Abstract
BackgroundCurrent use of prescribed or over the counter non-steroidal anti-inflammatory drugs (NSAIDs) for pain and osteoarthritis (OA) have untoward gastrointestinal and cardiovascular related side effects, as a result the need for a safe and effective alternative has become unequivocally crucial.MethodA randomized, double blind, placebo and active controlled pilot study of a novel dual pathway, COX1/2 and LOX, inhibitor anti-inflammatory agent of botanical origin, UP446 was conducted. Sixty subjects (age 40-75) with symptomatic OA of the hip or knee were assigned to 4 treatment groups (n = 15); Group A0 (Placebo, CMC capsule), Group A1 (UP446 250 mg/day), Group A2 (UP446 500 mg/day) and Group A3 (Celecoxib, 200 mg/day). MOS-SF-36 and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) data were collected at baseline and after 30, 60 and 90 days of treatment as a measure of efficacy. Erythrocyte sedimentation rate, C-reactive protein, plasma thrombin time (PTT), fructosamine, Hematology, clinical chemistry and fecal occult blood were monitored for safety.ResultsStatistically significant decrease in WOMAC pain score were observed for Group A1 at day 90, Group A2 at 30 and 90 days and Group A3 at 60 and 90 days. Statistically significant decrease in WOMAC stiffness score were observed for Group A1 and Group A2 at 30, 60 and 90 days; but not for Group A0 and Group A3. The mean change in WOMAC functional impairment scores were statistically significant for Group A1 and Group A2 respectively at 30 days (p = 0.006 and p = 0.006), at 60 days (p = 0.016 and p = 0.002) and at 90 days (p = 0.018 and p = 0.002), these changes were not significant for Group A0 and Group A3. Based on MOS -SF-36 questionnaires, statistically significant improvements in physical function, endurance and mental health scores were observed for all active treatment groups compared to placebo. No significant changes suggestive of toxicity in routine hematologies, serum chemistries, liver enzymes or PTT were noted in any of the treatment groups.ConclusionBased on current findings UP446 is safe and efficacious alternative to established anti-inflammatory medications for alleviating OA symptoms as measured by the WOMAC Index.
Highlights
Osteoarthritis (OA) is the most common form of joint disorder and the most frequent cause of musculo-skeletal disability worldwide [1,2]
This study demonstrated that UP446 at both dose levels and Celecoxib were associated with significant reduction in pain, stiffness and functional incapacity as compared to placebo
In summary the results of the present study provide data that supports the use of UP446 at 250 mg/day and at 500 mg/day for the effective management of the clinical course of osteoarthritis
Summary
Osteoarthritis (OA) is the most common form of joint disorder and the most frequent cause of musculo-skeletal disability worldwide [1,2]. The number of affected people with OA is expected to reach 60 million by the year 2020 [1]. Alone, there are 40 million people with this disease who cost the economy an estimated $60 billion yearly [1]. AA is metabolized by two parallel pathways, cyclooxygenase and 5-lipoxygenase to yield a variety of physiologically active compounds, notably prostaglandins and leukotrienes, respectively. Many of these molecules are involved in the inflammatory response [3]. Current use of prescribed or over the counter non-steroidal anti-inflammatory drugs (NSAIDs) for pain and osteoarthritis (OA) have untoward gastrointestinal and cardiovascular related side effects, as a result the need for a safe and effective alternative has become unequivocally crucial
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