Abstract
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
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Details
1 Centre Hospitalier Universitaire Sart-Tilman, University of Liège, musculoSKeletal Innovative Research Lab (mSKIL), Institute of Pathology, Level 5, Center for Interdisciplinary Research on Medicines (CIRM), Department of Motricity Sciences, Liège, Belgium (GRID:grid.4861.b) (ISNI:0000 0001 0805 7253); Princess Paola Hospital, Department of Physical Therapy and Rehabilitation, Marche-en-Famenne, Belgium (GRID:grid.4861.b); Artialis SA, GIGA Tower, Centre Hospitalier Universitaire Sart-Tilman, Liège, Belgium (GRID:grid.411374.4) (ISNI:0000 0000 8607 6858)
2 Rohrbach Berg, Austria (GRID:grid.411374.4)
3 Nestlé Health Science, Vevey, Switzerland (GRID:grid.411374.4)
4 Integrated Medhealth Communications (imc), London, UK (GRID:grid.411374.4)
5 University of Milano-Bicocca, School of Medicine and Surgery, Monza, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754)
6 Institute of Neurological Sciences IFNAP, Nuremberg, Germany (GRID:grid.7563.7)