Efficacy of a Multimodal Ayurveda Regimen in the Management of Primary Knee Osteoarthritis: Protocol for an Open-Label Randomized Controlled Trial (Preprint)
Authors:
- Amit Kumar RaiARAmit Kumar Rai
- Babita YadavBYBabita Yadav
- Uma KumarUKUma Kumar
- Bharti GuptaBGBharti Gupta
- Kishore PatelKPKishore Patel
- Shruti KhanduriSKShruti Khanduri
- Bhagwan S SharmaBSBhagwan S Sharma
- Richa SinghalRSRicha Singhal
- Bhogavalli ChandrasekhararaoBCBhogavalli Chandrasekhararao
- Narayanam SrikanthNarayanam Srikanth
- Rabinarayan AcharyaRARabinarayan Acharya
Preprint
- 2 November 2024
- preprint
- Published by JMIR Publications Inc. in JMIR Preprints
Abstract
BACKGROUND Ayurveda recommends a comprehensive therapeutic approach for osteoarthritis management. However, most of the published clinical studies on Ayurveda interventions for osteoarthritis management have addressed selected modalities of Ayurveda treatment rather than the holistic therapeutic regimen. OBJECTIVE This study aimed to assess the efficacy and safety of a multimodal Ayurveda treatment protocol in the long-term management of primary osteoarthritis of the knee compared with standard care. METHODS The proposed open-label, parallel-group randomized controlled trial was conducted in individuals of any gender aged 40 to 70 years and diagnosed with primary osteoarthritis of the knee as per the American College of Rheumatology criteria. Individuals with grade 4 radiographic changes in the affected knee (based on the Kellgren-Lawrence classification) and with comorbidities were not considered. The study was conducted at the All India Institute of Medical Sciences, New Delhi, India. A total of 150 participants underwent random assignment in a 1:1 ratio to receive either the Ayurveda treatment protocol or conventional standard care for 180 days. The primary outcome was the change in the Western Ontario and McMaster Universities Osteoarthritis Index score from baseline. The secondary outcome measures included the change in the score for pain, stiffness, and physical function from baseline; change in the range of motion of the knee joint; change in the score of the numeric pain rating scale, Pain Disability Index, and 12-item short-form survey questionnaire (to assess health-related quality of life); change in highly sensitive C-reactive protein levels, interleukin-6 levels, magnetic resonance imaging scan findings, and dual-energy X-ray absorptiometry scan findings; and change in the need for rescue analgesic medication from baseline. Safety was evaluated by recording the incidence of adverse events and changes in liver and kidney function tests from baseline. RESULTS Recruitment of study participants commenced on October 11, 2022. Currently, all the participants completed the study and the analysis of the study outcomes is ongoing. CONCLUSIONS This randomized controlled trial will be the first study to explore the potential benefits of a multimodal Ayurveda regimen (based on Ayurveda principles and scientific evidence) in the long-term management of osteoarthritis of the knee through validated subjective, laboratory, and imaging parameters. The outcomes of this study may address the needs and challenges associated with osteoarthritis management. CLINICALTRIAL Clinical Trial Registry of India CTRI/2022/05/042792; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=Njk0MTM=&Enc=&userName= INTERNATIONAL REGISTERED REPORT DERR1-10.2196/68306Keywords
All Related Versions
- Published version: JMIR Research Protocols, 14 (1), e68306.
This publication has 46 references indexed in Scilit:
- Withania somnifera (L.) Dunal - Modern perspectives of an ancient Rasayana from AyurvedaJournal of Ethnopharmacology, 2021
- Osteoarthritis year in review 2019: epidemiology and therapyOsteoarthritis and Cartilage, 2020
- Effectiveness of an Ayurveda treatment approach in knee osteoarthritis – a randomized controlled trialOsteoarthritis and Cartilage, 2018
- Reliability and validity of 12-item Short-Form health survey (SF-12) for the health status of Chinese community elderly population in Xujiahui district of ShanghaiAging Clinical and Experimental Research, 2015
- Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysisRheumatology International, 2014
- Anti-inflammatory and anti-osteoporotic lignans from Vitex negundo seedsFitoterapia, 2014
- Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short‐Form McGill Pain Questionnaire (SF‐MPQ), Chronic Pain Grade Scale (CPGS), Short Form‐36 Bodily Pain Scale (SF‐36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)Arthritis Care & Research, 2011
- Cissus quadrangularis extract enhances biomineralization through up-regulation of MAPK-dependent alkaline phosphatase activity in osteoblastsIn Vitro Cellular & Developmental Biology - Animal, 2008
- Chondroprotective potential of root extracts of Withania somnifera in osteoarthritisJournal of Biosciences, 2007
- Analgesic, antiinflammatory and hypoglycaemic activities of Sida cordifoliaPhytotherapy Research, 1999