25% DMSO gel 5–8 cm Placebo gel 5–8 cm Dosage: TID Treatment period: 3 weeks
Primary outcome: change in pain scores for.
(i) Pain under loading VAS(ii) Pain at rest: Likert scale(iii) Pain on palpation: Likert scaleSecondary outcomes:
(i) Mobility six-point likert(ii) Swelling(iii) Pt and physicians global assess of efficacy and tolerability(iv) Adverse events Evaluated baseline, 7, 14 and 21 days
All primary efficacy criteria significantly better than placebo
Statistically significant and clinically relevant reduction in loading pain of mean 42.7 mm (reduction of 64.5%) in DMSO compared to a significant reduction of 30.8 mm in the placebo (reduction of 46.5%).Difference in mean reduction was 11.7 mm (CI 18.35 to 5.1). DMSO significantly better than placebo ()Pain at rest is significantly reduced by mean of 1.3 in DMSO compared to 0.9 in placebo, Pain on palpation is significantly reduced by mean of 1.5 in DMSO compared to 1.1 in placebo, NS group diff for Mobility and swelling Pt and physician global assessment better for DMSO than placebo No serious AE 9 AE DMSO; 12 P
Double-blind, three arm comparative, multi-center and placebo-controlled trial
Knee
248 (84 DF; 80 DMSO; 84 placebo)
(1) Topical DF plus DMSO (45.5% wt/wt) 40 drops four times daily
(2) Topical (45.5% wt/wt) DMSO 40 drops four times daily
(3) Topical placebo-control solution (containing 4.5% wt/wt DMSO) 40 drops four times daily
(4) Dosage: Four times a day Treatment period: QID 28 days
Primary outcomes:
(i) WOMAC pain subscale Secondary outcomes:(i) Physical and stiffness subscales of (WOMAC)
(ii) Weekly patient global assessment (PGA).(iii) Pain on walking (post hoc)(iv) Amount of rescue medication taken.
WOMAC pain scores was significant reduced in the DF group (3.9 (95% (CI) 4.8 to 2.9)) compared to DMSO (2.5 (CI 3.3 to 1.7)): or placebo (2.5 (CI 3.3 to 1.7)): . DF is significantly greater at reducing pain compared to DMSO and placebo. DMSO was not superior to placebo in pain reduction. DF was significantly better than DMSO and placebo for improving physical function, stiffness, pain on walking and PGA.NSD for adverse event reporting No therapeutic benefit on efficacy variables for DMSO as vehicle control (45.5%) versus placebo solution (4.5% DMSO)
Primary outcomes (at baseline, 2, 4, 8 and 12 weeks):(i) Pain, Physical function and stiffness and total scores (WOMAC)Secondary outcomes (at baseline & 12 weeks)(i) Patient and Physician GA (5-point Likert scale)(ii) SF-36(iii) Labs (CRP, homocysteine, ESR, and MDA)
(iv) Use of rescue analgesia(v) weekly by telephone—compliance and AE
Primary: MSM significantly improved WOMAC pain (14.6 versus 7.3, ) & physical function (15.7 versus 8.8, ) compared to placebo. No significant difference noted for stiffness (10.1 versus 6.5, ) nor total scores (13.4 versus 7.5, ) compared to placebo.
Secondary: No significant difference in decrease in either patient () or physician (0.447) GA.Significant decreases in MDA () and homocysteine () observed in MSM compared to placebo. AE were minor (notably GI, fatigue, insomnia) and no group diff in levels reported (MSM, ; placebo, ).
Authors reported that significant differences found in MSM were not necessarily clinically relevant when compared to NSAID treatment changes on these measures.
One-week step up dose from 2 g per day until 6 g per day reached.
