Influence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip.
BACKGROUND
Nonsteroid anti-inflammatory drugs represent an important osteoarthritis (OA) therapy component, but also a leading cause of gastropathy: one of the most frequent and serious OA therapy complications. The aim of the present study was to study the influence of GI health in an OA population receiving either ginger or diclofenac.


METHODS
Forty-three (43) patients with confirmed OA (knee and hip) were included in a randomized controlled study. A ginger group of 21 patients (17 women, 4 men) was given a specific ginger combination daily (340 mg EV.EXT 35 Zingiber officinalis extract) for 4 weeks. A diclofenac group (positive control) of 22 patients (18 women, 4 men) received 100 mg diclofenac daily for the same period. Both groups also received 1000 mg glucosamine daily. Gastrointestinal pain and dyspepsia were evaluated according to the severity of dyspepsia assessment (SODA) form. Patients also underwent esophagogastroduodenoscopy (EGDS) including biopsy before and after the treatment. Serum gastrin-17 levels, and stomach mucosa prostaglandins (PG) E1, E2, F2α, and 6-keto PGF1α (PGI2) levels were measured. Arthritic pain was evaluated using the visual analogue scale (VAS) on standing and moving.


RESULTS
The ginger group showed a slight but significantly lowered SODA pain and no change of SODA dyspepsia. EGDS showed significantly increased levels of PGE1, PGE2, and PGF2α in the stomach mucosa. This rise in gastric mucosa PG levels correlated with an increase in serum gastrin-17. On the other hand, the diclofenac group showed increased SODA pain and dyspepsia values with a corresponding significant decrease of stomach mucosa prostaglandins and general negative stomach mucosa degeneration. Both groups showed a relevant and significantly lowered VAS pain both on standing and moving.


CONCLUSIONS
The ginger combination is as effective as diclofenac but safer in treating OA, being without effect on the stomach mucosa. The increased mucosal PGs synthesis in the ginger group supports an increased mucosa-protective potential. VAS; visual analogue scale, 0-100 mm.
Health Care Department, The Central Gastroenterology Scientific Research Institute, Moscow, Russia. vndrozdov@yandex.ru
Vladimir N
VN
Drozdov
Victoria A
VA
Kim
Elena V
EV
Tkachenko
Galina G
GG
Varvanina
D015746:Abdominal Pain / Q000209:etiology* / Q000378:metabolism; D000527:Alprostadil / Q000378:metabolism; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D004008:Diclofenac / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015237:Dinoprost / Q000378:metabolism; D015232:Dinoprostone / Q000378:metabolism; D004415:Dyspepsia / Q000209:etiology* / Q000378:metabolism; D016145:Endoscopy, Digestive System; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology; D005755:Gastrins / Q000097:blood; D020939:Zingiber officinale; D006615:Hip; D006621:Hip Joint; D006801:Humans; D007717:Knee; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000188:drug therapy*; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010147:Pain Measurement; D008517:Phytotherapy; D010936:Plant Extracts / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012720:Severity of Illness Index
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005755:Gastrins; D010936:Plant Extracts; D004008:Diclofenac; C013550:gastrin 17; D015237:Dinoprost; D000527:Alprostadil; D015232:Dinoprostone