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Evaluation of the Clinical use of Metformin or Pioglitazone in Combination with Meloxicam in Patients with Knee Osteoarthritis; using Knee Injury and Osteoarthritis outcome Score

Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.

This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygenase-2 (COX-2) inhibitor, meloxicam, in the treatment of knee osteoarthritis (OA).

Randomized, double blinded clinical study was performed on 98 patients who have symptomatic and radiologic evidence of painful OA of the knee (57 patients only completed the study). Patients were allocated into three groups, group (A); 20 patients treated with meloxicam (15mg/day) alone, group (B); 20 patients treated with metformin (1000mg/day) + meloxicam (15mg/day) and group (C); 17 patients treated with pioglitazone (15mg/day) + meloxicam (15mg/day). The treatment was followed for 12 weeks through measurement of the clinical effects of drugs each 7 days, using the Knee Injury and Osteoarthritis Outcome Score (KOOS) system.

The results showed that metformin or pioglitazone, when used in combination with NSAID resulted in significant improvement in the components of KOOS, higher than that produced by meloxicam when used alone. In conclusion, administration of metformin or pioglitazone as adjuvant therapy to NSAID, meloxicam, in OA patients produced very well characterized analgesic and anti-inflammatory activities, and improves the therapeutic profile of meloxicam.

Keywords: Metformin, Pioglitazone, Osteoarthritis, Knee injury, KOOS.

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Publication Date
Thu Feb 01 2018
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
IMPACT OF METFORMIN AND SERRATIOPEPTIDASE IN OBESE PATIENTS WITH KNEE OSTEOARTHRITIS

Objective: Knee osteoarthritis is a common disabling chronic disease globally. Many pharmacological agents have been used efficiently in treatment of knee osteoarthritis. This study aims to evaluate metformin and serratiopeptidase together in treatment and stop of osteoarthritis progression by different mechanisms. Methods: Present study was a randomized clinical trial study conducted in Al-Kindi teaching hospital through the period from 1st January to 30th of May, 2017 on two groups of 80 osteoarthritis patients (group I; treated with metformin 850 mg oral tablets) and (group II; treated with metformin 850 mg oral tablets and serratiopeptidase 20 mg oral tablets). Parameters of two groups were compared with those of 40 normal healt

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Fibromyalgia Syndrome among Iraqi Patients with Knee Osteoarthritis.

Back ground: Fibromyalgia syndrome (FMS) is a common chronic musculo-skeletal disorder resulting in chronic widespread pain impacting on quality life.
Objectives: To assess the relationship between FMS and knee osteoarthritis (KOA) and to evaluate the predictors of this relationship if present.
Patients and Methods: One hundred Iraqi KOA patients and 100 healthy controls were included in this cross-sectional study. Full history was taken and complete clinical examination was done for all patients. Baseline characteristics [age, sex, duration, body mass index (BMI), waist circumference, family history (Hx) of KOA, smoking history, and drug history.] were also documented. Laboratory analysis included complete blood count, erythrocyte

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Publication Date
Tue Jun 14 2022
Journal Name
International Journal Of Health Sciences
Knee osteoarthritis

Osteoarthritis (OA) is recognized as a main public health difficult. It is one of the major reasons of reduced function that diminishes quality of life worldwide. Osteoarthritis is a very common disorder affecting the joint cartilage. As there is no cure for osteoarthritis, treatments currently focus on management of symptoms. Pain relief, improved joint function, and joint stability are the main goals of therapy. The muscle weakness and muscle atrophy contribute to the disease process. So, rehabilitation and physiotherapy were often prescribed with the intention to alleviate pain and increase mobility. Medical therapy provides modest benefits in pain reduction and functional improvement; however, non-steroidal anti-inflammatory dru

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Publication Date
Wed Apr 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The role of Chloroquine phosphate on rheumatoid factor in patients with knee osteoarthritis

Background: Osteoarthritis (OA) is disorder of diarthrodial joints characterized clinically by pain and functional limitation. Rheumatoid factor (RF) represents one of routine laboratory tests that done for all patients have joint complaints. Chloroquine phosphate (CQP) is a disease modifying antirheumatic drug (DMARD) used for patients suffer from knee osteoarthritis (KOA) in order to reduce their RF value and improves the disease status.
Objective: To evaluate the effect of chloroquine phosphate on rheumatoid factor (RF) level in serum of patients with knee osteoarthritis KOA) Design: case report.
Subjects and methods: RF value were assessed quantitatively by ELISA technique before and after tre

