Summary:
The authors present the pharmacological profile and an account of the clinical effectiveness of
diacerein. It is a preparation which inhibits above all the production and activity of interleukin-1
(IL-1) as well as other cytokines and catabolic enzymes which participate in the degradation of
cartilage in osteoarthritis (OA). The implemented clinical studies provide evidence of its effective-
ness on pain and function in patients with hip and knee osteoarthritis. As to the character of its
effect diacerein belongs to so-called SYSADOA, symptomatically slow acting drugs in OA. The onset
of its effect is as compared with NSA retarded, the onset being after 2-4 weeks. Then its effectiveness
is identical as that of NSA. While after discontinuation of NSA treatment the patients exacerbates
as a rule, after termination of diacerein treatment the favourable effect persists for another 2-3
months. A recently completed study revealed that in addition to the purely symptomatic effect after
long-term diacerein treatment the progression of OA is perhaps slower. Thus a drug potentially
modifying the structure is involved. The assembled results will have to be confirmed in further
investigations. Diacerein is a safe preparation, the main undesirable effect is diarrhoea which
however occurs only at the onset of treatment and as a rule does not lead to discontinuation of
therapy.
Key words:
osteoarthritis, diacerein, therapy, SYSADOA
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