gold-level evidence supports diacerein's small, consistent benefit in improving OA pain.
  • Further research is required to confirm short- and long-term effectiveness and toxicity.
  • Diacerein may offer a valuable therapeutic option for osteoarthritis pain management.