Efficacy and Safety of Celecoxib and a Korean SYSADOA (JOINS) for the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Background: The efficacy of cyclooxygenase-2 (COX-2) inhibitors, including celecoxib, in managing knee osteoarthritis (KO) is well-established. Recently, the plant extract cocktail JOINS (SKI306X and its newer formulation, SKCPT) has been shown to be an effective slow-acting drug for KO. Aims: To compare the efficacy and safety of celecoxib and JOINS in patients with KO. Methods: A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified randomized controlled trials (RCTs) assessing the effectiveness and safety of celecoxib and JOINS. The outcomes included pain relief, functional improvement, and safety profiles. Outcome measurements were compared between the celecoxib and JOINS cohorts at the short-term (closest to 3 months) and mid-term (closest to 12 months). Results: Overall, 23 RCTs involving 3367 patients were included in this systematic review. The efficacy of JOINS in reducing pain, as indicated by the visual analog scale (VAS) score, was comparable to that of celecoxib. Regarding functional improvement assessed using the Western Ontario and McMaster University Arthritis Index (WOMAC), JOINS showed improvement comparable to that of celecoxib regardless of follow-up. In addition, no significant difference was observed in the incidence of adverse events between the celecoxib and JOINS cohorts. Conclusions: The results of this study suggest that JOINS could be considered as a pharmacological agent with significant efficacy for pain relief and functional improvement in patients with KO in clinical practice. © 2025 by the authors.