A Safer Osteoarthritis Treatment
By Alan R. Gaby, MD
Healthnotes Newswire (February 3, 2005)—A product containing two enzymes and a flavonoid is as effective as a nonsteroidal anti-inflammatory drug (NSAID) for treating osteoarthritis, reports Clinical Rheumatology(2004;23:410–5). This finding is welcome news for millions of osteoarthritis sufferers, especially given the growing body of evidence regarding the dangers of many arthritis medications.
Osteoarthritis, the most common form of arthritis, is characterized by progressive degeneration of the knees, hips, or other joints. People with osteoarthritis may experience pain, swelling, and decreased range of motion in affected joints.
Medications used to treat osteoarthritis include pain relievers (analgesics) such as acetaminophen (Tylenol®) and NSAIDs such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®, Naprosyn®). None of these medications are risk-free; acetaminophen has been linked in some cases to liver toxicity, and NSAIDs can cause bleeding peptic ulcers. A newer class of drugs, the cyclooxygenase-2 (COX-2) inhibitors (such as celecoxib [Celebrex®] and rofecoxib [Vioxx®]) are gentler on the stomach than NSAIDs. However, Vioxx was recently withdrawn from the market, because it was found to increase the risk of heart attacks. There is concern that Celebrex and naproxen may also increase the risk of heart disease.
Enzymes are naturally occurring protein molecules that have a wide array of biological functions. Some enzymes, such as trypsin (found in pancreatic secretions) and bromelain (from pineapple stems), have anti-inflammatory activity. Certain flavonoids—compounds in fruits, vegetables, and other edible plants—are also capable of inhibiting inflammation.
In the new study, people with painful osteoarthritis of the knee were randomly assigned to receive an oral enzyme-flavonoid preparation (Phlogenzym) or an NSAID (diclofenac; Voltaren®) for six weeks. Phlogenzym contains 90 mg of bromelain, 48 mg of trypsin, and 100 mg of rutosid (a derivative of the flavonoid rutin) per tablet. The tablets are enteric-coated in order to prevent the stomach juices from destroying the enzymes. After six weeks, significant improvements in pain and overall functioning were seen in each treatment group. The enzyme-flavonoid preparation was found to be at least as effective as diclofenac; the results were rated as good or better for 51.4% of the people taking Phlogenzym. No significant side effects were seen in either treatment group.
The results of the study suggest that this enzyme-flavonoid combination can relieve symptoms in people with osteoarthritis. Additional research is needed to determine whether this product slows the progression of the disease, or just reduces symptoms. Because the enzyme-flavonoid combination appears to work differently than compounds such as glucosamine sulfate, it is possible that using these products together would be more effective than using either one alone.
Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Three Rivers Press, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Three Rivers Press, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.
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