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Alves JC, Santos A, Filipe A, Carreira LM. The intravenous administration of blood cell secretome can improve clinical signs in dogs with osteoarthritis. Res Vet Sci 2024; 180:105422. [PMID: 39348758 DOI: 10.1016/j.rvsc.2024.105422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/25/2024] [Accepted: 09/23/2024] [Indexed: 10/02/2024]
Abstract
We aimed to evaluate the effect of the intravenous (IV) administration of blood cell secretome (BCS) compared to its intra-articular (IA) administration. In this cross-over study, ten dogs with bilateral hip osteoarthritis were initially assigned to an IA group (IAG). After a 180-day follow-up, the same 10 animals were assigned to an IV group (IVG). IAG received a single IA administration of 3 ml of BCS per hip joint, and IVG received a single 6 ml IV administration of BCS. Following each treatment, follow-up was conducted on days 0, 8, 15, 30, 60, 90, 120, 150, and 180. In each follow-up, copies of the Canine Brief Pain Inventory (divided into pain interference score - PIS and Pain Severity Score - PSS), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) were obtained. Results were analyzed with the Mann-Whitney test, and Kaplan-Meier estimators were calculated and compared, p < 0.05. The animals had a mean age of 7.6 ± 2.9 years and bodyweight of 27.8 ± 3.6 kg. Seven hips were classified as moderate osteoarthritis, and three as severe. No differences were found between groups from days 0 to +60d, with both groups showing clinically significant improvements. Improvements in the IAG lasted up to +120d. Kaplan-Meier estimators showed that dogs in IAG took longer to record the considered events. IVG also showed positive clinically significant results with different instruments. IV administration of BCS can improve the overall condition of dogs with hip OA, but the IA administration produces longer-lasting results.
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Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR). Rua Presidente Arriaga, 9 1200-771 Lisbon, Portugal; Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal; CECAV - Animal and Veterinary Research Center, Lusófona University, Lisbon, Portugal; MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal.
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR). Rua Presidente Arriaga, 9 1200-771 Lisbon, Portugal
| | - Ana Filipe
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa) -, Lisbon, Portugal; Interdisciplinary Centre for Research in Animal Health (CIISA) - University of Lisbon, (FMV/ULisboa) - Lisbon, Portugal; Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
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Alves JC, Santos A, Carreira LM. A Preliminary Report on the Combined Effect of Intra-Articular Platelet-Rich Plasma Injections and Photobiomodulation in Canine Osteoarthritis. Animals (Basel) 2023; 13:3247. [PMID: 37893971 PMCID: PMC10603638 DOI: 10.3390/ani13203247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Osteoarthritis (OA) is highly prevalent in the canine population. Due to the multiple dimensions of the disease, a multimodal approach is usually favored by clinicians. To evaluate the combined treatment with intra-articular platelet-rich plasma (PRP) and photobiomodulation in dogs with bilateral hip OA, thirty dogs were assigned to a PRP group (PRPG, n = 10), a photobiomodulation group (PBMTG, n = 10), or a combined therapies group (PRP+PBMTG, n = 10). The PRPG received two intra-articular administrations of platelet-rich plasma 14 days apart. The PBMTG received photobiomodulation with a therapeutic laser, with three sessions every other day in week one; two sessions in week two; a single session in week three; and one session/month on follow-up evaluation days. The PRP+PBMTG received the two combined therapies. The response to treatment was evaluated with weight-bearing distribution and the Canine Brief Pain Inventory, the Liverpool Osteoarthritis in Dogs, and the Canine Orthopedic Index. Evaluations were conducted before treatment and +8, +15, +30, +60, and +90 days after initial treatment. Normality was assessed with a Shapiro-Wilk test, and the groups' results in each evaluation moment were compared using a Mann-Whitney U test. Animals of both sexes (male n = 19, female n = 11) were included in the sample, with a mean age of 7.8 ± 2.5 years and a body weight of 26.5 ± 4.7 kg. Joints were classified as mild (n = 6, three in PRPG, two in PBMTG, and one in PRP+PBMTG), moderate (n = 18, six in PRPG, five in PBMTG, and seven in PRP+PBMTG), and severe (n = 6, one in PRPG, three in PBMTG, and two in PRP+PBMTG). No differences were found between groups at the initial evaluation. All treatments produced clinically significant improvements compared to the assessment on treatment day. The combination of PRP and photobiomodulation produced greater, longer-lasting improvements. PRP and photobiomodulation can improve objective outcomes and client-reported outcome measures in dogs with OA. Their combined use leads to greater, longer-lasting, clinically significant improvements.
