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Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study

Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study
Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study
Summary Background: Osteoarthritis (OA) of the knee is the most prevalent joint disorder. Previous studies suggest that bromelain, a pineapple extract, may be a safer alternative/adjunctive treatment for knee OA than current conventional treatment. Aim: To assess the efficacy of bromelain in treating OA of the knee. Design: Randomized, double-blind placebocontrolled trial. Methods: Subjects (n¼47) with a confirmed diagnosis of moderate to severe knee OA were randomized to 12 weeks of bromelain 800 mg/day or placebo, with a 4-week follow-up. Knee (pain, stiffness and function) and quality-of-life symptoms were reported monthly in the WOMAC and SF36 questionnaires, respectively. Adverse events were also recorded. The primary outcome measure was the change in total WOMAC score from baseline to the end of treatment at week 12. Longitudinal models were used to evaluate outcome. Results: Thirty-one patients completed the trial (14 bromelain, 17 placebo). No statistically significant differences were observed between groups for the primary outcome (coefficient 11.16, p¼0.27, 95%CI 8.86 to 31.18), nor the WOMAC subscales or SF36. Both treatment groups showed clinically relevant improvement in the WOMAC disability subscale only. Adverse events were generally mild in nature. Discussion: This study suggests that bromelain is not efficacious as an adjunctive treatment of moderate to severe OA, but its limitations support the need for a follow-up study.
1460-2725
841-850
Brien, S
4e8e97cd-7bc3-4efd-857e-20790040b80f
Lewith, G
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Walker, A.F
c2bf63bb-73c5-4c13-b840-2f4c1e533302
Middleton, R
5369e720-f866-4c75-bfbd-dd4c10c793b4
Prescott, P
cf0adfdd-989b-4f15-9e60-ef85eed817b2
Bundy, R
5ad2bc42-70ee-4527-9feb-10997d6ed039
Brien, S
4e8e97cd-7bc3-4efd-857e-20790040b80f
Lewith, G
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Walker, A.F
c2bf63bb-73c5-4c13-b840-2f4c1e533302
Middleton, R
5369e720-f866-4c75-bfbd-dd4c10c793b4
Prescott, P
cf0adfdd-989b-4f15-9e60-ef85eed817b2
Bundy, R
5ad2bc42-70ee-4527-9feb-10997d6ed039

Brien, S, Lewith, G, Walker, A.F, Middleton, R, Prescott, P and Bundy, R (2006) Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM: An International Journal of Medicine, 99 (12), 841-850. (doi:10.1093/qjmed/hcl118).

Record type: Article

Abstract

Summary Background: Osteoarthritis (OA) of the knee is the most prevalent joint disorder. Previous studies suggest that bromelain, a pineapple extract, may be a safer alternative/adjunctive treatment for knee OA than current conventional treatment. Aim: To assess the efficacy of bromelain in treating OA of the knee. Design: Randomized, double-blind placebocontrolled trial. Methods: Subjects (n¼47) with a confirmed diagnosis of moderate to severe knee OA were randomized to 12 weeks of bromelain 800 mg/day or placebo, with a 4-week follow-up. Knee (pain, stiffness and function) and quality-of-life symptoms were reported monthly in the WOMAC and SF36 questionnaires, respectively. Adverse events were also recorded. The primary outcome measure was the change in total WOMAC score from baseline to the end of treatment at week 12. Longitudinal models were used to evaluate outcome. Results: Thirty-one patients completed the trial (14 bromelain, 17 placebo). No statistically significant differences were observed between groups for the primary outcome (coefficient 11.16, p¼0.27, 95%CI 8.86 to 31.18), nor the WOMAC subscales or SF36. Both treatment groups showed clinically relevant improvement in the WOMAC disability subscale only. Adverse events were generally mild in nature. Discussion: This study suggests that bromelain is not efficacious as an adjunctive treatment of moderate to severe OA, but its limitations support the need for a follow-up study.

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Published date: December 2006

Identifiers

Local EPrints ID: 44640
URI: http://eprints.soton.ac.uk/id/eprint/44640
ISSN: 1460-2725
PURE UUID: d7458147-9f4f-41bd-98f2-d4c9417da08b

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Date deposited: 06 Mar 2007
Last modified: 13 Mar 2019 21:06

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