The University of Tasmania's Menzies Institute for Medical Research has found that commonly prescribed medication, Diacerein, does not improve knee osteoarthritis symptoms, following a national study.
Diacerein, a medication derived from plants such as rhubarb and aloe vera, has long been recognised for its anti-inflammatory properties and is commonly used to treat osteoarthritis in Europe and Asia.
Led by Associate Professor Dawn Aitken, head of the Musculoskeletal Research Group at Menzies, the DICKENS trial is the largest study globally to investigate Diacerein's ability to reduce pain in people with knee osteoarthritis who also have inflammation within the joint (effusion synovitis).
"We designed this large trial to test Diacerein in a group of osteoarthritis patients who we thought would have the best chance at benefiting from the drug and found that it did not improve pain or function or decrease local knee inflammation.
"We were hoping that if the drug was effective, it could be included on the Australian Register of Therapeutic Goods (ARTG) as an approved treatment for osteoarthritis in Australia," Associate Professor Aitken said. "Unfortunately, it's back to the drawing board to find more effective drug therapies."
Osteoarthritis is the most common form of arthritis, affecting one in five Australians over the age of 45 and is a major cause of pain, disability, and joint replacement surgery. Despite its widespread burden, very few effective drug treatments exist.
Associate Professor Aitken said the publication of the trial in JAMA Internal Medicine - one of the world's most prestigious medical journals - highlighted both the significance and rigour of the work.
"While the findings weren't what we expected or hoped for, publishing this work in JAMA Internal Medicinereinforces the global importance of high-quality research, and we are proud that Menzies is contributing to the global effort to better understand and treat osteoarthritis."
Associate Professor Aitken is hopeful that other promising drugs in the development stage will become available to bring relief to those suffering chronic pain, but highlighted that non-drug therapies are available.
"Chronic pain has a huge impact on the lives of those who live with it, and the lack of effective drug treatments is frustrating.
"While we currently lack drug treatments for chronic pain, we know that the most effective therapies include education, exercise, weight management and psychological support."
Despite these findings, patients should not stop taking Diacerein without talking to their treating doctor first.
The national, multi‑centre trial involved participants from Hobart, Adelaide, Melbourne and Perth and collaboration with researchers from Monash University, the University of Adelaide, and the University of Western Australia.
The Menzies Institute acknowledges the National Health and Medical Research Council of Australia for funding the research and TRB Chemedica International S.A for supplying Diacerein free of charge.
The results of this major Australian clinical trial have been published in JAMA Internal Medicine , one of the world's most prestigious medical journals.
