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Ahmed O, Block J, Mautner K, Plancher K, Anitescu M, Isaacson A, Filippiadis DK, Epelboym Y, Bercu Z, Mitchell JW, Cristescu M, White SB, Prologo JD. Percutaneous Management of Osteoarthritis in the Knee: Proceedings from the Society of Interventional Radiology Research Consensus Panel. J Vasc Interv Radiol 2021; 32:919.e1-919.e6. [PMID: 33689834 DOI: 10.1016/j.jvir.2021.03.409] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 01/21/2023] Open
Affiliation(s)
- Osman Ahmed
- Department of Radiology, Section of Interventional Radiology, University of Chicago, Chicago, Illinois.
| | - Joel Block
- Division of Rheumatology, Rush Medical College, Chicago, Illinois
| | - Kenneth Mautner
- Department of Rehabilitation Medicine and Department of Orthopedics, Emory University, Atlanta, Georgia
| | - Kevin Plancher
- Department of Orthopedics, Albert Einstein College of Medicine, Bronx, New York; Department of Orthopedics, Weill Cornell Medical College, Cornell University, Ithaca, New York
| | - Magdalena Anitescu
- Department of Anesthesia and Critical Care, Section of Anesthesia and Pain Medicine, University of Chicago, Chicago, Illinois
| | - Ari Isaacson
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina
| | | | - Yan Epelboym
- Department of Radiology, Harvard University, Cambridge, Massachusetts, and Brigham & Women's Hospital, Boston, Massachusetts
| | - Zachary Bercu
- Department of Radiology, Division of Interventional Radiology and Image-Guided Medicine, Emory University, Atlanta, Georgia
| | - Jason W Mitchell
- Department of Radiology, Capital Regional Medical Center, Tallahassee, Florida
| | - Mircea Cristescu
- Department of Radiology and Imaging Services, Emory University, Atlanta, Georgia
| | - Sarah B White
- Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Primorac D, Molnar V, Matišić V, Hudetz D, Jeleč Ž, Rod E, Čukelj F, Vidović D, Vrdoljak T, Dobričić B, Antičević D, Smolić M, Miškulin M, Ćaćić D, Borić I. Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies' Guidelines. Pharmaceuticals (Basel) 2021; 14:ph14030205. [PMID: 33801304 PMCID: PMC8001498 DOI: 10.3390/ph14030205] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis is the most common musculoskeletal progressive disease, with the knee as the most commonly affected joint in the human body. While several new medications are still under research, many symptomatic therapy options, such as analgesics (opioid and non-opioid), nonsteroid anti-inflammatory drugs, symptomatic slow-acting drugs in osteoarthritis, and preparations for topical administration, are being used, with a diverse clinical response and inconsistent conclusions across various professional societies guidelines. The concept of pharmacogenomic-guided therapy, which lies on principles of the right medication for the right patient in the right dose at the right time, can significantly increase the patient’s response to symptom relief therapy in knee osteoarthritis. Corticosteroid intra-articular injections and hyaluronic acid injections provoke numerous discussions and disagreements among different guidelines, even though they are currently used in daily clinical practice. Biological options, such as platelet-rich plasma and mesenchymal stem cell injections, have shown good results in the treatment of osteoarthritis symptoms, greatly increasing the patient’s quality of life, especially when combined with other therapeutic options. Non-inclusion of the latter therapies in the guidelines, and their inconsistent stance on numerous therapy options, requires larger and well-designed studies to examine the true effects of these therapies and update the existing guidelines.
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Affiliation(s)
- Dragan Primorac
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA
- The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, CT 06516, USA
- Medical School, University of Split, 21000 Split, Croatia;
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School, University of Rijeka, 51000 Rijeka, Croatia
- Medical School REGIOMED, 96450 Coburg, Germany
- Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
- Correspondence: ; Tel.: +385-98-470-710
| | - Vilim Molnar
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vid Matišić
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
| | - Damir Hudetz
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital “Sveti Duh”, 10000 Zagreb, Croatia
| | - Željko Jeleč
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Department of Nursing, University North, 48000 Varaždin, Croatia
| | - Eduard Rod
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
| | - Fabijan Čukelj
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Medical School, University of Split, 21000 Split, Croatia;
- Department of Health Studies, University of Split, 21000 Split, Croatia
- Clinic for Traumatology, University Hospital “Sisters of Mercy”, 10000 Zagreb, Croatia
| | - Dinko Vidović
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Clinic for Traumatology, University Hospital “Sisters of Mercy”, 10000 Zagreb, Croatia
| | - Trpimir Vrdoljak
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Clinical Hospital “Sveti Duh”, 10000 Zagreb, Croatia
| | - Borut Dobričić
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Department of Orthopaedics and Traumatology, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Darko Antičević
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
| | - Martina Smolić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Mladen Miškulin
- Medical School, University of Split, 21000 Split, Croatia;
- Aksis Specialty Hospital, 10000 Zagreb, Croatia
| | - Damir Ćaćić
- General Hospital Karlovac, 47000 Karlovac, Croatia;
| | - Igor Borić
- St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; (V.M.); (V.M.); (D.H.); (Ž.J.); (E.R.); (F.Č.); (D.V.); (T.V.); (B.D.); (D.A.); (I.B.)
