Seventy-one patients with primary knee osteoarthritis were randomized to receive either diacerein and celecoxib combination therapy (n=25), diacerein and placebo (n=24), or celecoxib and placebo (n=22). The primary outcome was the change in visual analog scale (VAS) score after 12 weeks. Secondary outcomes included WOMAC pain, stiffness, and physical function scores, and safety outcomes. Outcomes were assessed at baseline, 4, 8, 12, and 16 weeks. Overall, the results of the study revealed that while all groups showed significant improvement in VAS and WOMAC scores, the combination group had greater early improvement in stiffness and function at 4 weeks. No serious adverse events were reported. The findings suggest that combination therapy may provide early symptomatic benefit with a similar safety profile to monotherapy.