Efficacy and safety of glucosamine, diacerein, and NSAIDs in osteoarthritis knee: a systematic review and network meta-analysisReportar como inadecuado




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European Journal of Medical Research

, 20:24

First Online: 13 March 2015Received: 12 September 2014Accepted: 23 February 2015DOI: 10.1186-s40001-015-0115-7

Cite this article as: Kongtharvonskul, J., Anothaisintawee, T., McEvoy, M. et al. Eur J Med Res 2015 20: 24. doi:10.1186-s40001-015-0115-7

Abstract

BackgroundTo 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.

MethodsMedline 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.

ResultsThirty-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.

ConclusionsThe 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.

KeywordsOsteoarthritis Gonarthrosis Systematic review Network meta-analysis SYSADOA AbbreviationsASUavocado soybean unsaponifiables

BMIbody mass index

CIconfidence intervals

GIgastrointestinal

NSAIDsnon-steroidal anti-inflammatory drugs

OAosteoarthritis

RCTsrandomized controlled trials

RRrelative risk

SDstandard deviation

SYSADOAsymptomatic slow-acting drugs for OA

UMDunstandardized mean difference

VASvisual analog scores

WOMACWestern Ontario and McMaster Universities Osteoarthritis index

Electronic supplementary materialThe online version of this article doi:10.1186-s40001-015-0115-7 contains supplementary material, which is available to authorized users.

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Autor: Jatupon Kongtharvonskul - Thunyarat Anothaisintawee - Mark McEvoy - John Attia - Patarawan Woratanarat - Ammarin Thakkinstia

Fuente: https://link.springer.com/



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