Possible Beneficial Role of Novel Anti-Osteoarthritic Drug Diacerein in Rheumatoid Arthritis

A network of proinflammatory cytokines plays an important role in the pathogenesis of osteoarthritis and rheumatoid arthritis. Among these pro-inflammatory cytokines, IL-1 superfamily cytokines like IL-1α, IL-1β, IL-18, IL-33, IL-36 (α, β, γ) play a pivotal role in the pathogenesis in both osteoarthritis & rheumatoid arthritis. IL-1β produced by activated macrophages, activated chondrocytes, synoviocytes, osteoarthritic cartilage & subchondral bone. Various literature reveals that IL-1β also plays deleterious effects in cartilage destruction in osteoarthritis & rheumatoid arthritis by increasing the release of various proteolytic enzymes like A Disintegrin-like and Metalloproteinases with Thrombospondin Motifs (ADAMTS) and matrix metalloproteinases (MMPs) like MMP-1, MMP-3 and MMP-13. Apart from this, IL-1β also increases the expression of cathepsin B in chondrocytes that act as an important mediator of cartilage degradation. Novel anti-osteoarthritic drug diacerein shows pro-anabolic, anticatabolic and anti-inflammatory effects on synovial membrane and cartilage by its IL-1β inhibitory effects. The aim of this review article is to discuss the role of diacerein in osteoarthritis and to explore the possible mechanism of action of diacerein in rheumatoid arthritis.