Treatment with oral enzymes in painful osteoarthritis of the knee and periarthritis of the shoulder
Kullich W.*, Klein G.**. Treatment with oral enzymes in painful
osteoarthritis of the knee and periarthritis of the shoulder.
Reumatologia 1998, Suppl Vol. XXXVI, Warsaw 1998, Lectures No. 213,
pp 111-114. ISSN 0034-6233. 619 KA (19-09-2)
* Ludwig Boltzmann Institute for Rehabilitation of Internal
Diseases, Saalfelden, Austria. ** Rehabilitation Centre for
Rheumatic and Cardiovascular Diseases, Saalfelden, Austria. 2nd
Central European Congress of Rheumatology, 13-16 May, 1998, Warsaw,
Poland
40 patients with periarthropathia tendopathica simplex, aged between
38 and 68 years, were observed. The patients took double-blind
randomized the non-steroidal antiinflammatory drug diclofenac in a
dosage of 2 x 50 mg daily or oral enzymes (Phlogenzym®;
Mucos Pharma GesmbH., Germany) in a dosage of 3 x 2 enteric coated
tablets daily, consisting of 90 mg bromelain, 48 mg trypsin and 100
mg of the flavonoid rutosid which normalizes pathologically
increased vessel permeability without inhibiting the endogenous
defensive power.
The randomization resulted in a patients' group with enzyme
treatment of 12 men and 8 women with an average age of 54.5 years
and a group with diclofenac treatment of 12 men and 8 women with an
average age of 51.9 years.
Examinations were made at the beginning and after 1, 2 and 3 weeks
of therapy.
For judgement of efficacy, a sum score of four different types of
pain (pain on rest, pain on motion, pain on pressure, night pain)
and functional impairment was compared.
In our second study 73 patients (36 male, 37 female; 52,0 + 9,1
years of age) with symptomatic OA of the knee and radiographic
evidence of joint space narrowing and osteophyte were recruited. A
patients sum score of the Lequesne's index > 10 was demanded.
The study was performed double-blind randomized with a three weeks
medication.
Due to the "double blind" method, 37 patients were treated with 50
mg diclofenac sodium 3 times daily.
(TID) during the first week, followed by a dosage of 50 mg
diclofenac sodium twice a day (BID) during week 2 and 3, in order to
improve the gastroduodenal tolerance. Those patients additionally
got "enzyme placebo" tablets. 36 patients were treated with 2 enzyme
tablets TID during the whole period. These tablets were an enteric
coated enzyme preparation as mentioned in the former presented study
of
. The "double blind" method required an
additional application of "diclofenac placebo" in this group. In
both groups the therapy was continued with 2 enzyme tablets TID
during the weeks 4-7.
[See
Summary of Study Report]