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Publication Date
Wed Oct 01 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Role of Chloroquine phosphate on Acute phase reactant in patients with knee osteoarthritis

Background: The acute phase response is a major pathophysiologic phenomena that accompanies inflammation whether acute or chronic. The complements 3 (C3), complement4
(C4) and C-reactive protein (CRP) are positive acute phase proteins (+ve APPs) their production is increased by hepatocyte in osteoarthritis (OA). Chloroquine (CQ) which is a diprotic weak base traditionally used to treat malaria.Todate, the phosphate salt of CQ is used to decrease +ve APPs.
Objective: To evaluate the role of chloroquine phosphate on acute phase proteins C3, C4 and Creactive protein in patients with knee OA.
Subjects and methods :A total of seventy four patients (45 female and 29male) were selected randomly from the outpati

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Chloroquine Phosphate on Acute Phase Reactant Proteins in Patients with Knee Osteoarthritis

The acute phase response is a major pathophysiologic phenomenon that accompanies inflammation whether acute or chronic. Complement (C3 and C4) and C - reactive protein (CRP) are positive acute phase proteins (+ ve APPs ). Their production takes place in hepatocyte and the blood concentration of these parameters are increased in osteoarthritis (OA). Chloroquine (CQ) is a diprotic weak base traditionally used to treat malaria. Recently the phosphate salt of CQ is used to decrease this type of (+ve APPs) . In this study,  patients who suffered from knee osteoarthritis (KOA) are treated with oral dosage form of chloroquine phosphate (CQP) for one month, twice daily. Our results demonstrate that CQP improves the patient status by decreas

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
Association of radiological osteoarthritis of the knee joint with locomotor disability

Background:  Knee osteoarthritis (KOA) is a common joint disorder leading to considerable pain and locomotor disability in lower limb function. Locomotor disability, which is difficulty in activities of daily living related to lower limb function, can be the consequence of KOA, so early diagnosis and management may improve quality of life.

Objective: To assess the contribution of radiological osteoarthritis of the knees to disability in the activities of daily living related to lower limb function.

 Methods: One hundred twenty Iraqi KOA patients (104 females and 16 males) who were attending to Rheumatology Unit, Full history was taken and complete clinical exami

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Publication Date
Wed Oct 01 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
A STUDY OF LEPTIN & LIPID PROFILE IN A SAMPLE OF IRAQI PATIENTS WITH KNEE OSTEOARTHRITIS.

Background: New data suggests that joint damage in Knee Osteoarthritis (KOA) may be caused by systemic factors like adipose tissue products; Adipokines, which may provide a
metabolic link between obesity & KOA. Recently, one of the known adipokines named LEPTIN has been linked to KOA because it can be detected in serum & synovial fluid of
patients with KOA.
Objective: To evaluate the contribution of Leptin & serum lipids to the pathophysiology of Osteoarthritis in Iraqi patients with Knee OA.
Subjects& Methods: The study was carried on 90 subjects divided into four groups: Knee Osteoarthritis cases group (n=60). Control group (n=30). Obese subjects group (n=60).
Non-obese subje

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Publication Date
Sat Apr 30 2022
Journal Name
Pakistan Journal Of Medical And Health Sciences
Role of Progranulin and its Implication in Knee Osteoarthritis among Iraqi Patients

Background: Osteoarthritis is a complicated, chronic disorder of cartilage and bone, associated with homeostasis of bio-elements. The current study aims to assess the role of serum progranulin levels among Iraqi patients with knee osteoarthritis. Patients and Methods: The study encompassed 50 patients aged 52.50 ± 3.12 years (25 males and 25 females), admitted to the at the Baghdad Medical City through the period from November 2021 to March 2022. All individuals were identified by physicians in a Rheumatology and Rehabilitation Outpatient Clinic and the clinical data was collected along with the assess¬ment of biochemical parameters. Fasting serum glucose, lipid profile, calcium, magnesium, alkaline phosphatase, vitamin D3, and p

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The effects of chloroquine phosphate on the serum level of proinflammatory interleukins in patients with knee osteoarthritis.

Background: Osteoarthritis is the most common joint disorder. Treatment is usually limited to short term symptom relived and is by no means satisfactory.

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