- Medical School, University of Split, 21000 Split, Croatia;
- Medical School, University of Rijeka, 51000 Rijeka, Croatia
- Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
- Department of Health Studies, University of Split, 21000 Split, Croatia
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Jargin SV. Chondroprotectives used for the treatment of knee osteoarthritis: A comment. Int J Rheum Dis 2021; 24:459-461. [PMID: 33502114 DOI: 10.1111/1756-185x.14071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/27/2020] [Accepted: 01/05/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Sergei V Jargin
- Peoples' Friendship University of Russia, Moscow, Russian Federation
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Culibrk RA, Hahn MS. The Role of Chronic Inflammatory Bone and Joint Disorders in the Pathogenesis and Progression of Alzheimer's Disease. Front Aging Neurosci 2020; 12:583884. [PMID: 33364931 PMCID: PMC7750365 DOI: 10.3389/fnagi.2020.583884] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022] Open
Abstract
Late-onset Alzheimer's Disease (LOAD) is a devastating neurodegenerative disorder that causes significant cognitive debilitation in tens of millions of patients worldwide. Throughout disease progression, abnormal secretase activity results in the aberrant cleavage and subsequent aggregation of neurotoxic Aβ plaques in the cerebral extracellular space and hyperphosphorylation and destabilization of structural tau proteins surrounding neuronal microtubules. Both pathologies ultimately incite the propagation of a disease-associated subset of microglia-the principle immune cells of the brain-characterized by preferentially pro-inflammatory cytokine secretion and inhibited AD substrate uptake capacity, which further contribute to neuronal degeneration. For decades, chronic neuroinflammation has been identified as one of the cardinal pathophysiological driving features of AD; however, despite a number of works postulating the underlying mechanisms of inflammation-mediated neurodegeneration, its pathogenesis and relation to the inception of cognitive impairment remain obscure. Moreover, the limited clinical success of treatments targeting specific pathological features in the central nervous system (CNS) illustrates the need to investigate alternative, more holistic approaches for ameliorating AD outcomes. Accumulating evidence suggests significant interplay between peripheral immune activity and blood-brain barrier permeability, microglial activation and proliferation, and AD-related cognitive decline. In this work, we review a narrow but significant subset of chronic peripheral inflammatory conditions, describe how these pathologies are associated with the preponderance of neuroinflammation, and posit that we may exploit peripheral immune processes to design interventional, preventative therapies for LOAD. We then provide a comprehensive overview of notable treatment paradigms that have demonstrated considerable merit toward treating these disorders.
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Affiliation(s)
| | - Mariah S. Hahn
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, United States
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Ma W, Liu C, Wang S, Xu H, Sun H, Fan X. Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e23343. [PMID: 33285713 PMCID: PMC7717742 DOI: 10.1097/md.0000000000023343] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To evaluate the effects and safety of intra-articular injection of mesenchymal stem cells on patients with knee osteoarthritis by a systematic review and meta-analysis. METHODS PubMed, EMBASE, and Cochrane Library were retrieved. An assessment of the risk of bias was done through the Cochrane Collaborative Bias Risk Tool, publication bias was assessed by plotting funnel plots and Egger tests. Pain and functional improvements in patients with knee osteoarthritis were determined by changes in VAS scores and WOMAC scores at baseline and follow-up endpoints. For the evaluation of MRI, the WORMS score and changes in cartilage volume were used. In addition, the number of adverse events in the intervention group and the control group were counted to explore the safety. RESULTS A total of 10 randomized controlled trials involving 335 patients were included. In the pooled analysis, compared with the control groups, the VAS scores of MSC groups decreased significantly (MD,-19.24; 95% CI: -26.31 to -12.18, P < .00001. All of the WOMAC scores also improved significantly: the total scores (SMD, - 0.66; 95% CI: - 1.09 to -0.23, P = .003), pain scores (SMD, - 0.46; 95% CI: - 0.75 to -0.17, P = .002), stiffness scores (SMD, -0.32; 95% CI: -0.64 to 0.00 P = 0.05), and functional scores (SMD, -0.36; 95% CI: -0.69 to -0.04, P = .03). Two studies with non-double-blind designs were the main source of heterogeneity. In terms of cartilage repair, there was no significant difference in the WORMS score, but there was a significant increase in cartilage volume in the MSC group (SMD, 0.69; 95% CI: 0.25 to 1.13, P = .002). The proportion of patients with adverse events in the MSCs treatment group was significantly higher than that in the control group (OR, 3.20; 95% CI: 1.50 to 6.83, P = .003). CONCLUSIONS Intra-articular injection of mesenchymal stem cells is effective and safety to relieve pain and improve motor function of patients with knee osteoarthritis in a short term which is different to conclusions of previous study.
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Affiliation(s)
- Wei Ma
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine
| | - Cuimiao Liu
- Qingdao Huangdao District Changjiang Road Street Community Health Service Center, China
| | - Shilu Wang
- Department of Orthopedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan
| | - Honghao Xu
- Department of Orthopedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan
| | - Haichao Sun
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine
| | - Xiao Fan
- Qingdao Municipal Hospital, 266011 Qingdao, Shandong Province
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Topical Diclofenac Solution for Osteoarthritis of the Knee: An Updated Meta-Analysis of Randomized Controlled Trials. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1758071. [PMID: 33299860 PMCID: PMC7707945 DOI: 10.1155/2020/1758071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 12/28/2022]
Abstract
This study was performed to assess the efficacy and safety of a topical diclofenac solution in patients with knee osteoarthritis (OA). PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched for randomized controlled trials until June 2020. The WOMAC pain, stiffness, physical function subscales, pain on walking, and the occurrence of adverse events were pooled to comprehensively analyse the efficacy and safety of topical diclofenac solution. All statistical analyses were conducted using Review Manager 5.3 software. Five RCTs were included, which provided high-quality evidence. In comparison to the vehicle control, the mean differences for WOMAC pain, stiffness, and physical function subscales, as well as pain on walking, were all statistically significant in favor of topical diclofenac solution. The safety of topical diclofenac solution was similar to the vehicle control, apart from adverse events involving application-site skin reactions. Topical diclofenac solution is effective and safe for use in patients with knee OA, but may cause minor skin reactions.
