Efficacy And Safety Of Diacerein In The Treatment Of Osteoarthritis-a Meta-analysis Of Randomized Controlled Trials

Objective:Systematic evaluation of the efficacy and safety of diacerein in the treatment of osteoarthritis.Methods:Computer searches of the Wanfang database,Vipshop Chinese Journal Service Platform,China Knowledge Network,China Biomedical Literature Database,Chinese Academic Journals Online Publishing Database,Pubmed,Web of Science,Embase and Cochrane Library were conducted according to the Cochrane systematic evaluation method(up to December 31,2022).All randomized controlled trials of diacerein for osteoarthritis were included and evaluated for methodological quality.Meta-analysis was performed on studies that met the inclusion criteria using STATA 12.0 software.The main efficacy indicators(joint pain VAS score,WOMAC osteoarthritis index,adverse drug reactions)were observed in the diacerein and control groups after treatment.Results:A total of 7 RCT studies with a total of 1041 patients were included.In terms of efficacy assessment: 1.pain improvement(VAS score): knee VAS score diacerein was better than placebo at ≤12 weeks of treatment,I~2=66.4%,WMD=6.725,95% CI(0.403,13.048);knee VAS score diacerein did not differ from placebo at >12 weeks of treatment,I~2=54.3%,WMD=0.753,95% CI(-3.221,4.728).2.knee stiffness improvement(WOMAC B score).WMD=0.753,95% CI(-3.221,4.728).2.Knee stiffness improvement(WOMAC B score):knee WOMAC B score at ≤12 weeks of treatment showed no difference between diacerein and placebo,I~2=0%,WMD=4.767,95% CI(-2.454,11.988);knee at >12 weeks of treatment WOMAC B score showed that diacerein improved knee stiffness,I ~2 =0%,WMD=19.961,95% CI(13.365,26.557).3.Knee function improvement(WOMAC C score): diacerein improved knee function,I ~2 =13.4%,WMD=151.810,95% CI(85.584,218.036).Knee WOMAC C score at ≤ 12 weeks of treatment showed that vinorelbine improved knee stiffness,I~2=0%,WMD=150.065,95% CI(98.258,201.871).The knee WOMAC C score at >12 weeks of treatment showed that vinorelbine improved knee stiffness,I ~2 =0%,WMD=165.087,95% CI(129.378,200.795).Adverse effects were higher in the double vinorelbine than in the placebo group P < 0.01,but no serious adverse effects were observed.Conclusion:The results of this study showed that,according to the available clinical data,diacerein for the treatment of osteoarthritis was superior to placebo in improving knee pain only in the short term,and its efficacy was not significantly different from placebo in the long term;in improving knee stiffness,its efficacy was not significantly different from placebo in the short term,but it could improve knee stiffness in the long term;in improving knee function,it could improve knee function.Diacerein has a risk of adverse reactions,but no serious adverse reactions were found.