A comparison of oral versus topical combination of glucosamine sulphate and diacerein in patients of grade 2 osteoarthritis

Background: The study aimed to compare oral versus topical combination of glucosamine sulphate and diacerein in patients of grade 2 Osteoarthritis.Methods: This was a prospective study of 70 patients with grade 2 osteoarthritis knee, randomly divided into 2 groups of 35 each. The first group was given oral 1500mg of glucosamine and 100mg of diacerein per day and second group was given topical preparation of 10% w/w glucosamine sulphate and 1% w/w diacerein to be applied twice. Both the groups were followed up at 1, 3, 6 and 12 weeks. At each follow up, Visual Analog Scale (VAS) and Lequesne et al scores were used as efficacy parameters. C-Reactive Protein (CRP) level was measured in the beginning and at the end of 12 weeks.Results: Both the groups showed improvement in pain and joint function as depicted by VAS score and Lequesne index however the difference was not statistically significant. The decrease in CRP value was significant in oral group (p value<0.001) but not in topical group (p value of 0.047). Paracetamol demand was slightly higher in topical group however the difference was not significant.Conclusions: Glucosamine sulphate and diacerein combination are effective in improving pain, stiffness and function in patients of grade 2 osteoarthritis knee. However, the efficacy of glucosamine sulphate and diacerein combination- oral as well as topical, in improving pain and stiffness is similar- there is no superiority of one over the other