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Affiliation(s)
- J. C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- Centro de Ciência Animal e Veterinária, Lusófona University, 1749-024 Lisbon, Portugal
- MED—Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - Ana Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
| | - L. Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), 1300-477 Lisbon, Portugal;
- Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon (FMV/ULisboa), 1649-004 Lisbon, Portugal
- Anjos of Assis Veterinary Medicine Centre (CMVAA), 2830-077 Barreiro, Portugal
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Alves JC, Innes JF. Minimal clinically-important differences for the "Liverpool Osteoarthritis in Dogs" (LOAD) and the "Canine Orthopedic Index" (COI) in dogs with osteoarthritis. PLoS One 2023; 18:e0291881. [PMID: 37729288 PMCID: PMC10511076 DOI: 10.1371/journal.pone.0291881] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE Osteoarthritis is the most common joint disease in companion animals. Several client-report outcome measures (CROMs) have been developed and validated to monitor patients and their response to treatment. However, estimates for minimal clinically-important differences for these CROMs in the context of osteoarthritis have not been published. PATIENTS AND METHODS Data from the Clínica Veterinária de Cães (Portuguese Gendarmerie Canine Clinic) clinical records were extracted. Baseline and 30-day post-treatment follow-up data from 296 dogs treated for hip osteoarthritis were categorized based on an anchor question, and estimates of minimal clinically-important differences (MCIDs) using distribution-based and anchor-based methods were performed. RESULTS For the LOAD, the anchor-based methods provided a MCID estimate range of -2.5 to -9.1 and the distribution-based methods from 1.6 to 4.2. For the COI, the anchor-based methods provided a MCID estimate range of -4.5 to -16.6 and the distribution-based methods from 2.3 to 2.4. For the dimensions of COI, values varied from -0.5 to -4.9 with the anchor-based methods and from 0.6 to 2.7 with the distribution-based methods. Receiver operator characteristic curves provided areas under the curve >0.7 for the COI, indicating an acceptable cut-off point, and >0.8 for the LOAD, indicating an excellent cut-off point. CONCLUSION Our estimates of MCIDs for dogs with OA were consistent with previously proposed values of -4 for the LOAD and -14 for the COI in a post-surgical intervention context. ROC curve data suggest that LOAD may more reliably differentiate between anchor groups. We also presented estimates from COI of -4 for Stiffness, Function, and Gait and -3 for quality of life. These estimates can be used for research and patient monitoring.
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Affiliation(s)
- J. C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
- Centro de Ciência Animal e Veterinária, Lusófona University, Lisbon, Portugal
- MED–Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Évora, Portugal
| | - John F. Innes
- Movement Veterinary Referrals, Preston Brook, Runcorn, Cheshire, United Kingdom
- School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Liverpool, United Kingdom
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Alves JC, Santos A, Jorge P, Carreira LM. A Comparison of Intra-Articular Blood Cell Secretome and Blood Cell Secretome with Triamcinolone Acetonide in Dogs with Osteoarthritis: A Crossover Study. Animals (Basel) 2022; 12:3358. [PMID: 36496879 PMCID: PMC9741238 DOI: 10.3390/ani12233358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Osteoarthritis (OA) is a growing welfare problem for dogs and a challenge to manage for the clinician, and most therapeutic options aim to control pain. In a randomized, double-blinded, placebo-controlled, 2-way, 2-period crossover study, we aimed to evaluate the use of Blood Cell Secretome (BCS) administrated intra-articularly, with or without the combination with triamcinolone, in dogs with bilateral hip OA. BCS is an acellular orthobiologic containing anti-inflammatory and anabolic proteins produced from the patient’s own blood through extended coagulation in a defined environment. Fifteen dogs were initially assigned to a BCS group (BCSG, n = 5), a triamcinolone group (TG, n = 5), or a combination group (BCS+TG, n = 5). All had bilateral hip OA. After a 180-day follow-up, the crossover was performed with BCSG (n = 7) and BCS+TG (n = 7). BCSG received a single intra-articular administration of 3 mL of Blood Cell Secretome, and BCS+TG received BCS plus 0.5 mL of triamcinolone acetonide (40 mg/mL). The volume in BCSG was corrected to 3.5 mL