Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2005; 10: 08
Current conventional treatment for the most prevalent joint disorder, knee osteoarthritis (OA), is associated with a high incidence of adverse reactions. Bromelain, an extract from the pineapple plant, has purported anti-inflammatory and analgesic properties, and may provide a safer alternative or adjunctive treatment. This pilot is the first double-blind placebo-controlled study to assess bromelain’s specific efficacy and safety profile for this condition.
Forty-seven subjects with moderate-to-severe knee OA were randomised in this double-blind, randomised placebo-controlled study to receive 12 weeks of treatment intervention (bromelain 800 mg/day or placebo) with a 4-week follow-up. Monthly knee (pain, stiffness and function) and quality of life symptoms were reported using the WOMAC and SF-36 questionnaires. Adverse events were also recorded. The primary outcome measure was the change in total WOMAC score from baseline to the end of treatment. Longitudinal models were used to evaluate outcome.
Thirty-one patients completed the trial (n=14 bromelain; n=17 placebo). Both treatment groups reported an overall relative reduction in mean total WOMAC scores that was clinically significant for the bromelain group (bromelain group 25.2% improvement; placebo 14.2% improvement) although no statistically significant group differences were observed (coefficient = 11.16, P = 0.27, CI −8.86 to 31.18). Clinically relevant reductions in the WOMAC pain and stiffness subscales were also identified in both groups, and the bromelain group demonstrated clinical improvement in the WOMAC disability scores. However, no statistically significant group differences were reported in these WOMAC subscores nor in the quality of life assessment. Adverse events were generally mild in nature.
Bromelain may potentially be effective in the treatment of moderate-to-severe OA in a fully powered study.
This study was funded by the Lichtwer Pharma UK Ltd and Boots PLC. Medications were supplied free of charge by Lichtwer Pharma UK Ltd, Marlow, Bucks, UK. Dr Brien’s fellowship was funded by the Hospital Savings Association, Dr Lewith’s post was funded by a grant from the Maurice Laing Foundation, Dr Walker’s post was funded by the University of Reading and Dr Bundy’s fellowship was funded by Lichtwer Pharma UK.
