Diacerein: An Anti-Inflammatory Drug from Plants
Diacerein is an anti-inflammatory drug derived from plants including rhubarb and aloe vera. It is widely used to treat osteoarthritis in parts of Europe and Asia. Unlike conventional pain relievers, it works by targeting inflammatory pathways involved in joint disease.
Major Trial Results Disappoint
A national study led by the Menzies Institute for Medical Research at the University of Tasmania (the DICKENS trial) found that diacerein did not relieve pain or improve function in people with knee osteoarthritis, even among patients with inflammation inside the joint (effusion synovitis) who were considered especially likely to benefit.
Associate Professor Dawn Aitken, head of the Musculoskeletal Research Group at Menzies and lead author of the study, said: "We designed this large trial to test diacerein in a group of osteoarthritis patients who we thought would have the best chance at benefiting from the drug and found that it did not improve pain or function or decrease local knee inflammation."
Limited Treatment Options for Osteoarthritis
Osteoarthritis is the most common type of arthritis. It affects one in five Australians older than 45 and is a major driver of pain, disability, and joint replacement surgery. Even with its broad impact, few effective medication options are available.
Associate Professor Aitken said the trial's publication in JAMA Internal Medicine, one of the world's leading medical journals, underscores the importance and rigor of the research. "While the findings weren't what we expected or hoped for, publishing this work in JAMA Internal Medicine reinforces the global importance of high-quality research."
Non-Drug Approaches Matter
Associate Professor Aitken said she remains hopeful that other drugs now in development may eventually help people living with chronic pain. She also emphasized that treatment approaches beyond medication are already available.
- Education: Understanding the condition and self-management strategies
- Exercise: Appropriate physical activity to maintain joint function
- Weight management: Reducing weight to decrease joint load
- Psychological support: Helping cope with the mental burden of chronic pain
Despite these results, anyone taking diacerein should speak with their treating doctor before stopping the medication.
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