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Zhou X, Xiang K, Yuan X, Wang Z, Li K. A comparison of the effects of acupoint injection combined with hyaluronic acid versus isolated hyaluronic acid for knee osteoarthritis: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e23262. [PMID: 33217849 PMCID: PMC7676597 DOI: 10.1097/md.0000000000023262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a kind of degenerative osteoarthropathy, which causes joint pain and limited mobility, seriously affects the quality of life of the patient. Traditional Chinese Medicine acupuncture and moxibustion has been widely used to treat KOA, and acupoint injection is 1 of the acupuncture treatment methods. The purpose of this work is to evaluate the effectiveness of Acupoint injection combined with Hyaluronic Acid injection compared with isolated Hyaluronic Acid injection for KOA. METHODS We will search articles in 7 electronic databases including Chinese National Knowledge Infrastructure, Wanfang Data, Chinese Scientific Journals Database, Chinese databases SinoMed, PubMed, Embase, and Cochrane Library databases. All the publications, with no time restrictions, will be searched without any restriction of language and status, the time from the establishment of the database to October 2020. Two reviewers will independently assess the quality of the selected studies, NoteExpress and Excel software will be used to extract data, and the content will be stored in an electronic chart. Different researchers will separately screen the titles and abstracts of records acquired potential eligibility which comes from the electronic databases. Full-text screening and data extraction will be conducted afterward independently. Statistical analysis will be conducted using RevMan 5.4 software. RESULTS This study will evaluate the efficacy and safety of Acupoint injection combined with Hyaluronic Acid injection compared with isolated Hyaluronic Acid injection in the treatment of KOA, to provide high-quality, evidence-based clinical recommendations. TRIAL REGISTRATION NUMBER INPLASY2020100058 CONCLUSION:: This study will provide reliable evidence on whether Acupoint injection combined with Hyaluronic Acid injection compared with isolated Hyaluronic Acid injection is more effective in treating KOA.
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Goldwire MA, Shea LA. Intra-articular hyaluronic acids for osteoarthritis of the knee. DRUGS & THERAPY PERSPECTIVES 2020. [DOI: 10.1007/s40267-020-00764-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Effectiveness of micronized nasal irrigations with hyaluronic acid/isotonic saline solution in non-polipoid chronic rhinosinusitis: A prospective, randomized, double-blind, controlled study. Am J Otolaryngol 2020; 41:102502. [PMID: 32460989 DOI: 10.1016/j.amjoto.2020.102502] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sodium hyaluronate has been proposed as a treatment for improving the symptoms of chronic rhinosinusitis. The present study evaluated the effect of the intranasal administration of hyaluronic acid in a group of patients affected by chronic rhinosinusitis without nasal polyps (CRSsNP). MATERIALS AND METHODS Thirty subjects aged 18-65 years affected by CRSsNP were enrolled. The subjects were randomly administered hyaluronic acid or isotonic saline solution by nasal nebulizer twice per day for 30 days. They were evaluated before (T0) and after the treatment (T1) with Sino-Nasal Outcome Test-22, visual analogue scale for rhinorrhea, nasal obstruction, facial pain and hyposmia/hypogeusia, nasal endoscopy, active anterior rhinomanometry, peak nasal inspiratory flow and nasal cytology. RESULTS Comparing the study and the control group, at T1 no significant differences were observed in both objective and subjective parameters. Being included in the study group rather than in the control group did not have a significant effect on the variation of the considered parameters between T0 and T1. Considering the effects of the micronized douches independently from the type of solution used (either hyaluronic acid or isotonic saline solution), although no difference emerged between study and control group for any of the objective parameters, there was an improvement of Sino-Nasal Outcome Test-22 scores (p = .0005), visual analogue scale for nasal obstruction (p = .0006) and for hyposmia/hypogeusia (p = .04). CONCLUSIONS The treatment with micronized nasal douches can improve the sino-nasal symptoms of CRSsNP, in particular nasal obstruction and olfactory ability. No advantage of the use of hyaluronic acid over isotonic saline solution emerged.
