Knee pain research
Knee osteoarthritis is a common disabling condition causing significant pain and impaired physical function. Reduced ability to walk can hamper everyday tasks and limit a person’s physical activity and social interactions, potentially leading to a raft of physical health, mental health and quality-of-life issues.
Currently there is no treatment that slows the progression of knee osteoarthritis, so there is an urgent and unmet need for effective treatment.
Randomised controlled trials are the most rigorous type of clinical trials, that demonstrate effect by allowing comparison with a neutral (control) group that do not receive the drug or therapy being investigated.
Metformin for Knee Osteoarthritis
The Metformin for Knee Osteoarthritis Study is a randomised clinical trial with the aim to investigate the effect of metformin on knee pain and function in people with symptomatic knee osteoarthritis and overweight or obesity.
Metformin is a type 2 diabetes medication that works by preventing the production of sugar in the liver, and is a widely used and effective treatment for patients with type 2 diabetes mellitus. The main effect of metformin is to reduce blood glucose levels, resulting in sustained, modest weight loss, and lowering of lipids (fats) and inflammation.
There is emerging evidence suggesting metformin may have the potential to slow the rate of knee cartilage loss and reduce pain in people with knee osteoarthritis and obesity. If our research finds that metformin is effective, it will offer a new way to improve pain and function in those with knee osteoarthritis and overweight or obesity.
This study is funded by NHMRC. We anticipate completion by December 2023.
Does low dose amitriptyline reduce pain in knee osteoarthritis?
The main symptom of knee osteoarthritis is pain. There are drug and non-drug treatments for knee pain in osteoarthritis, however, most of these do not control pain well. This may be because whilst some pain comes from the changes at the knee, there is evidence that shows pain can also be related to changes that occur in the nervous system after pain has been present for some time. These changes are called pain sensitisation.
Pain sensitisation is also seen in unrelated conditions, such as after shingles. In these cases, a medication called amitriptyline can be used to control the pain related to pain sensitisation.
The aim of this clinical trial is to determine whether low-dose amitriptyline is effective in the management of pain in people with knee pain related to knee osteoarthritis. If this study finds amitriptyline to be effective, it will potentially enable this treatment to be considered by more individuals. It will also tell us more about why people have pain in knee osteoarthritis, which may in turn help us to find even more effective treatments for this condition.
DICKENS: A randomised controlled trial of Diacerein to treat knee osteoarthritis with effusion-synovitis
The DICKENS study is a multi-centre, randomised clinical trial with the aim to investigate the effect of the drug diacerein on the reduction of knee pain and inflammation in people with symptomatic knee osteoarthritis and effusion-synovitis.
Diacerein is an anti-inflammatory medication that works by blocking the actions of a protein called interleukin-1 beta, that is involved in inflammation. Diacerein is approved in a number of countries in Europe and Asia for the treatment of joint diseases such as osteoarthritis.
Our research study could be used to justify the approval of diacerein for therapeutic use in Australia.
This study is funded by NHMRC. We anticipate completion by December 2022.