Abstract: Background: Osteoarthritis is a major cause of disability worldwide, especially in older adults. Alternative treatments are preferred due to the cardiovascular and gastrointestinal side effects of non-steroidal anti-inflammatory drugs (NSAIDs). Nutraceuticals help in balancing anabolic and catabolic processes in the joint tissue, improve redox balance, free-radical scavenging, thus provide cartilage protection
. Rosa canina L. (Rosehip),
Boswellia serrata and
Harpagophytum procumbens (Devil`s claw) extract are being recognized for their anti-inflammatory, antioxidant, analgesic and chondroprotective properties in Osteoarthritis.
Aim: A post-marketing clinical evidence generation program was conducted to assess the effectiveness and tolerability of capsule TriNyros in knee osteoarthritis.
Methods: An evidence generation program was conducted in 20 outpatient orthopedic clinics. All patients received TriNyros containing [Rosehip 275 mg, Irido ForceTM (Devil`s claw extract) 100 mg and Aflapin® 50 mg] twice daily for 90 days. Patients were on their regular anti-arthritic treatment and TriNyros was added as an adjuvant to their regular treatment. Clinical assessment of symptoms included palpation pain, limitation of mobility, joint crepitus, swelling and redness was assessed. Osteoarthritis symptoms were measured using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 3- pointer and 10mm visual analogue scale (VAS). Hematological and serum biomarkers were analyzed to evaluate tolerability of TriNyros.
Results: A total of 105 patients, comprising 42 women and 63 men mostly belonging to the age group of 58-65 years (39.05%) enrolled in the program. Significant reduction in WOMAC scores was seen in majority of the patients at day 15, 30, 60 and 90 (P< 0.0001). WOMAC scores for joint pain declined by 58.82% (mean ± SD: 66.43 ± 11.97 to 27.35 ± 7.92) at the end of 3 months (p< 0.0001). The reduction was significant from the 15th day itself (p = 0.02) and continued till day 90. Pain measured by VAS significantly reduced by 67% (7.11 ± 1.56 to 2.34 ± 0.72, P< 0.0001) at day 30, 60 and 90. At the end of the treatment, palpation pain, limitation of mobility, joint crepitus, swelling and redness showed significant improvements (P< 0.01). Intake of concomitant medication was observed in 32 (30.48%) patients. No major adverse reactions were reported.
Conclusion: Overall, this preliminary study concluded that TriNyros was found to be effective and well tolerated in reducing pain and improving general condition in osteoarthritis of the knee.
