It appears this would mainly be used to help with digestive problems.
Thanks for posting.
Does anyone have any information to add?
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What is the combine process of Trypsin, Bronmelain, rutoside trihydrate BP
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Trypsin, rutin and bromelain used together has been shown in studies to be as effective against osteoarthritis pain as Diclofenac. These ingredients also have the benefit of helping with digestion. And Rutin will help with hemorroids.
" Participants: A six-week, multi-center, randomized, double-blind, parallel-group trial was conducted with 96 volunteers (28 men and 70 women, mean age approximately 56.5 years) with radiologically confirmed and symptomatic osteoarthritis (OA) in one knee were enrolled in two clinical centers in Pakistan. All volunteers had a Lequesne's Functional Index (LFI) [greater than or equal to] 10. Volunteers were excluded if they had been treated with corticosteroids within two months of the study, received any other treatment within two weeks prior to the study, had rheumatoid arthritis (RA) in addition to OA, or had been diagnosed with a disease causing secondary arthritis.
Study Medication and Dosage: One enteric-coated, enzyme-rutoside combination (ERC), (Phlogenzym[R], Mucos Pharma, Geretsried, Germany) containing 90 mg bromelain, 48 mg trypsin and 100 mg rutosid t.i.d. or diclofenac sodium (Duravolten[R], Durachemie, Wolfsrathausen, Germany) 50 mg b.i.d. Using a "double-dummy technique," volunteers in the ERC group received ERC treatment medication plus diclofenac placebo, while those in the diclofenac group received active diclofenac treatment in addition to ERC placebo.
Outcome Measures: The primary outcome measures included LFI (which measures pain or discomfort, maximum distance walked, and activities of daily living) and visual analog scale (VAS). The VAS questionnaire included assessments of pain at rest, pain with movement, and restriction of function, each on a 10-point scale (0 = best; 10 = worst). The sum of the three VAS judgments (from 0-30 points) provided the VAS rating. Additional criteria included judgment of disability based on a 5-point scale, from 1 (light) to 5 (unbearable), therapy efficacy on a 7-point scale from 1 (much better) to 7 (much worse), range of motion without pain (angle in degrees) and knee circumference (cm). Treatment efficacy was determined by scores provided by the volunteer and doctor on a scale from 1 (very good) to 5 (poor). Adverse events (AEs), as well as volunteer and researcher assessment of safety, were calculated on a 5-point scale, from 1 (very good) to 5 (poor). Hematology and biochemical indicators were also tested, including indicators of liver function (SGOT, SGPT, and GGT).
Key Findings: LFI decreased by a mean 26.3% (13.0-9.4) in the ERC group and by a mean 23.6% (12.5-9.4) in the diclofenac group. The mean complaint index decreased by 30.2% (4.9-3.5) in the ERC group and by 26.6% (4.9-3.6) in the diclofenac group. Pain at rest decreased by 41.0% in the ERC group compared to 22.5% in the diclofenac group. Pain with motion was equally reduced by 28.6% in both groups. ERC improved restricted function by a mean 10.0%, while there was no improvement with diclofenac. More of the ERC volunteers (24.4%) rated their symptoms "much better" compared with 19.2% of those in the diclofenac group. Examining physicians rated treatment efficacy "good" in 51.4% of ERC volunteers compared with 37.2% of diclofenac volunteers, which was similar to the frequency of this rating by the volunteers (data not reported).
No "remarkable differences" were detected in serum laboratory values in the ERC compared to diclofenac groups; however, median SGOT, SGPT, and GGT decreased in the ERC group and increased in the diclofenac group. No serious AEs were reported during the study. AEs were generally mild and similar in each group. AEs were experienced by 27.5% of volunteers in the ERC group compared to 23.1% with diclofenac. Diarrhea was the most frequently reported AE in each group. Safety ratings by physicians and volunteers were similar for both treatments. ERC and diclofenac were rated as "very good" or "good" by 89.2% vs. 86.0% of volunteers, respectively, and 84.2% vs. 86.0% of physicians, respectively.
Practice Implications: With the increasingly negative information regarding cardiovascular risk emerging on the regular use of COX-2 inhibitors such as rofecoxib (Vioxx[R]) and celecoxib (Celebrex[R]), patients with OA are clamoring for alternatives to help manage pain. Although lacking a placebo group, this trial suggests that the combination of two enzymes, bromelain and trypsin, combined with rutosid (a synthetic derivative of rutin), is as effective as the NSAIDdiclofenac (Voltaren[R]) for the management of pain in patients with OA of the knee. Future trials should focus on longer treatment duration and whether this natural combination may work synergistically with glucosamine sulfate. It is important to note that the product was enteric-coated to avoid destruction by the acidic pH of the stomach.
Akhtar N, et al. "Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee--A double-blind, prospective, randomized study." Clin Rheumatol, 2004; 23:410-15.
By Donald Brown, MD
COPYRIGHT 2005 Original Internist, Inc. COPYRIGHT 2007 Gale Group "