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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
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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 Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Anti-Inflammatory Effect of Pioglitazone in Experimental Models of Inflammation in Rats
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         The antidiabetic thiozolidinediones (TZDs) a class of peroxisome proliferators-activated receptor (PPAR) ligands has recently been the focus of much interest for their possible role in regulation of inflammatory response. The present study was designed to evaluate the anti-inflammatory activity of pioglitazone in experimental models of inflammation in rats. The present study was conducted to evaluate the anti inflammatory effect of TZDs (pioglitazone 3mg/Kg) on acute, sub acute and chronic model of inflammation by using egg-albumin and formalin–induced paw edema in 72 rats, relative to reference drugs Dexamethasone 5mg/Kg and Piroxicam 5mg/Kg. In each inflammation model, 24 rats wer

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Publication Date
Sat Apr 12 2025
Journal Name
Journal Of Physical Education
The Effect Of Absolute Strength Training On Knee Injuries Rehabilitation And Special Strength In Muay Thai Fighters
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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
Violation of the Hormonal Spectrum in Polycystic Ovaries in Combination with Insulin Resistance. What is the Trigger: Insulin Resistance or Polycystic Ovary Disease?
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Polycystic ovary syndrome (PCOS) is the main cause of female infertility. The role of insulin resistance in the development of polycystic ovary is actively discussed here. The study included patients with PCOS without insulin resistance (n = 48) and with insulin resistance (n = 39). The comparison groups were patients with no history of PCOS: a control group without insulin resistance (n = 46) and a group of patients with insulin resistance (n = 45). The following parameters were determined in patients: FSH, LH, TSH, T3f, T4f, PRL, E2, 17-OHd, Pr, AMH, Test total, Testf, DHEAS, DHEASs, SHBG, ACTH, cortisol, IRI, IGF-1, C-peptide, and glucose level. The HOMA-IR index and the LH / FSH ratio and t

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Publication Date
Mon Apr 01 2024
Journal Name
Medical Journal Of Babylon
Clinical Evaluation and Comparison between Effects of Rituximab and Prednisolone with Imuran to Neutrophils and Platelet Counts in Pemphigus Vulgaris Patients
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Background: Pemphigus vulgaris (PV) is an autoimmune vesiculobullous mucocutaneous disease with life-threatening consequences. Rituximab (RTX) has recently emerged as an effective treatment for PV. Objectives: This study aims to determine changes in neutrophil and platelet counts for PV patients treated with RTX or corticosteroids combined with Imuran (azathioprine). Materials and Methods: The present cross-sectional study was conducted in the Department of Dermatology at Baghdad Teaching Hospital, Baghdad, Iraq. Thirty PV patients received two types of treatment: 15 patients were administered RTX and 15 patients took corticosteroids with Imuran (azathioprine). Neutrophil and platelet counts were detected at the hospital laboratory. Results

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Publication Date
Wed Dec 29 2021
Journal Name
Modern Sport
Effect of rehabilitation exercises in improving the motor range of people with partial rupture of the anterior cruciate ligament of the knee joint by ages (30-35) men
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The study aimed to prepare rehabilitation exercises using some rubber ropes for people with partial rupture of the anterior cruciate ligament, to recognize their effect on the recovery of motor tides and to reduce the pain of those with partial rupture of the anterior cruciate ligament of the knee joint, and adopted the experimental method by designing the experimental and controlled groups on a sample of those with partial rupture of the anterior cruciate ligament of men (30-35) One year of those who attend the Physiotherapy Center/Rafidain University College of 12 injured were deliberately selected from their community of origin by (100%), and after determining the measuring tools and preparation of exercises applied with rubber r

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Publication Date
Mon May 20 2019
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Effect of Metformin and Glimepiride Treatment on Some Biochemical Parameters in Diabetic Male Patients with Chronic Renal Failure
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The present study was included a measurements of fasting serum glucose, total protein, potassium, and calcium levels in the sera of 25 diabetic male patients suffer from chronic renal failure; their ages range were (32-75) and compared them with 25 healthy males as control group. The aim of this study was to study the effects of antidiabetic drugs on some biochemical parameters such as fasting serum glucose, serum total protein, serum potassium and calcium. The current results demonstrated a hyperkalemia in patients and this increasing of potassium is significantly (p = 0.03), but calcium level showed no significant variations ( p>0.05 ), and serum total protein was significantly decreased in patients as compared to t

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Effects of local Infiltration of Bupivacaine in total hip and knee replacement for post - operative analgesia
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Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
THE PREVALENCE AND CLINICAL SIGNIFICANCE OF PERINUCLEAR ANTINEUTROPHIL CYTOPLASMIC ANTIBODY IN PATIENTS WITH INDETERMINATE COLITIS
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Background: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Clinical and Doppler Study of Restrictive Filling Pattern in Patients with Dilated Cardiomyopathy
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Background: Dilated cardiomyopathy (DCM) is a well-recognized cause of cardiovascular morbidity and mortality.Objectives: To evaluate the prognostic implications of the restrictive left ventricular filling pattern (RFP) in dilated cardiomyopathy.Methods: Patients with DCM admitted to Ibn AL-Bitar Hospital for Cardiac Surgery, Baghdad-Iraq, from May 2006 to August 2008, underwent a full clinical evaluation and Doppler echocardiography study. Patients were classified into three groups: Group I had persistent restrictive filling pattern; Group II had reversible restrictive filling pattern; and Group III had nonrestrictive filling pattern. Results: The current study was conducted on a total number of 80 patients with DCM, fifty (62.5 %) were

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Publication Date
Tue Feb 26 2019
Journal Name
Journal Of Contemporary Medical Sciences
Demographic and clinical profiles of female patients diagnosed with breast cancer in Iraq
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Objective To highlight the main demographic characteristics and clinical profiles of female patients registered with breast cancer in Iraq; focusing on the impact of age.Methods This retrospective study enrolled 1172 female patients who were diagnosed with breast cancer at the Main Center for Early Detection of Breast Cancer/Medical City Teaching Hospital in Baghdad. Data were extracted from an established information system, developed by the principal author under supervision of WHO, that was based on valid clinical records of Iraqi patients affected by breast cancer. The recorded information regarding clinical examination comprised positive palpable lumps, bloody nipple discharge, skin changes, bilateral breast involvement, tumor

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