NEW YORK (Reuters Health) – Long-term treatment with the interleukin-1beta inhibitor, diacerein, effectively slows the progression of osteoarthritis, French researchers report.
Dr. Maxime Dougados from Hפpital Cochin, Paris, and colleagues randomly assigned 507 patients with primary osteoarthritis of the hip to diacerein, 50 mg twice daily or placebo. Over 3 years the researchers measured minimal hip joint space width.
During the study 238 patients dropped out of the trial. Forty-seven percent left due to adverse events (25% in the diacerein group and 12% in the placebo group). The others left because the therapy was ineffective, the researchers report.
Among the 269 patients who completed the trial, patients receiving diacerein had significantly lower joint space loss (47.3%) compared with those receiving placebo (62.3%, p = 0.007). Mean joint space narrowing was also significantly reduced among patients in the diacerein group compared with those in the placebo group (0.18 mm/year versus 0.23 mm/year, p = 0.042), the French team found.
Although diacerein did not have an effect on osteoarthritis symptoms, the results of an analysis of analgesic and antiinflammatory use indicated that diacerein had beneficial effects on the Lequesne functional index (p < 0.05). Diacerein use also improved pain level (p = 0.063), Dr. Dougados' group notes.
Moreover, diacerein had a good safety profile. During 3 years of daily diacerein use most adverse events were only mild or moderate, according to the report in the November issue of Arthritis and Rheumatism.
Dr. Dougados and colleagues conclude that "treatment with diacerein for 3 years has a significant structure-modifying effect [on hip osteoarthritis] as compared with placebo, coupled with a good safety profile."