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JAMA:不支持使用唑来膦酸治疗膝盖骨关节炎

2020-04-22 MedSci原创 MedSci原创

研究认为,对于症状性膝盖骨关节炎和骨髓损伤患者,每年注射唑来膦酸并不能显著减少24个月内软骨体积的损害。研究不支持唑来膦酸治疗膝盖骨关节炎

理论研究认为静脉注射唑来膦酸可以缓解膝盖骨关节炎患者的疼痛和骨髓病变,但这一结论缺乏大规模试验的数据。近日研究人员考察了静脉注射唑来膦酸对症状性膝盖骨关节炎和骨髓病变患者的影响。
 
50岁或50岁以上患有症状性膝盖骨关节炎,并经磁共振成像(MRI)证实存在骨下骨髓病变的成年患者参与研究。在基线和12个月时,静脉输注5毫克唑来膦酸(n=113)或安慰剂生理盐水(n=110)。研究的主要结果是24个月内用MRI评估的胫股关节软骨体积的绝对变化。三个预先指定的次要结果是用视觉模拟量表(0[无疼痛]至100[难以忍受的疼痛])、西安大略大学和麦克马斯特大学骨关节炎指数(0[无疼痛]至500[难以忍受的疼痛])评估的3、6、12、18和24个月膝盖关节疼痛变化,以及在6和24个月内评估骨髓病变变化。
 
223名参与者,平均年龄62.0岁,52%为女性,190人(85%)完成了试验。在24个月内,唑来膦酸组和安慰剂组的胫股关节软骨体积变化无显著性差异(分别为-878 mm3 vs -919 mm3;组间差异为41 mm3)。组间次要结果均未发现显著差异:视觉模拟量表评估的膝关节疼痛的变化,唑来膦酸组为-11.5,安慰剂组为-16.8,组间差异为5.2;西安大略大学和麦克马斯特大学骨关节炎指数评估的膝关节疼痛变化分别为-37.5和-58.0,组间差异为20.5;超过24个月的骨髓病变大小的变化分别为-33 mm2 vs -6 mm2;组间差异为-27 mm2 。与安慰剂相比,唑来膦酸的不良反应较多(分别为96% vs 83%),主要包括急性反应(定义为输液后3天内的症状;87% vs 56%)。
 
研究认为,对于症状性膝盖骨关节炎和骨髓损伤患者,每年注射唑来膦酸并不能显著减少24个月内软骨体积的损害。研究不支持唑来膦酸治疗膝盖骨关节炎。
 
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    2020-12-03 lisa438
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    2020-04-24 lmm397
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    2020-04-22 lovetcm

    主要是关节软骨的问题,唑来膦酸应该没有用

    0

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    2020-04-22 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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