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Vangsness CT, Adamson TC, Daley MJ. Consequences on Private Insurance Coverage: The AAOS Clinical Practice Guidelines and Hyaluronic Acid Injections. J Bone Joint Surg Am 2020; 102:920-926. [PMID: 32079873 PMCID: PMC7508284 DOI: 10.2106/jbjs.19.00272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- C. Thomas Vangsness
- Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California,Email address for C.T. Vangsness Jr.:
| | - Thomas C. Adamson
- Department of Rheumatology, Sharp Rees-Stealy Medical Group, San Diego, California
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Mochizuki T, Ikari K, Yano K, Okazaki K. Comparison of patient-reported outcomes of treatment with low- and intermediate molecular weight hyaluronic acid in Japanese patients with symptomatic knee osteoarthritis: A prospective, randomized, single-blind trial. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2020; 21:22-26. [PMID: 32395434 PMCID: PMC7203510 DOI: 10.1016/j.asmart.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/30/2020] [Accepted: 04/21/2020] [Indexed: 01/27/2023]
Abstract
Objectives The objective of this study was to compare the clinical outcomes of treatment with low- or intermediate-molecular-weight hyaluronic acid (HA) in patients with knee osteoarthritis (OA). Methods In total, 59 patients with OA who fulfilled the criteria of the American College of Rheumatology for OA were enrolled. Patients were randomly assigned in a 1:1 ratio to the low- or intermediate-molecular-weight HA group. An intraarticular injection of HA into the knee joint was performed five times per week. The visual analog scale for pain (pain VAS) and Japanese Knee Osteoarthritis Measure (JKOM) score were analyzed at baseline and week 6 to assess the outcomes. Results Pain VAS and JKOM score were significantly improved in both groups. At follow-up, there were no significant between-group differences in pain VAS or total JKOM score. Moreover, reduction in pain VAS and JKOM score was not significantly different between the two groups. Conclusions Both low- and intermediate-molecular-weight HA have significant efficacy in the first-line treatment of patients with knee OA as indicated by patient-reported outcomes. However, there does not appear to be any difference between the efficacy of low- and intermediate-molecular-weight HA as indicated by the JKOM score. We believe that the results of this study provide important insights into the clinical management of Japanese patients with knee OA.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Katsunori Ikari
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichiro Yano
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
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Jung JH, Kim SE, Kim HJ, Park K, Song GG, Choi SJ. A comparative pilot study of oral diacerein and locally treated diacerein-loaded nanoparticles in a model of osteoarthritis. Int J Pharm 2020; 581:119249. [PMID: 32217157 DOI: 10.1016/j.ijpharm.2020.119249] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/19/2020] [Accepted: 03/20/2020] [Indexed: 12/13/2022]
Abstract
Diacerein (DIA) is a slow-acting drug for osteoarthritis (OA). Oral DIA administration, however, exerts side effects including diarrhea and urine discoloration. We fabricated DIA-loaded poly(d,l-lactide-co-glycolide) nanoparticles (DIA/PLGA NPs) that allow sustained release of DIA. In vitro, rat synoviocytes were used to investigate the cytotoxicity and anti-inflammatory effects of DIA-loaded NPs. In vivo, monosodium iodoacetate (MIA)-induced OA rats were divided into seven groups that included non-treated healthy control rats and rats injected with MIA alone or in combination with NPs, DIA(5%) solution, DIA(1%)/NPs, DIA(5%)/NPs, or oral DIA. The in vitro studies revealed that DIA/PLGA NPs dose-dependently suppressed mRNA levels of pro-inflammatory cytokines and enzymes, including interleukin-1 (IL-1), IL-6, tumor necrosis factor-α, matrix metalloproteinase-3 (MMP-3), MMP-13, cyclo-oxygenase-2, and a disintegrin and metalloproteinase with thrombospondin motifs-5 in synoviocytes. The in vivo studies demonstrated that intra-articular treatment of OA rat models with DIA-loaded PLGA NPs markedly decreased mRNA levels of these pro-inflammatory factors and increased those of anti-inflammatory cytokines (IL-4 and IL-10). Micro-computed tomography and histological evaluations indicated that intra-articular injection of DIA-loaded NPs was effective in protecting against cartilage degradation. Administration of DIA/PLGA NPs via intra-articular injection is promising for inhibiting inflammation and protecting against cartilage degradation in OA.
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Affiliation(s)
- Jae Hyun Jung
- Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea.
| | - Sung Eun Kim
- Department of Orthopedic Surgery and Rare Diseases Institute, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea.
| | - Hak-Jun Kim
- Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; Department of Orthopedic Surgery and Rare Diseases Institute, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea.
| | - Kyeongsoon Park
- Department of Systems Biotechnology, Chung-Ang University, 4726 Seodong-daero, Daedeok-myeon, Anseong-si, Gyeonggi-do 17546, Republic of Korea.
| | - Gwan Gyu Song
- Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; Division of Rheumatology, Department of Internal Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea.
| | - Sung Jae Choi
- Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea.
