A Control Study on the Clinical Efficacy of Glucosamine Hydrochloride and Diacerein in Treating Knee Osteoarthritis and the MRI Variation_West China Medical Journal

Authors：

 WuRui , ChenXixi , ChengJia , LiuJian ,  ZhouBin

Department of Rheumatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

ZhouBin, Email: bingb2917@126.com

Keywords：

Glucosamine hydrochloride; Osteoarthritis, knee; Magnetic resonance imaging

DOI：

10.7507/1002-0179.201600226

Video：

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Objective To compare the clinical efficacy of glucosamine hydrochloride and diacerein for patients with knee osteoarthritis and the MRI variation. Methods Between January and June 2014, 90 patients with knee osteoarthritis were randomized into three groups: group A (treated by glucosamine hydrochloride), group B (treated by diacerein) and group C (treated by both glucosamine hydrochloride and diacerein). The score of Western Ontario and McMaster Universities (WOMAC) index of osteoarthritis, MRI cartilage injury Recht grading and the curative effects for bone marrow edema, joint cavity effusion and meniscus injury were compared before and after the treatment. Results The scores of WOMAC after treatment in all the groups were improved, while the therapeutic effect of group C lasted longer when medical treatment suspended. The number of articular surface with different degrees of cartilage injury showed no statistically significant change in all three groups (P ＞ 0.05) . The state of bone marrow edema and joint cavity effusion were improved with a statistically significant difference in all groups (P ＜ 0.05) . Patients with lateral meniscus degeneration in group A and patients with medial meniscal tear in group B both increased with statistically significant differences (P ＜ 0.05) . However, in group C, patients with lateral meniscus degeneration or meniscal tear decreased with statistically significant differences (P ＜ 0.05) . Conclusions The treatment for osteoarthritis by glucosamine hydrochloride is effective, and the curative effect lasts longer when treated by both glucosamine hydrochloride and diacerein. Glucosamine hydrochloride ameliorates the bone marrow edema and joint cavity effusion. Treatment together with diacerein leads to a better therapeutic effect for patients with meniscus degeneration, yet further studies are needed to prove its effects in ameliorating cartilage injury.

Citation： WuRui, ChenXixi, ChengJia, LiuJian, ZhouBin. A Control Study on the Clinical Efficacy of Glucosamine Hydrochloride and Diacerein in Treating Knee Osteoarthritis and the MRI Variation. West China Medical Journal, 2016, 31(5): 827-830. doi: 10.7507/1002-0179.201600226 Copy

1.	Jordan KM, Arden NK, Doherty M, et al. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the Standing Committee for international clinical studies including therapeutic trials (ESCISIT) [J]. Ann Rheum Dis, 2003, 62(12) : 1145-1155.
2.	Hochberg MC, Altman RD, April KT, et al. American college of rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee[J]. Arthritis Care Res (Hoboken), 2012, 64(4) : 465-474.
3.	Bliddal H, Christensen RD, Kristensen PK, et al. Glucosamine effectiveness in the treatment of knee osteoarthritis. Presentation of a Cochrane analysis with the perspective on the GAIT trial[J]. Ugeskr Laeger, 2006, 168(50) : 4405-4409.
4.	Mcconnell S, Kolopack P, Davis AM. The western Ontario and McMaster universities osteoarthritis index (WOMAC): a review of its utility and measurement properties[J]. Arthritis Rheum, 2001, 45(5) : 453-461.
5.	Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy inpatients with osteoarthritis of the hip or knee[J]. J Rheumatol, 1988, 15(12) : 1833-1840.
6.	Recht MP, Kramer J, Marcelis S, et al. Abnormalities of articular cartilage in the knee: analysis of available Mr techniques[J]. Radiology, 1993, 187(2) : 473-478.
7.	Valdes AM, Spector TD. The genetic epidemiology of osteoarthritis[J]. Curr Opin Rheumatol, 2010, 22(2) : 139-143.
8.	谭静雅, 杨南萍. 骨关节炎的发病机制及其诊治的研究进展[J]. 华西医学, 2012, 27(12) : 1828-1832.
9.	石晓明, 于占革. 骨关节炎发病机制的研究进展[J]. 中华临床医师杂志: 电子版, 2013, 12(24) : 11607-11610.
10.	Uitterlinden EJ, Koevoet JL, Verkoelen CF, et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants[J]. BMC Musculoskelet Disord, 2008, 9(7) : 120.
11.	Lee YH, Woo JH, Choi SJ, et al. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis[J]. Rheumatol Int, 2010, 30(3) : 357-363.
12.	Wandel S, Jueni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis[J]. BMJ, 2010, 341(4) : 4675.
13.	Loredo R, Sanders TG. Imaging of osteochondral injuries[J]. Clin Sports Med, 2001, 20(2) : 249-278.
14.	张敏, 李石玲, 郭智萍, 等. 膝关节软骨损伤的MR诊断及与关节镜结果对照[J]. 中华放射学杂志, 2005(7) : 731-735.
15.	Reginster JV, Deroisy R, Rovati LC, et al. Long term effects of glucosamine sulfate on osteoarthritis progression: a randomized, placebo controlled clinic trail[J]. Lancet, 2001, 357(27) : 251-256.

