No significant between-group difference seen in outcomes; similar incidence of treatment-related adverse events reported

WEDNESDAY, May 22, 2024 (HealthDay News) -- For patients with symptomatic knee osteoarthritis (OA), diacerein is noninferior to celecoxib for reducing pain, according to a study published online Dec. 1, 2020, in Rheumatology.

Jean-Pierre Pelletier, M.D., from the University of Montréal Hospital Research Centre in Canada, and colleagues conducted a randomized, double-blind noninferiority trial comparing diacerein to celecoxib for knee OA patients with Kellgren-Lawrence grade 2 to 3 and pain scoring ≥4 on a 10-cm visual analog scale. Participants were randomly assigned to six months of diacerein 50 mg once daily for one month and twice daily thereafter or celecoxib 200 mg once daily (187 and 193, respectively).

The researchers found that the adjusted mean change from baseline in the Western Ontario and McMaster Universities Osteoarthritis Index pain score was –11.1 and –11.8 with diacerein and celecoxib, respectively, in the per-protocol population (difference, 0.7; 95 percent confidence interval, –1.8 to 3.2; P = 0.597, meeting the noninferiority margin). Similar results were seen in a supportive analysis of the intention-to-treat population. No significant between-group difference was seen in other outcomes. A low incidence of treatment-related adverse events was seen, and these incidences were balanced between the groups, apart from an increased incidence of diarrhea with diacerein (10.2 versus 3.7 percent).

This study "confirms the positive benefit–risk ratio of diacerein in knee OA and re-establishes diacerein as a therapeutic option to avoid the use of COX-2 inhibitors in this indication," the authors write.

Several authors disclosed ties to the pharmaceutical industry, including TRB Chemedica International SA, which provided study medications free of charge.

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