[en] Osteoarthritis is the most common joint disorder affecting over 300 million people worldwide. It typically affects the knees and the hips, and is characterized by a loss in normal joint movement, stiffness, swelling, and pain in patients. The current gold standard therapy for osteoarthritis targets pain management using nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are associated with several potentially serious side effects, the most common being gastrointestinal perforation and bleeding. Owing to the side effects, NSAID treatment doses need to be as low as possible and should be continued for the shortest duration possible, which is problematic in a chronic condition like osteoarthritis, which requires long-term management. Numerous clinical trials have examined oral enzyme combinations as a potential new approach in managing pain in patients with osteoarthritis. Oral enzyme combinations containing bromelain in combination with trypsin, both proteolytic enzymes, as well as the plant flavonoid rutin, may be an effective alternative to typical NSAIDs. The aim of this narrative review is to summarize and discuss the evidence on the efficacy of oral enzyme combinations compared to the gold standard (NSAID) in the management of osteoarthritis symptoms. Nine randomized controlled trials identified in this review assessed the efficacy and safety of the oral enzyme combination containing bromelain, trypsin, and rutin in patients with osteoarthritis. Most of the studies assessed the impact of the oral enzyme combination on the improvement of the Lequesne Algofunctional index score, treatment-related pain intensity alterations and adverse events compared to patients receiving NSAIDs. Although largely small scale, the study outcomes suggest that this combination is as effective as NSAIDs in the management of osteoarthritis, without the adverse events associated with NSAID use. INFOGRAPHIC.
Research Center/Unit :
CIRM - Centre Interdisciplinaire de Recherche sur le Médicament - ULiège
Disciplines :
Rheumatology
Author, co-author :
Henrotin, Yves ; Université de Liège - ULiège > Département des sciences de la motricité > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie ; Department of Physical Therapy and Rehabilitation, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
Michlmayr, Christoph; , Stadtplatz 26, A-4150, Rohrbach Berg, Austria
Rau, Stefanie M; Nestlé Health Science, 1800, Vevey, Switzerland
Quirke, Anne-Marie; Integrated Medhealth Communications (imc), London, UK
Bigoni, Marco; School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
Ueberall, Michael A; Institute of Neurological Sciences IFNAP, Nordostpark 51, 90411, Nuremberg, Germany. michael.ueberall@ifnap.de
Language :
English
Title :
Combination of Enzymes and Rutin to Manage Osteoarthritis Symptoms: Lessons from a Narrative Review of the Literature.
Sponsorship for this review and the Rapid Service Fee were funded by Nestlé. The authors acknowledge Maria Haughton, MSci, CMPP of integrated medhealth communication (imc), UK, for critical review, which was funded by Nestlé. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Conceptualization; Stefanie Rau; data acquisition, analysis or interpretation of data: Yves Henrotin, Christoph Michlmayr, Stefanie Rau, Anne-Marie Quirke, Marco Bigoni and Michael Ueberall; Writing – original draft preparation: Anne-Marie Quirke; Writing – review and editing: Yves Henrotin, Christoph Michlmayr, Stefanie Rau, Anne-Marie Quirke, Marco Bigoni and Michael Ueberall. Yves E Henrotin is the founder and the Executive President of Artialis SA. He received consulting fees from Tilman SA, Laboratoires Expanscience, Nestlé, Naturex and Labrha Laboratories. Christoph Michlmayr has received consulting fees from Nestlé. Stefanie D Rau is the Global Medical Affairs Lead Wobenzym of Nestlé Health Science. Anne-Marie Quirke is a medical writer of imc for which writing support was funded by Nestlé Health Science. Marco Bigoni has received consulting fees from Nestlé. Michael A Ueberall is Medical Director of the Institute of Neurological Sciences, Vice President of the German Pain Association and President of the German Pain League. He receives consulting and honorary fees from AbbVie, Allergan, Allmirall, Amicus Therapeutics, Aristo Pharma, Dermapharm, GlaxoSmithKline, Grünenthal, Kyowa-Kirin, Nestlé, Spectrum Therapeutics, Teva, and Trommsdorff. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.Sponsorship for this review and the Rapid Service Fee were funded by Nestlé.The authors acknowledge Maria Haughton, MSci, CMPP of integrated medhealth communication (imc), UK, for critical review, which was funded by Nestlé.
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