EVALUATING ADJUNCTIVE ROLE OF PPI AS ANTI INFLAMMATORY AGENT IN KNEE OSTEOARTHARITIS: A PROSPECTIVE STUDY IN TERTIARY CARE HOSPITAL

Osteoarthritis (OA) is one of the main causes of disability worldwide. Patients are mostly treated with NSAIDS with PPI and H₂ blockers, analgesics, opoids etc in everyday practice. In addition to anti-secretory effects, PPIs have anti-oxidant and anti-inflammatory actions in vitro. But the role of PPIs as anti-inflammatory agents remains to be explored. Aim: Present study was aimed to compare efficacy and safety of Diclofenac (DIC) + Proton pump inhibitor(PPI) and Diclofenac+H2 blocker in  patients  with knee osteoarthritis  methodology: We conducted  prospective randomised control open label study on 40 patients at Orthopedic  OPD of tertiary care hospital. Patients were given either DIC(100mg SR OD) + PPI (Omeprazole 20mg OD) or DIC (100mg SR OD)+ H₂ blocker (Famotidine 20mgOD) for two weeks. Clinical effectiveness was assessed by using Knee injury and Osteoarthritis Outcome Score (KOOS) and Visual analogue score(VAS) as efficacy parameters. Suspected ADRs were recorded at each visit.  Observation: In the present study, the prevalence of osteoarthritis was more common in the age group 50-59 years (48%) with female predominance (95%). After application of KOOS questionnaire and VAS net quality gain in symptoms were better with SR diclofenac +PPI group than SR diclofenac+H₂ blockers. Less ADR profile were seen in diclofenac +PPI group with epigastric pain topping the list. Conclusion: Addition of PPI act not merely as potent acid suppressing agents but also add to the anti-inflammatory and  analgesic action of diclofenac and  increases patients adherence / compliance to the treatment.