gms | German Medical Science

44. Kongress der Deutschen Gesellschaft für Rheumatologie, 30. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 26. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

31.08. - 03.09.2016, Frankfurt am Main

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Comparative effectiveness of Ayurveda and conventional care in knee osteoarthritis - a randomized controlled trial (CARAKA)

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  • Christian Kessler - Charité Hochschulambulanz für Naturheilkunde am Immanuel Krankenhaus Berlin, Innere Medizin & Naturheilverfahren, Berlin
  • Kartar Dhiman - CCRAS, Ayurveda, Neu Delhi, Indien
  • Abhimanyu Kumar - AYUSH, Ayurveda, Neu Delhi, Indien
  • Thomas Ostermann - Universität -Herdecke, Witten
  • Shivenarain Gupta - P.D. Patel Hospital, Ayurveda, Nadiad, Indien
  • Antonio Morandi - Ayurvedic Point, Ayurveda, Mailand, Italien
  • Martin Mittwede - REAA, Ayurveda, Birstein
  • Elmar Stapelfeldt - Immanuel Krankenhaus Berlin, Naturheilkunde, Berlin
  • Michaela Spoo - Immanuel Krankenhaus Berlin, Naturheilkunde, Berlin
  • Katja Icke - Charité Universitätsmedizin Berlin, Berlin
  • Andreas Michalsen - Immanuel Krankenhaus Berlin, Zentrum für Naturheilkunde, Berlin
  • Claudia Witt - Charité Universitätsmedizin Berlin, Berlin

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 44. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 30. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 26. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Frankfurt am Main, 31.08.-03.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocOS.03

doi: 10.3205/16dgrh282, urn:nbn:de:0183-16dgrh2827

Veröffentlicht: 29. August 2016

© 2016 Kessler et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Background: Ayurveda is used to treat knee osteoarthritis (OA) despite limited evidence. We aimed to evaluate the effectiveness of complex multimodality Ayurvedic treatment in comparison to conventional care in OA knee patients.

Methods: Patients with OA of the knee according to ACR criteria were included in a multicenter randomized, controlled trial and treated in 2 hospital outpatient clinics and 2 private outpatient clinics with a total of 5 physicians and 20 therapists participating. Patients received either Ayurvedic treatment (n=77) or conventional care (n=74) with 15 treatments over 12 weeks. Primary outcome was the change on the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index after 12 weeks. Secondary outcomes included the WOMAC subscales, a pain disability index, numeric rating scales for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood index, rescue medication use, and safety issues.

Results: A total of 151 patients (Ayurveda n=77, conventional care n=74) were included. Changes of the WOMAC Index from baseline to 12 weeks were more pronounced in the Ayurveda group (mean difference 61.1 [95% CI 52.4;69.6]) than in the conventional group (32.0 [95% CI 21.4;42.6]) resulting in a significant difference between groups (p<0.001) and a clinically relevant effect size (Cohen’s d 0.68 [95% CI 0.35;1.00]). Similar tendencies were observed for all secondary outcomes at week 12. Effects were sustainable at follow-ups after 6 and 12 month.

Conclusion: The results suggest that a complex Ayurvedic treatment might be clinically superior to a complex conventional intervention in the treatment of OA of the knee.

The trial was registered at clinicaltrials.gov under NCT01225133.Primary Funding Source: Ministry of AYUSH, Government of India.