Comparison of the effect of topical Hedera helix L. extract gel to diclofenac gel in the treatment

Objective: The aim of this study was to comparatively investigate the effect of the topical 1% Hedera. helix extract gel to 1% diclofenac gel on knee osteoarthritis. Methods: A total of 150 patients with primary osteoarthritis were randomly divided into three groups: 1% H. helix gel-treated, 1% diclofenac gel-treated, and placebo-treated. The topical gels were applied for 3-5 min three times a day for 6 weeks. Celecoxib capsules were also administered daily. The effects of the gels were evaluated compared to placebo gel using the visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: Pain reduction was significantly more pronounced in 1% H. helix gel group than in the placebo group (P=0.021), but was not significantly different from the pain reduction in diclofenac gel group (P=0.416). Both 1% H. helix gel and diclofenac gel significantly reduced morning stiffness, daytime stiffness, and physical function compared to placebo group (P<0.05). Reduction in pain, morning stiffness, and daytime stiffness were higher in 1% H. helix gel group than in diclofenac gel group, but the difference was not statistically significant (P>0.05). Conclusion: 1% H. helix gel has a relatively similar effect to diclofenac gel on pain severity, morning stiffness, daytime stiffness, and physical function in patients with knee osteoarthritis, and therefore is recommended as a natural therapeutic agent with optimal efficiency to supplement chemical drugs used for knee osteoarthritis.