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Eur J Med Res. 2015 Mar 13;20:24. doi: 10.1186/s40001-015-0115-7.

Efficacy and safety of glucosamine, diacerein, and NSAIDs in osteoarthritis knee: a systematic review and network meta-analysis.

Author information

1
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Faculty of Medicine Ramathibodi Hospital, Ratchathewi, Chang Wat Bangkok, Bangkok, 10400, Thailand. Jatupon_kong@hotmail.com.
2
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Faculty of Medicine Ramathibodi Hospital, Ratchathewi, Chang Wat Bangkok, Bangkok, 10400, Thailand. ratan@mahidol.ac.th.
3
Centre for Clinical Epidemiology and Biostatistics, The University of Newcastle, University Drive, Newcastle, NSW 2308, Australia. McEvoy@newctle.edu.au.
4
Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, University Drive, Newcastle, NSW 2308, Australia. john.attia@newcastle.edu.au.
5
Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Bangkok, Mahidol University, Highway 3310, Bangkok, 73170, Thailand. patarawan.wor@mahidol.ac.th.
6
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Faculty of Medicine Ramathibodi Hospital, Ratchathewi, Chang Wat Bangkok, Bangkok, 10400, Thailand. ammarin.tha@mahidol.ac.th.

Abstract

BACKGROUND:

To conduct a systematic review and network meta-analysis of randomized controlled trials (RCTs) with the aims of comparing relevant clinical outcomes (that is, visual analog scores (VAS), total and sub-Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores, Lequesne algofunctional index, joint space width change, and adverse events) between diacerein, glucosamine, and placebo.

METHODS:

Medline and Scopus databases were searched from inception to 29 August 2014, using PubMed and Scopus search engines and included RCTs or quasi-experimental designs comparing clinical outcomes between treatments. Data were extracted from original studies. A network meta-analysis was performed by applying weight regression for continuous outcomes and a mixed-effect Poisson regression for dichotomous outcomes.

RESULTS:

Thirty-one of 505 identified studies were eligible. Compared to placebo, glucosamine showed a significant improvement with unstandardized mean differences (UMD) in total WOMAC, pain WOMAC, function WOMAC, and Lequesne score of -2.49 (95% confidence interval (CI) -4.14, -0.83), -0.75 (95% CI: -1.18, -0.32), -4.78 (95% CI: -5.96, -3.59), and -1.03 (95% CI: -1.34, -0.72), respectively. Diacerein clinically improves visual analog scores, function WOMAC, and stiffness WOMAC with UMD values of -2.23 (95% CI: -2.82, -1.64), -6.64 (95% CI: -10.50, -2.78), and -0.68 (95% CI: -1.20, -0.16) when compared to placebo.

CONCLUSIONS:

The network meta-analysis suggests that diacerein and glucosamine are equally efficacious for symptom relief in knee OA, but that the former has more side effects.

PMID:
25889669
PMCID:
PMC4359794
DOI:
10.1186/s40001-015-0115-7
[Indexed for MEDLINE]
Free PMC Article

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