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Angadi DS, Macdonald H, Atwal N. Autologous cell-free serum preparations in the management of knee osteoarthritis: what is the current clinical evidence? Knee Surg Relat Res 2020; 32:16. [PMID: 32660628 PMCID: PMC7219223 DOI: 10.1186/s43019-020-00036-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 02/27/2020] [Indexed: 12/14/2022] Open
Abstract
Background There is paucity in the current literature regarding clinical outcomes of autologous cell-free serum preparations. The objective of this paper is to collate the clinical evidence and review the results of intraarticular injections of autologous cell-free serum preparations in the management of knee osteoarthritis (OA). Methods A comprehensive English literature search was undertaken using the healthcare database website (https://hdas.nice.org.uk/). The PubMed, Medline, CINAHL, Embase and the Cochrane library databases were searched to identify all studies of autologous protein solution/autologous conditioned serum (ACS/APS) in the management of knee OA. We evaluated the reported clinical outcomes with respect to pain, function, morbidity, adverse effects and complications. Results Fifteen relevant articles were identified in the current literature. Outcomes following injection of ACS/APS have been reported in patients with age range (34–87 years) and unilateral or bilateral knee OA. Seven studies reported improvement in visual analog scale (VAS) whereas the Western Ontario and McMaster Universities osteoarthritis instrument (WOMAC) score improved in nine studies. Considerable variation was noted in the injection technique and duration of post-procedure assessment with only one study reporting long-term follow-up beyond 24 months. Joint swelling and injection-site pain were reported to be the most common complications; only one study reported a case of septic arthritis. However, no evidence is available to clearly identify factors that may predict the outcomes following this procedure. Conclusion Current data from the clinical studies would suggest that the intraarticular administration of autologous cell-free serum preparations, such as ACS/APS, in patients with knee OA may improve pain and function, with limited morbidity. High-quality clinical trials with stratified patient cohorts, longer follow-up duration and robust reporting of outcome measures are essential to improve the understanding of the indications and clinical effectiveness of these novel products.
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Affiliation(s)
- Darshan S Angadi
- Department of Trauma and Orthopaedics, Cheltenham General Hospital, Sandford Rd, Cheltenham, UK.
| | - Hamish Macdonald
- Department of Trauma and Orthopaedics, Cheltenham General Hospital, Sandford Rd, Cheltenham, UK
| | - Navraj Atwal
- Department of Trauma and Orthopaedics, Cheltenham General Hospital, Sandford Rd, Cheltenham, UK
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Procedural Treatments for Knee Osteoarthritis: A Review of Current Injectable Therapies. Pain Res Manag 2020; 2020:3873098. [PMID: 32148599 PMCID: PMC7049418 DOI: 10.1155/2020/3873098] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 12/18/2019] [Accepted: 01/22/2020] [Indexed: 12/13/2022]
Abstract
Knee osteoarthritis is a common painful degenerative condition affecting the aging Canadian population. In addition to pain and disability, osteoarthritis is associated with depression, comorbid conditions such as diabetes, and increased caregiver burden. It is predicted to cost the Canadian healthcare system $7.6 billion dollars by 2031. Despite its high cost and prevalence, controversy persists in the medical community regarding optimal therapies to treat knee osteoarthritis. A variety of medications like nonsteroidal anti-inflammatories and opioids can cause severe side effects with limited benefits. Total knee arthroplasty, although a definitive management, comes with risk such as postoperative infections, revisions, and chronic pain. Newer injectable therapies are gaining attention as alternatives to medications because of a safer side effect profile and are much less invasive than a joint replacement. Platelet-rich plasma is beginning to replace the more common injectable therapies of intra-articular corticosteroids and hyaluronic acid, but larger trials are needed to confirm this effect. Small studies have examined prolotherapy and stem cell therapy and demonstrate some benefits. Trials involving genicular nerve block procedures have been successful. As treatments evolve, injectable therapies may offer a safe and effective pathway for patients suffering from knee osteoarthritis.
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Hsieh CK, Chang CJ, Liu ZW, Tai TW. Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis. INTERNATIONAL ORTHOPAEDICS 2020; 44:877-884. [PMID: 31993710 DOI: 10.1007/s00264-020-04489-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/17/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE Extracorporeal shockwave therapy (ESWT) has become a common practice for treating knee osteoarthritis (OA). However, the effectiveness and safety of this treatment are still questionable. This meta-analysis is aimed at determining the degree of pain reduction and functional outcome after ESWT for knee OA. METHODS We systematically searched MEDLINE, EMBASE, and other online databases. The articles comparing the outcomes between ESWT and controls were included in the analysis. RESULTS Nine studies with 705 patients were included. The pooled data revealed significantly lower pain scores in the ESWT groups than in the control groups within two weeks of treatment and six months after treatment (visual analogue scale, - 1.59, p = 0.0003, 95% confidence interval (CI) - 2.45 to - 0.72 at 2 weeks; - 1.12, p = 0.005, 95% CI - 1.89 to - 0.34 at 6 months). The ESWT group also had better functional outcomes four to six weeks post treatment (Western Ontario and McMaster Universities Osteoarthritis Index, - 11.96, p = 0.003, 95% CI - 19.76 to - 4.15). No rebound pain was noted for up to 12 months. CONCLUSION Using ESWT to treat knee OA may reduce pain and improve functional outcomes. The effect may last six months to one year. More prospective studies are needed to investigate the settings for ESWT to optimize treatment results.
