The effectiveness of Zingiber Zerumbet ointment compared to Diclofenac Gel on clinical symptoms of patients with Knee Osteoarthritis: A double-blind Randomized Controlled Trial (RCT)

Background and Purpose: Osteoarthritis is a joint disease in which cartilage and bone tissues are gradually destroyed. The disease is a global problem and its prevalence is higher in Asia than Europe and the United States. According to WHO recommendations on the use of medicinal plants in the regional nature of any country, the present study aimed to evaluate the effectiveness of Zingiber zerumbet ointment compared with Diclofenac gel on clinical manifestations of patients with knee osteoarthritis. Material and Method: The present double-blind clinical randomized controlled trial (RCT) was conducted on patients with knee osteoarthritis in Tehran (Iran) from February 2017 to September 2018. In the present study, the first group (intervention) consumed Zingiber zerumbet ointment and the second group (positive control) consumed diclofenac gel at a dose of 1 g every 8 hours for 4 consecutive weeks. In the study, the severity of symptoms (pain, stiffness and physical functioning) were considered as the initial outcomes by the WOMAC (Western Ontario and McMaster Universities Arthritis Index), and the experimental tests, namely the CBC, Cr, BUN, ALP, ALT, AST, CRP, 10, and IL6 were considered as secondary outcomes of study. Results: The present study was conducted on 92 patients with Osteoarthritis (drug group: 48 individuals; positive control group: 44 individuals). In the present study, two groups were similar in terms of demographic characteristics. The research results indicated differences in scores of physical functioning (drug group = -11.94, MD of Control+ group = -6.43, P <0.001), Pain (MD of drug group = -3.94, MD of Control+ group = -2.43, P-value = 0.039), Stiffness (MD of drug group= -1.31, MD of Control+ group= -0.91, P-value= 0.135). Furthermore, further results indicated that except for CRP and Bun variables, other Laboratory variables had no significant changes in two groups, Zingiber zerumbet ointment and Diclofenac gel. Furthermore, both groups were similar in terms of number of taken acetaminophen pills. Conclusion: Given that Zingiber zerumbet ointment has an herbal base and its use in reducing symptoms of osteoarthritis is very simple and effective, is use can be recommend in improving symptoms for osteoarthritis.