1. Jordan KM, Arden NK, Doherty M, et al. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the Standing Committee for international clinical studies including therapeutic trials (ESCISIT) [J]. Ann Rheum Dis, 2003, 62(12) : 1145-1155.
2. Hochberg MC, Altman RD, April KT, et al. American college of rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee[J]. Arthritis Care Res (Hoboken), 2012, 64(4) : 465-474.
3. Bliddal H, Christensen RD, Kristensen PK, et al. Glucosamine effectiveness in the treatment of knee osteoarthritis. Presentation of a Cochrane analysis with the perspective on the GAIT trial[J]. Ugeskr Laeger, 2006, 168(50) : 4405-4409.
4. Mcconnell S, Kolopack P, Davis AM. The western Ontario and McMaster universities osteoarthritis index (WOMAC): a review of its utility and measurement properties[J]. Arthritis Rheum, 2001, 45(5) : 453-461.
5. Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy inpatients with osteoarthritis of the hip or knee[J]. J Rheumatol, 1988, 15(12) : 1833-1840.
6. Recht MP, Kramer J, Marcelis S, et al. Abnormalities of articular cartilage in the knee: analysis of available Mr techniques[J]. Radiology, 1993, 187(2) : 473-478.
7. Valdes AM, Spector TD. The genetic epidemiology of osteoarthritis[J]. Curr Opin Rheumatol, 2010, 22(2) : 139-143.
8. 谭静雅, 杨南萍. 骨关节炎的发病机制及其诊治的研究进展[J]. 华西医学, 2012, 27(12) : 1828-1832.
9. 石晓明, 于占革. 骨关节炎发病机制的研究进展[J]. 中华临床医师杂志: 电子版, 2013, 12(24) : 11607-11610.
10. Uitterlinden EJ, Koevoet JL, Verkoelen CF, et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants[J]. BMC Musculoskelet Disord, 2008, 9(7) : 120.
11. Lee YH, Woo JH, Choi SJ, et al. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis[J]. Rheumatol Int, 2010, 30(3) : 357-363.
12. Wandel S, Jueni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis[J]. BMJ, 2010, 341(4) : 4675.
13. Loredo R, Sanders TG. Imaging of osteochondral injuries[J]. Clin Sports Med, 2001, 20(2) : 249-278.
14. 张敏, 李石玲, 郭智萍, 等. 膝关节软骨损伤的MR诊断及与关节镜结果对照[J]. 中华放射学杂志, 2005(7) : 731-735.
15. Reginster JV, Deroisy R, Rovati LC, et al. Long term effects of glucosamine sulfate on osteoarthritis progression: a randomized, placebo controlled clinic trail[J]. Lancet, 2001, 357(27) : 251-256.

West China Medical Journal

A Control Study on the Clinical Efficacy of Glucosamine Hydrochloride and Diacerein in Treating Knee Osteoarthritis and the MRI Variation

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