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Affiliation(s)
- Chi-Kun Hsieh
- Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Chao-Jui Chang
- Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Zhao-Wei Liu
- Physical Therapy Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ta-Wei Tai
- Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan. .,Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Tapasvi S, Mohanty SS, Vedavyasa Acharya KK, Bhattacharya K, Easwaran R, Charugulla SN. Viscosupplementation for Management of Knee Osteoarthritis from an Indian Perspective: An Expert Consensus Report. Pain Ther 2019; 8:217-231. [PMID: 31309467 PMCID: PMC6857206 DOI: 10.1007/s40122-019-0131-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Knee osteoarthritis (OA) is a progressive degenerative condition and is a significant contributor toward physical disability in the aging population. The current treatment modalities for this condition focus on joint preservation with alleviation of symptoms. Intra-articular hyaluronic acid (IAHA) injections have emerged as the promising mainstay of nonsurgical treatment of OA, especially in patients with mild-to-moderate OA and in certain subgroups of severe OA with comorbidities or with poor response to first-line therapy. The absence of standard guidelines or recommendations for the use of IAHA in India has led to vast variations in the usage of IAHA among practitioners. Hence, this consensus-based document aims to address the issue and establish simplified and easily implemented recommendations on the use of IAHA. METHODS A group of 78 expert orthopedic surgeons discussed in detail the evidence on appropriate criteria for diagnosis, patient selection, and follow-up evaluation for knee OA at two national meetings. In subsequently held regional meetings, key discussion points and clinical experience-based answers were translated into a questionnaire to develop the final expert consensus-based statements for the use of IAHA in patients with knee OA. RESULTS Various consensus statements were obtained on the basis of scientific evidence obtained from PubMed, Cochrane-indexed database, and guidelines related to viscosupplementation and knee OA as well as the experts' clinical experience. This document was drafted, reviewed, validated, and modified by the expert panel until a final agreement was reached. CONCLUSION In this pioneering attempt, the document lays down structured, expert consensus-based statements to guide and align practitioners on the appropriate use of IAHA in the Indian setting. FUNDING Dr. Reddy's Laboratories Ltd.
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Affiliation(s)
| | - Shubhranshu S Mohanty
- Department of Orthopaedics, King Edward Memorial Hospital, Jaslok, Shushrusha and Nanavati Hospitals, Mumbai, India
| | | | | | - Raju Easwaran
- Department of Orthopaedics, Shree Meenakshi Orthopedics and Sports Medicine Clinic, Delhi, India
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Najafi S, Sanati E, Khademi M, Abdorrazaghi F, Mofrad RK, Rezasoltani Z. Intra-articular botulinum toxin type A for treatment of knee osteoarthritis: Clinical trial. Toxicon 2019; 165:69-77. [PMID: 30995453 DOI: 10.1016/j.toxicon.2019.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/07/2019] [Accepted: 04/12/2019] [Indexed: 12/14/2022]
Abstract
In recent years, there is a growing interest in new medical applications of botulinum toxin, including pain control, osteoarthritis treatment, and wound healing. While clinical applications of botulinum toxin seem promising, existing evidence regarding the therapeutic effects is still inadequate. The aim was to assess the efficacy of a single injection of abobotulinumtoxin A into the knee joint cavity to reduce pain in elderly people. We carried out a single group clinical trial in a University Hospital. Thirty participants (24 women) more than 50 years of age with knee osteoarthritis were included. Diagnosis of osteoarthritis was based on clinical and radiologic findings. We gave a single injection containing 250 units of Dysport (= 100 units of botulinum neurotoxin type A) diluted with 5 ml of normal saline. The primary outcome measure was knee pain. The secondary outcome was the patients' opinion about their knee and associated problems measured with the Knee injury and Osteoarthritis Outcome Score. The outcomes were measured at the baseline and at 4 weeks after the intervention. Within-group comparisons based on the Knee injury and Osteoarthritis Outcome Scores showed favorable results for joint pain and stiffness, sports, severity of symptoms, quality of life, and daily activities (all p-values < 0.001). Also, pain intensity, joint effusion, knee clicking and locking, and flexion-extension scores showed significant beneficial results (all p-values ≤ 0.005). We concluded that botulinum neurotoxin type A is an effective and safe initial treatment of knee osteoarthritis with clear clinical advantages. Patients' satisfaction, minimum adverse effects in addition to single-dose prescription make the toxin as a choice for the first-line therapy of osteoarthritis at least at the short-term in elderly people. The symptom relief increases the patient's compliance and willing to participate in other therapeutic programs. REGISTRATION: Iranian Registry of Clinical Trials (IRCT) website http://www.irct.ir/, a WHO Primary Register setup, with registration code: Irct ID: IRCT20180416039323N1.
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Affiliation(s)
- Sharif Najafi
- Aja University of Medical Sciences, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Islamic Republic of Iran.
| | - Ehsan Sanati
- Aja University of Medical Sciences, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Islamic Republic of Iran.
| | - Mahsa Khademi
- Aja University of Medical Sciences, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Islamic Republic of Iran.
| | - Fateme Abdorrazaghi
- Aja University of Medical Sciences, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Islamic Republic of Iran.
| | - Reza Kazempoor Mofrad
- Shahid Beheshti University of Medical Sciences, Faculty of Medicine, Islamic Republic of Iran.
| | - Zahra Rezasoltani
- Aja University of Medical Sciences, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Islamic Republic of Iran.
