An open, prospective, comparative study of the efficacy of Revokka in patients with osteoarthritis of the small joints of the hands

Osteoarthritis (OA) is one of the leading causes of chronic pain and disability worldwide, with its prevalence steadily increasing, particularly among older adults and patients with obesity. Nutraceuticals are considered an adjunctive component of symptomatic OA therapy aimed at reducing pain intensity and the need for nonsteroidal anti-inflammatory drugs (NSAIDs), while maintaining a relatively favorable safety profile. Experimental and clinical data indicate that selected nutraceutical components (zinc, Boswellia serrata, avocado/soybean unsaponifiables, rosehip, resveratrol, etc.) exert anti-inflammatory and chondroprotective effects through modulation of pro-inflammatory cytokines. However, the available evidence is limited in both number and duration of studies, underscoring the need for further independent randomized trials and providing the rationale for the present open prospective comparative study of Revokka in patients with hand OA.

The aim – to evaluate the efficacy of adding Revokka to analgesic therapy in patients with hand osteoarthritis, compared with analgesic monotherapy, with regard to pain and function (AUSCAN questionnaire), treatment satisfaction (physician and patient), adherence, and changes in analgesic dosing.

Materials and methods. This open cohort comparative study included 60 female patients with hand OA of Kellgren – Lawrence stages I–III fulfilling ACR (American College of Rheumatology) criteria; median age was 63.0 [59.0; 65.0] years. Patients were randomized into two groups: meloxicam monotherapy (7.5–15 mg/day) or combined therapy with meloxicam plus Revokka (2 capsules/day) for 90 days with three study visits. Efficacy and safety were assessed using the AUSCAN questionnaire, visual analogue scale (VAS; patient/physician), and NSAID use.

Results. The groups were comparable in age (63.0 [59.0; 65.0] years), body mass index, comorbidity profile, OA duration, and radiographic stage distribution (predominantly stages II–III, with no cases of stage IV in Kellgren – Lawrence). By visit 3, VAS pain in hand joints decreased from 74.2 [58.6; 86.3] to 21.2 [15.4; 27.2] mm in group 1 and from 67.1 [62.4; 74.2] to 10.5 [8.7; 14.0] mm in group 2 (total reduction – 71.4% and 84.4%, respectively; between-group p<0.001). Pain reduction was accompanied by an increase in treatment satisfaction on the patient VAS to 71.0 [66.0; 81.0] and 92.5 [89.0; 98.0] mm and on the physician VAS to 76.0 [73.0; 84.0] and 80.0 [75.0; 84.0] mm in groups 1 and 2, respectively. In addition, the median duration of NSAID use from day 30 to day 90 decreased from 56 days in group 1 to 35 days in group 2, with high adherence (90.1% and 97.4%, respectively), indicating additional benefits of including Revokka in the treatment regimen.

Conclusion. In female patients with hand osteoarthritis, combination therapy including the nutraceutical complex Revokka provides a greater reduction in pain intensity, higher treatment satisfaction, and a reduction in NSAID use compared with meloxicam monotherapy.

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