Arthritis and Enzymes

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Oral enzyme therapy in osteoarthritis of the knee. Proteolytic enzyme are effective with few risks.
MMW Fortschr Med. 2001 Jun 7;143(23):44-6.
PMID: 11460424

Systemic enzyme therapy in osteosynthesis of the long bones

Kamenicek V, Holan P. Chirurgicke oddeleni Nemocnice Bilovec.
Rozhl Chir. 1999 Jun;78(6):279-81. PMID: 10596557

The authors focused their attention on the application of systemic enzyme therapy in traumatology, in particular on its anti-oedematous, fibrinolytic and analgetic effects during the postoperative period in osteosyntheses of the long bones. In a group of 40 patients they investigated postoperative changes of the volume of operated extremities. They found a very marked anti-oedematous effect of Phlogenzym. The authors draw attention to the great importance of anti-oedematous treatment and mention also possibilities of systemic enzyme therapy in this indication.

Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac

Singer F, Oberleitner H. Aus dem Rehabilitationszentrum fur Bewegungsstorungen.
Wien Med Wochenschr. 1996;146(3):55-8. PMID: 8867274

Clinical efficacy of the antiphlogistic potency of enzymes (Wobenzym, 4 x 7 capsules/day) vs. Diclofenac-Na (2 x 50 mg capsules/day) on patients (n = 80) suffering from osteoarthritis of the knee in an acute phase was evaluated. The study design was double blind according to the GCP-guidelines. The treatment period lasted 28 days and was followed by a treatment-free controll-period of another 28 days. There was equal status of age, sex, duration and impact of osteoarthritis in both groups. The clinical parameters as pain at rest, on motion, on walking, at night and pain tenderness showed a significant improvement (p < 0.05) after the treatment period, with tendency to relapse in the following observation period. No significant difference between both treatment-groups could be seen. No changes in laboratory findings were observed. The global-assessment (physician's and patient's score) of efficacy and tolerability in both groups were mostly stated as "very good" and "good". Adverse events were reported as: Wobenzym: total 14 patients: gastrointestinal complaints (obstipation, vomiting, meteorism), allergic rash once and dizziness twice, 6 of these patients discontinued by that reasons. Diclofenac: total 11 patients: gastrointestinal complaints (epigastrical pain, upset stomach, meteorism), dizziness, 3 of these discontinued. All of these vanished after intake was stopped. Summarizing up it could be demonstrated that both evaluated drugs showed equal clinical potency. So it might be assumed that Wobenzym can be used as an alternative substance in treatment of acute painful osteoarthritis.

Enzyme therapy in comparison with immune complex determinations in chronic polyarthritis

Steffen C, Smolen J, Miehlke K, Horger I, Menzel J.
Z Rheumatol. 1985 Mar-Apr;44(2):51-6. PMID: 4050140

42 patients with definite or classic rheumatoid arthritis were treated with an enzyme mixture (Wobenzym) for 6 weeks. Circulating immune complexes were investigated with a Clq-solid phase RIA in weekly intervals and also rheumatoid factors were determined together with other routine laboratory tests. The condition of patients after therapy was recorded together with amount of circulating immune complexes during treatment. 26 (61.9%) patients improved, 13 (30.9%) patients remained unchanged, and 3 (17.1%) showed impairment. No side effects were observed. Patients who primarily showed no immune complexes or patients who had immune complexes which became negative during enzyme therapy, showed improvement more often than patients which had immune complexes and remained positive during the entire course of therapy.

Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthrosis of knee joint: an open randomized controlled clinical trial.

Tilwe GH, Beria S, Turakhia NH, Daftary GV, Schiess W. Department of Medicine, GS Medical College and KEM Hospital, Mumbai.
J Assoc Physicians India. 2001 Jun;49:617-21. PMID: 11584936

OBJECTIVE: To compare the efficacy and tolerability of an oral enzyme preparation (Phlogenzym) with that of an NSAID (diclofenac) in the treatment of active osteoarthrosis. METHODS: Prospective, randomized, controlled, single-blind study of seven weeks duration at a tertiary care centre wherein 50 patients aged 40-75 years, with activated osteoarthrosis of knee joint were randomized to receive phlogenzym tablets (2-3 tablets, bid) or diclofenac sodium 50 mg bid for three weeks. RESULTS: At the end of therapy (three weeks) and at follow-up visit at seven weeks there was reduction in pain and joint tenderness and swelling in both groups, and slight improvement in the range of movement in the study group. The reduction in joint tenderness was greater (p < 0.05) in the study group receiving phlogenzym. CONCLUSION: Phlogenzym is as efficacious and well tolerated as diclofenac sodium in the management of active osteoarthrosis over three weeks of treatment.



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