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Is Repeated Arthrocentesis Beneficial in the Treatment of Temporomandibular Disorders: A Retrospective Study. J Oral Maxillofac Surg 2019; 77:1359-1364. [PMID: 30825439 DOI: 10.1016/j.joms.2019.01.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/20/2019] [Accepted: 01/24/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE Arthrocentesis is an effective, simple, and minimally invasive treatment in patients with temporomandibular joint (TMJ) closed lock (CL). The aim of this study was to compare the effectiveness of 1- versus 2-session arthrocentesis procedures in the management of TMJ CL. MATERIALS AND METHODS A retrospective cohort study was conducted using the files of patients with TMJ CL according to diagnostic criteria for temporomandibular disorders. Patients who underwent 1- or 2-session arthrocentesis were included in the study. The decision of whether to undergo 1- or 2-session arthrocentesis was made by the patients: Those who accepted a second arthrocentesis procedure were assigned to group 1 (repeated arthrocentesis group), and those who did not accept, to group 2 (arthrocentesis group). The primary predictor variable was treatment method. TMJ pain (scored on a visual analog scale) and maximum mouth opening (MMO) were selected as the outcome variables. To evaluate the clinical outcomes of 1- or 2-session arthrocentesis, MMO and pain score (on a visual analog scale) before treatment and at 1, 3, and 6 months' follow-up were analyzed. Descriptive, comparative, correlation, and multivariate analyses were conducted. RESULTS A total of 30 patients (25 female and 5 male patients) with TMJ disc displacement without reduction were enrolled in the study. Each group consisted of 15 patients. Statistically significant decreases in pain scores and increases in MMO values were observed in both treatment groups at 3 and 6 months (P < .05). At 6 months, MMO values were significantly higher and pain levels were significantly lower in patients who received 2 arthrocentesis procedures. CONCLUSIONS Repeated arthrocentesis is more successful at reducing pain and improving MMO than a single intervention in the treatment of TMJ CL.
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Sherman BJ, Chahla J, Glowney J, Frank RM. The Role of Orthobiologics in the Management of Osteoarthritis and Focal Cartilage Defects. Orthopedics 2019; 42:66-73. [PMID: 30889253 DOI: 10.3928/01477447-20190225-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Individuals with osteoarthritis have a diminished quality of life, and the condition is a major cause of disability. Newer biologic treatments have been developed that are believed to modify disease progression. These predominantly include hyaluronic acid, platelet-rich plasma, bone marrow aspirate concentrate, and adipose-derived mesenchymal stem cells. There is conflicting evidence regarding the use of orthobiologics for osteoarthritis and for focal chondral defects, although most studies indicate that injections of biologics are safe and without significant adverse effects. [Orthopedics. 2019; 42(2):66-73.].
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Pontes-Quero GM, García-Fernández L, Aguilar MR, San Román J, Pérez Cano J, Vázquez-Lasa B. Active viscosupplements for osteoarthritis treatment. Semin Arthritis Rheum 2019; 49:171-183. [PMID: 30878154 DOI: 10.1016/j.semarthrit.2019.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/05/2019] [Accepted: 02/12/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Osteoarthritis is a chronic, painful and disabling disease which prevalence is increasing in developing countries. Patients with osteoarthritis present a reduced synovial fluid viscoelasticity due to a reduction in concentration and molecular weight of hyaluronic acid. Currently, the main treatment used to restore the compromised rheological properties of synovial fluid is the viscosupplementation by hyaluronic acid injections that can be combined with oral anti-inflammatory drugs for pain relief. Combination of viscosupplements with chemical agents or drugs is emerging as a new strategy to provide a double action of synovial fluid viscoelasticity recovery and the therapeutic effect of the bioactive principle. METHODS In this review, we present the latest research on the combination of viscosupplements with active molecules. We conducted a literature review of articles published in different web search engines and categorized according to the active molecule introduced into the viscosupplement. RESULTS Generally, the introduction of anti-inflammatory molecules have shown to improve pain relief although some cytotoxicity has been demonstrated especially for non-steroidal anti-inflammatory drugs. Other molecules such as antioxidant or disease modifying osteoarthritis drugs have been reported to improve viscosupplementation action. Drug delivery systems combined with hyaluronic acid could enhance the activity of the encapsulated molecules and provide better control over the drug release. Finally, biological approaches such as the use of stem cells or platelet-rich plasma seem to be the most promising strategies for cartilage recovery. CONCLUSIONS Combination therapy of viscosupplements with therapeutic agents, drug delivery systems or regenerative therapies can improve viscosupplementation outcome in terms of pain relief and joint functionality. However, further research is needed in order to reach more conclusive results.
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Affiliation(s)
- Gloria María Pontes-Quero
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology (ICTP-CSIC), Madrid, Spain; Alodia Farmacéutica SL, Madrid, Spain
| | - Luis García-Fernández
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology (ICTP-CSIC), Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - María Rosa Aguilar
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology (ICTP-CSIC), Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
| | - Julio San Román
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology (ICTP-CSIC), Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | | | - Blanca Vázquez-Lasa
- Group of Biomaterials, Department of Polymeric Nanomaterials and Biomaterials, Institute of Polymer Science and Technology (ICTP-CSIC), Madrid, Spain; Networking Biomedical Research Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
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Jargin SV. Scientific Papers and Patents on Substances with Unproven Effects. Part 2. RECENT PATENTS ON DRUG DELIVERY & FORMULATION 2019; 13:160-173. [PMID: 31424374 PMCID: PMC7011683 DOI: 10.2174/1872211313666190819124752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/19/2019] [Accepted: 08/01/2019] [Indexed: 12/03/2022]
Abstract
Several examples are discussed in this review, where substances without proven effects were proposed for practical use within the scope of evidence-based medicines. The following is discussed here: generalizations of the hormesis concept and its use in support of homeopathy; phytoestrogens and soy products potentially having feminizing effects; glycosaminoglycans for the treatment of osteoarthritis and possibilities of their replacement by diet modifications; flavonoids recommended for the treatment of chronic venous insufficiency and varicose veins; acetylcysteine as a mucolytic agent and its questionable efficiency especially by an oral intake; stem cells and cell therapies. In conclusion, placebo therapies can be beneficial and ethically justifiable but it is not a sufficient reason to publish biased information. Importantly, placebo must be devoid of adverse effects, otherwise, it is named pseudo-placebo. Therapeutic methods with unproven effects should be tested in high-quality research shielded from the funding bias. Some issues discussed in this review are not entirely clear, and the arguments provided here can initiate a constructive discussion.
