Short-Term Treatment of Painful Osteoarthritis of the Knee with Oral Enzymes

A study conducted in January of 2000 sought to examine the effects of oral enzymes on knee pain caused by degenerative osteoarthritis. Osteoarthritis of the knee (or gonoarthritis) is a common degenerative disorder the increases with age. Inflammatory processes ultimately destroy the cartilage surrounding the knee joint, causing pain and decreased range of motion. Current standards of therapy for this condition involve non-steroidal anti-inflammatory drugs (NSAID’s) and corticosteroids in an attempt to control the inflammatory process. The trouble with NSAID’s involves the adverse effects accompanying their long-term use. Prolonged NSAID use can be damaging to both the gastrointestinal lining and the kidneys.

The use of oral proteolytic enzymes is a fairly new concept in arthritis treatment, although there are several studies that back their efficacy and tolerability. Some studies even report their efficacy as equal to or better than ibuprofen in animal models. A significant difference between enzymes and NSAID’s, however, is that enzymes are capable of greatly reducing joint degeneration. Enzymes exert their benefits by modifying inflammatory mediators on a cellular level, resulting in: decreased swelling, scar tissue break down, and inhibition of inflammatory molecules reaching their targets.

The study was carried out on 73 patients with symptomatic osteoarthritis of the knee, and was conducted on a double-blind, randomized 3 week trial. Patients were split into two groups: a group receiving a small amount of enzymes and placebo, and a second group receiving active enzymes in larger doses. The efficacy of oral enzyme therapy was then evaluated over the 3-week trial period by measuring the pain and joint function of the knee. After one week of enzyme therapy, the enzyme group experienced vast improvements in rest pain, pain on movement and restricted movement. These improvements were measured as 59% from baseline measurements. After 3 weeks of enzyme therapy, this group saw an 87.5% improvement from baseline measures. After the trial, researchers followed up with the subjects at the 7-week mark, and the follow-up revealed a 94% improvement from baseline measures.

What’s especially interesting, however, is that even the group receiving only a small amount of enzyme therapy reported improvement in the same areas. Motility of the knee was improved and pain was significantly reduced. The tolerability to enzyme therapy was reported as “very good” for those in the enzyme-treated group, and “very good to good” in the enzyme-placebo group.

Enzyme therapy is a clinically relevant and widely available option for patients with osteoarthritis. NSAID’s are currently the first line of therapy used by these patients, even though lesions of the gastrointestinal lining can develop with regular use. Even more importantly, elderly patients are seven times more likely to develop ulcers with NSAID use. The use of several drugs for other existing conditions further puts this population at risk for adverse side-effects. The main goal in treatment of any arthritic symptom is pain relief, and the analgesic effects of enzyme therapy offer a direct influence on pain mediators. Enzyme therapy should be considered in light of prolonged NSAID use and the presence of arthritic symptoms.


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