with saline. In all patients, both hips were treated. For treatment follow-up, a copy of the Canine Brief Pain Inventory (divided into pain interference score—PIS and Pain Severity Score—PSS), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) was completed on days 0, 8, 15, 30, 60, 90, 120, 150, and 180. Results were analyzed with the Mann−Whitney U test, effect size, and Kaplan−Meier estimators, followed by the log-rank test. p was set at <0.05. Patients of the sample had a mean age of 9.6 ± 2.9 years and a body weight of 29.2 ± 3.9 kg. Seven hips were classified as severe osteoarthritis, and eight were classified as moderate. No differences were found between groups at T0. Significant differences were observed in PSS scores at +8d, with BCS+TG exhibiting better results. PIS, PSS, LOAD, stiffness, and function scores were also lower in BCS+TG from +15 to +60d. The two groups showed similar improvements from +90 to +120d. Kaplan−Meier estimators showed that dogs in BCS+TG showed clinically-important differences for longer, despite a positive result in BCSG. The intra-articular administration of BCS alone was able to improve the overall condition of OA patients. Its combined use with triamcinolone acetonide lead to a faster and longer-lasting improvement in pain scores.
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Affiliation(s)
- J. C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
- MED—Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - Ana Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
| | - Patrícia Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
| | - L. Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), 1300-477 Lisbon, Portugal
- Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon (FMV/ULisboa), 1649-004 Lisboa, Portugal
- Anjos of Assis Veterinary Medicine Centre (CMVAA), 2830-077 Barreiro, Portugal
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Alves JC, Santos A, Jorge P, Carreira LM. A first report on the efficacy of a single intra-articular administration of blood cell secretome, triamcinolone acetonide, and the combination of both in dogs with osteoarthritis. BMC Vet Res 2022; 18:309. [PMID: 35962448 PMCID: PMC9375423 DOI: 10.1186/s12917-022-03413-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Osteoarthritis represents a significant welfare problem for many dogs, with limited therapeutic options other than palliative pain control. To evaluate the effect of the intra-articular administration of blood cell secretome and triamcinolone, 15 dogs with bilateral hip osteoarthritis were randomly assigned to a blood cell secretome (BCSG, n = 5), triamcinolone (TG) or their combination group (BCS + TG, n = 5). BCSG received a single intra-articular administration of 3 ml of blood cell secretome, TG 0.5 ml of triamcinolone acetonide 40 mg/ml, and BCS + TG received the combined products. The volume to administrate was corrected to 3.5 ml with saline. On days 0, 8, 15, 30, 60, 90, 120, 150, and 180, a copy of the Canine Brief Pain Inventory (divided into pain interference score—PIS and Pain Severity Score—PSS), Liverpool Osteoarthritis in Dogs (LOAD), Hudson Visual Analogue Scale (HVAS), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) was completed. Results were analyzed with the Kruskal–Wallis test and the Kaplan–Meier estimators were conducted and compared with the Log Rank test, p < 0.05. Results Animals in the sample had a mean age of 9.0 ± 2.9 years and a bodyweight of 28.8 ± 4.1 kg. Hips were classified as moderate (8) and severe (7) osteoarthritis. No differences were found between groups at T0 regarding considered evaluations. Significant differences were observed between groups in pain scores from + 8d- + 150d, with BCS + TG exhibiting better results. The same was observed for HVAS and LOAD, from + 8d- + 120d. Improvements were also observed in several dimensions of the COI. Kaplan–Meier estimators showed that BCS + TG produced longer periods with better results, followed by BCSG and TG. Conclusion The intra-articular administration of blood cell secretome improved the clinical signs and scores of several clinical metrology instruments in dogs with hip OA, particularly when combined with triamcinolone. Further studies are required.
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Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal. .,Environment and Development, MED - Mediterranean Institute for Agriculture, Instituto de Investigação E Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - P Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon, (FMV/ULisboa), Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
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