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Affiliation(s)
- Sergei V. Jargin
- Peoples’ Friendship University of Russia, Clementovski per 6-82, Moscow115184, Russia
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Chen YP, Wang SM, Wu Y, Lin HY, Wu CC, Chuang TY, Ho WP, Kuo YJ, Leu TH, Lin CY. Worsen depression after viscosupplementation treatment for geriatric people with knee osteoarthritis? Int J Clin Health Psychol 2018; 19:31-40. [PMID: 30619495 PMCID: PMC6300725 DOI: 10.1016/j.ijchp.2018.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background/objective: Knee osteoarthritis (OA) in older people may result in psychological impairment, including anxiety and depression. This study investigates the effect of intraarticular hyaluronic acid injection (IAHA) on geriatric patients with OA. Method: A total of 102 geriatric patients with knee OA undergoing IAHA were prospectively enrolled in this study. Geriatric Depression Scale (GDS), State-Trait Anxiety Inventory (STAI), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), and Visual Analogue Scale (VAS) for pain were recorded. All outcomes were measured at baseline before injection and during two, four, and six month follow-ups. Results: IAHA had a significant short-term effect, relieving pain at the two month follow-up, but the effect was weaker at the four month follow-up. Both IKDC and WOMAC scores were significantly improved at the two month follow-up. Viscosupplementation did not improve STAI. GDS exhibited significant deterioration at the four month follow-up. Conclusions: Although IAHA for the treatment of OA provided short-term efficiency, it had no effects on anxiety and increased depression of geriatric people. Health education should be provided with caution before viscosupplementation treatment to manage expectations of the efficacy of treatment for geriatric OA patients.
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Affiliation(s)
- Yu-Pin Chen
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shu-Mei Wang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yueh Wu
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Yu Lin
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Chun Wu
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tai-Yuan Chuang
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Pin Ho
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsai-Hsueh Leu
- Department of Orthopedics, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Le Clanche S, Cheminel T, Rannou F, Bonnefont-Rousselot D, Borderie D, Charrueau C. Use of Resveratrol Self-Emulsifying Systems in T/C28a2 Cell Line as Beneficial Effectors in Cellular Uptake and Protection Against Oxidative Stress-Mediated Death. Front Pharmacol 2018; 9:538. [PMID: 29910729 PMCID: PMC5992418 DOI: 10.3389/fphar.2018.00538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/04/2018] [Indexed: 01/11/2023] Open
Abstract
Osteoarthritis (OA) is the most prevalent rheumatic disease in the world. Although its etiology is still unknown, one of the key processes in OA progression and development is oxidative stress. In this context, resveratrol, a well-known anti-oxidant from the stilbene family, could be of particular interest in future OA therapeutic strategies. However, currently, because of its low bioavailability, use of resveratrol in human health is very limited. In this study, we tested two resveratrol self-emulsifying systems previously developed in our laboratory in order to determine if they could improve cellular uptake of resveratrol in a human immortalized chondrocytic cell line (T/C28a2) and enhance protection against oxidative stress. Our results showed that resveratrol self-emulsifying systems were able first to increase cellular tolerance towards resveratrol, and thus decrease resveratrol intrinsic cellular toxicity, allowing the use of higher concentrations, second, to increase resveratrol uptake in membrane and intracellular fractions, and finally, to improve protection against oxidative stress-mediated death in human immortalized chondrocytic cell line T/C28a2. These data suggest that new formulations of resveratrol could be considered as potential beneficial effectors in future OA treatments.
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Affiliation(s)
- Solenn Le Clanche
- UMR-S 1124 INSERM Toxicologie, Pharmacologie et Signalisation Cellulaire, CUSP, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Unité Pédagogique de Biochimie, Faculté de Pharmacie de Paris, Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Tristan Cheminel
- Unité Pédagogique de Biochimie, Faculté de Pharmacie de Paris, Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - François Rannou
- UMR-S 1124 INSERM Toxicologie, Pharmacologie et Signalisation Cellulaire, CUSP, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin (AP-HP), Paris, France
| | - Dominique Bonnefont-Rousselot
- Unité Pédagogique de Biochimie, Faculté de Pharmacie de Paris, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Service de Biochimie Métabolique, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix (AP-HP), Paris, France.,INSERM U 1022 CNRS UMR 8258, Chimie ParisTech, PSL Research University, Unité de Technologies Chimiques et Biologiques pour la Santé, Faculté de Pharmacie de Paris, Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Didier Borderie
- UMR-S 1124 INSERM Toxicologie, Pharmacologie et Signalisation Cellulaire, CUSP, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Unité Pédagogique de Biochimie, Faculté de Pharmacie de Paris, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Service de Diagnostic Biologique Automatisé, Hôpital Cochin (AP-HP), Paris, France
| | - Christine Charrueau
- INSERM U 1022 CNRS UMR 8258, Chimie ParisTech, PSL Research University, Unité de Technologies Chimiques et Biologiques pour la Santé, Faculté de Pharmacie de Paris, Sorbonne Paris Cité, Université Paris Descartes, Paris, France
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