Treewipanon Nathapon, Kasetsuwan Ngamjit, Reinprayoon Usanee, Satitpitakul Vannarut, Uthaithammarat Lita, Tanpowpong Thanathep
Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Excellence Center for Cornea Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Clin Ophthalmol. 2023 Oct 9;17:2967-2974. doi: 10.2147/OPTH.S419310. eCollection 2023.
To evaluate diacerein (interleukin-1β inhibitor) efficacy on ocular surface disease (OSD).
This prospective observational study included patients who received diacerein for osteoarthritis and had dry eye (DE). The primary outcome was corneal staining score. Secondary outcomes were ocular surface disease index (OSDI) score, tear breakup time (TBUT), tear osmolarity (Osm), Schirmer's test results, interleukin-1α (IL-1α), interleukin-1β (IL-1β), and interleukin-1 receptor antagonist (IL-1Ra) levels in tears. All measurements were done at baseline and 2-month follow-up visits. Linear mixed models were used to examine the effect of all parameters, and log-transformed models were used for IL-1α, IL-1β, and IL-1Ra analyses.
Thirty-four patients (31 females and 3 males) were enrolled. The corneal staining score improved by 1.29 points (P=0.022, 95% confidence interval [95% CI] 0.19 to 2.40) after 2 months, and the OSDI score improved by 17.2 points (P<0.001, 95% CI 10.82 to 23.58) but TUBT decreased by 0.66 seconds (P=0.021, 95% CI 0.10 to 1.22). No significant differences were observed in the tear Osm and Schirmer's test. IL-1Ra demonstrated no statistical difference, IL-1α was significantly increased by 80% (P=0.260), and IL-1β was significantly decreased by 99.21% (P<0.001).
Diacerein can improve corneal staining and decrease IL-1β levels in tears, which reflects better DE symptoms. Diacerein may be a promising alternative treatment for patients with OSD and osteoarthritis.
评估双醋瑞因（白细胞介素-1β抑制剂）对眼表疾病（OSD）的疗效。
这项前瞻性观察性研究纳入了因骨关节炎接受双醋瑞因治疗且患有干眼症（DE）的患者。主要结局指标为角膜染色评分。次要结局指标包括眼表疾病指数（OSDI）评分、泪膜破裂时间（TBUT）、泪液渗透压（Osm）、泪液分泌试验结果、泪液中白细胞介素-1α（IL-1α）、白细胞介素-1β（IL-1β）和白细胞介素-1受体拮抗剂（IL-1Ra）水平。所有测量均在基线和2个月随访时进行。采用线性混合模型检验所有参数的效应，对IL-1α、IL-1β和IL-1Ra分析采用对数转换模型。
共纳入34例患者（31例女性和3例男性）。2个月后角膜染色评分提高了1.29分（P = 0.022，95%置信区间[95%CI]0.19至2.40），OSDI评分提高了17.2分（P < 0.001，95%CI 10.82至23.58），但TBUT缩短了0.66秒（P = 0.021，95%CI 0.10至1.22）。泪液Osm和泪液分泌试验未观察到显著差异。IL-1Ra无统计学差异，IL-1α显著升高80%（P = 0.260），IL-1β显著降低99.21%（P < 0.001）。
双醋瑞因可改善角膜染色并降低泪液中IL-1β水平，这反映出干眼症症状得到更好改善。双醋瑞因可能是眼表疾病和骨关节炎患者一种有前景的替代治疗方法。
