EVALUATION OF DIACEREIN AND GLUCOSAMINE COMBINATION THERAPY ON OSTEOARTHRITIS OUTCOMES: A META-ANALYSIS IN AN ATHLETIC POPULATION

Abstract

Objective: To evaluate the combined therapeutic efficacy of diacerein and glucosamine in treating osteoarthritis within an athletic population, focusing on symptom management and joint health preservation. Methods: A systematic search was conducted in major databases for randomized controlled trials (RCTs) comparing the effects of diacerein combined with glucosamine versus monotherapy or placebo in athletes with osteoarthritis. The search covered publications from January 2010 to the present. Data extraction and risk of bias assessment were independently performed by two reviewers using Cochrane Handbook guidelines. Meta-analysis was executed using Review Manager (RevMan 5.4) software. Results: Six RCTs met the inclusion criteria, totaling 494 participants predominantly from athletic backgrounds. The meta-analysis of pain scores, measured by the Visual Analogue Scale (VAS), indicated a statistically significant improvement in the combination therapy group compared to controls (P<0.05). The joint tenderness scores also significantly decreased in the combination therapy group (P<0.05). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, while improved, did not reach statistical significance. The incidence of adverse reactions was slightly higher in the treatment group but was not statistically significant (P>0.05). Funnel plot analysis suggested minimal publication bias, albeit with some asymmetry potentially due to heterogeneity or small sample sizes. Conclusion: In athletes suffering from osteoarthritis, the combination of diacerein and glucosamine appears to be more effective in reducing joint tenderness and pain during activity compared to single-agent therapies. These findings support the potential of this combination therapy in enhancing joint function and reducing symptoms in this population, though further large-scale and long-term studies are required to confirm these results and ascertain safety profiles.