Diacerein versus chondroitin sulfate in treatment of adult Kashin-Beck Disease: an intervention trial in Heilongjiang Province, China

Abstract Background: Kashin-Beck disease (KBD) is a kind of rare disease and currently only spread across 13 provinces from southwest to northeast China, including Tibet, Qinghai, Sichuan, Shaanxi, Heilongjiang and so on. The aim of this trial was to evaluate and compare therapeutic effects of diacerein and chondroitin sulfate on adult KBD. Methods: Total 308 KBD patients were divided into two groups that received chondroitin sulphate (Group A) and diacerein (Group B) for 24 weeks. Data were collected at 0 (baseline), 12 (primary end point) and 24 weeks (secondary end point) to calculate the proportion of patients with effective therapeutic effect and overall improvement rate (primary efficacy parameters), WOMAC pain and stiffness scores (secondary efficacy parameters). Blood sample was collected to measure liver and renal function indexes. Results: Two primary efficacy parameters in group B at primary end point were significantly higher than those in group A (P=0.021, P=0.007), but no statistical differences were seen in these two primary efficacy parameters between two groups at secondary end point or between primary and secondary end points in same group (all P>0.05). In both groups, with the prolongation of treatment time, WOMAC pain and stiffness scores decreased significantly (all P<0.001), but no significant differences were seen between primary and secondary end points (all P>0.05). In addition, in both groups, the occurrences of total adverse events were relatively low and no side effect on liver function was seen. Diacerein also had no side effect on renal function. Conclusion: For treatment of adult KBD, both diacerein and chondroitin sulfate were effective, and diacerein might be effective and stronger than chondroitin sulfate. Taking into account both efficacy and safety, the optimal intervention time of diacerein for adult KBD patients was 12 weeks.