Efficacy and safety of diacerein monotherapy in adults with obesity: A randomized, double‐blind, placebo‐controlled trial

Aim To assess the efficacy and safety of diacerein monotherapy in adults with obesity. Methods Forty‐two adults with obesity participated in the study and were randomly assigned to receive diacerein or placebo in addition to lifestyle modification for 14 weeks, in a double‐blinded fashion. Differences in changes in body weight, body composition, metabolic variables, fatty liver‐related indicators, cardiovascular system variables, lifestyle score and metabolic factors were compared. Results Post‐treatment weight loss percentage from baseline was −6.56% (−8.71%, −4.41%) in the diacerein group and −0.59% (−2.74%, 1.56%) in the placebo group. Compared with the placebo group, the diacerein group showed significant improvements in body composition, metabolic variables and indicators related to fatty liver. In addition, after 14 weeks of treatment, diacerein led to a significant reduction in serum visfatin concentration versus the placebo group. The reductions in total body fat mass and visceral fat area mediated the weight loss induced by diacerein. No significant differences were found between the groups in the number of adverse events and safety variables. Conclusions For adults with obesity, diacerein led to a clinically meaningful weight loss and provided multiple metabolic benefits with acceptable safety. These results support that diacerein is a promising candidate medicine to be developed for obesity management.