Diacerein : Benefits, Risks and Place in the Management of Osteoarthritis. An Opinion-Based Report from the ESCEO
Pavelka, Karel (Charles University)
Bruyère, Olivier (Liège, Belgium)
Cooper, Cyrus (Southampton, UK)
Kanis, John A. (Sheffield, UK)
Leeb, Burkhard F. (State Hospital Stockerau)
Maheu, Emmanuel (St-Antoine Hospital)
Martel-Pelletier, Johanne
Monfort, Jordi (Hospital del Mar (Barcelona, Catalunya))
Pelletier, Jean-Pierre (University of Montreal Hospital Research Centre (CRCHUM))
Rizzoli, René (Geneva University Hospitals (Suïssa))
Reginster, Jean-Yves (Université de Liège)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2016
Abstract:	Diacerein is a symptomatic slow-acting drug in osteoarthritis (SYSADOA) with anti-inflammatory, anti-catabolic and pro-anabolic properties on cartilage and synovial membrane. It has also recently been shown to have protective effects against subchondral bone remodelling. Following the end of the revision procedure by the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) constituted a panel of 11 experts to better define the real place of diacerein in the armamentarium for treating OA. Based on a literature review of clinical trials and meta-analyses, the ESCEO confirms that the efficacy of diacerein is similar to that of non-steroidal anti-inflammatory drugs (NSAIDs) after the first month of treatment, and superior to that of paracetamol. Additionally, diacerein has shown a prolonged effect on symptoms of several months once treatment was stopped. The use of diacerein is associated with common gastrointestinal disorders such as soft stools and diarrhoea, common mild skin reactions, and, uncommonly, hepatobiliary disorders. However, NSAIDs and paracetamol are known to cause potentially severe hepatic, gastrointestinal, renal, cutaneous and cardiovascular reactions. Therefore, the ESCEO concludes that the benefit-risk balance of diacerein remains positive in the symptomatic treatment of hip and knee osteoarthritis. Furthermore, similarly to other SYSADOAs, the ESCEO positions diacerein as a first-line pharmacological background treatment of osteoarthritis, particularly for patients in whom NSAIDs or paracetamol are contraindicated.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Estudi clínic ; recerca ; Versió publicada
Published in:	Drugs & Aging, Vol. 33 (february 2016) , p. 75-85, ISSN 1179-1969

DOI: 10.1007/s40266-016-0347-4
PMID: 26849131

11 p, 634.6 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles