Abstract
Purpose The high prevalence of knee osteoarthritis (KOA) is a major cause of disability among elders. NSAIDs are recommended to reduce KOA patients' symptoms, but their adverse side effects limit their consumption. In this study, we evaluated the effectiveness of Harpagophytum procumbens compared to a routine NSAID (meloxicam) on pain reduction and functional improvement of KOA patients. Patients and Methods. Sixty patients aged 40–60 years, with painful knee osteoarthritis (grades 1-2 of Kellgren–Lawrence scale) for at least one month, were randomized into two groups with different routine medication periods. Group A consisted of daily administration of two Harpagophytum procumbens (Teltonal) tablets (2∗480 mg) for one month, and group B consisted of daily administration of meloxicam (15 mg) for ten days. The visual analogue scale (VAS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), Oxford Knee Scale (OKS), and patient satisfaction were evaluated at the baseline and after 2, 4, and 8 weeks. Results There were no statistically significant differences between demographic characteristics, pain intensity, and function scores before the treatment. VAS, OKS, and WOMAC scores improved in both groups (p < 0.001) over time, but no significant superiority was shown; after 8 weeks: VAS (Teltonal (4.80 ± 1.80) vs. meloxicam (5.06 ± 1.43)), OKS (34.06 ± 4.38, 34.00 ± 7.87, Teltonal vs. meloxicam, respectively), and WOMAC scores (25.73 ± 10.11 Teltonal vs. 26.20 ± 13.94, meloxicam). Conclusion Teltonal is an effective and safe treatment in patients with mild KOA in the short term. However, no significant superiority was shown in using Teltonal or meloxicam, in people who cannot take NSAIDs, it can be a good alternative, although difference in medication periods should be considered.
Highlights
Osteoarthritis (OA) is a progressive joint disease, and knee OA, which accounts for 83% of total OA, is the most common cause of disability among older adults worldwide [1]
Study Design. is study was a double-blind, randomized clinical trial approved by the Ethics Committee of Shiraz University of Medical Sciences; the protocol was registered at the Iranian Clinical Trial Center with the code of IRCT20191031045291N1. e sample size was determined based on statistical analysis and taking into account the information of the same study with a conflict interval of 95%, power of 85%, and the probable drop rate of 20%. e sample size in each group was determined 30
Given the inclusion and exclusion criteria, 38 knees were included in the study. ey were randomly divided into two groups: A (Teltonal group) with 20 knees and group B with 18 knees
Summary
Osteoarthritis (OA) is a progressive joint disease, and knee OA, which accounts for 83% of total OA, is the most common cause of disability among older adults worldwide [1]. Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to approximately 65% of patients because of their analgesic and anti-inflammatory effects; these drugs are typical options for knee OA treatments, but there is controversy about their role; these medications can be costly or carry substantial side effects, especially in older adults [8,9,10,11,12]. Using NSAIDs in patients with knee OA is associated with gastrointestinal, cardiovascular, and renal complications [13].
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