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洛索洛芬水凝胶贴剂与洛索洛芬片剂治疗膝骨关节炎患者的疗效和安全性:一项随机对照非劣效性试验

Efficacy and safety of loxoprofen hydrogel patch versus loxoprofen tablet in patients with knee osteoarthritis: a randomized controlled non-inferiority trial.

作者信息

Mu Rong, Bao Chun-de, Chen Zhi-wei, Zheng Yi, Wang Guo-chun, Zhao Dong-bao, Hu Shao-xian, Li Yu-jun, Shao Zeng-wu, Zhang Zhi-yi, Xiao Wei-guo, Zhang Weiya, Li Zhan-guo

机构信息

Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044, China.

Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Clin Rheumatol. 2016 Jan;35(1):165-73. doi: 10.1007/s10067-014-2701-4. Epub 2014 Jun 14.

Abstract

This study is aimed at comparing the efficacy and safety of loxoprofen sodium hydrogel patch (LX-P) with loxoprofen sodium tablet (LX-T) in patients with knee osteoarthritis (OA). One hundred sixty-nine patients were enrolled in a randomized, controlled, double-blind, double-dummy, multicenter, non-inferiority trial of LX-P. Patients were randomly assigned to either LX-P or LX-T groups for a 4-week treatment. The primary efficacy endpoint was the proportion of patients with an overall improvement of ≥50%, and the secondary efficacy endpoint was the proportion of patients with an improvement of ≥25% from baseline in each of the seven main symptoms. The non-inferiority trial was based on a power of 80% and significance level of 2.5% with a non-inferiority margin of -10%. In both intention-to-treat (ITT) and per-protocol (PP) analyses, LX-P was as effective as LX-T in regard to the primary endpoint. In the ITT analysis, the difference between the two groups was 12.6% [95% confidence interval, -1.7 to 26.9%]. No significant differences were found between the two groups in any of the secondary efficacy outcomes. A lower incidence of adverse events was observed in LX-P group; however, the difference was not statistically significant. No serious adverse events were reported in the LX-P group, whereas one case was reported in LX-T group. Based on the present study, topical loxoprofen patch was non-inferior to oral loxoprofen in patients with knee osteoarthritis.

摘要

本研究旨在比较洛索洛芬钠水凝胶贴剂(LX-P)与洛索洛芬钠片(LX-T)治疗膝骨关节炎(OA)患者的疗效和安全性。169例患者纳入LX-P的随机、对照、双盲、双模拟、多中心、非劣效性试验。患者被随机分配至LX-P组或LX-T组进行为期4周的治疗。主要疗效终点为总体改善≥50%的患者比例,次要疗效终点为7项主要症状中每项症状较基线改善≥25%的患者比例。非劣效性试验的检验效能为80%,显著性水平为2.5%,非劣效界值为-10%。在意向性分析(ITT)和符合方案分析(PP)中,LX-P在主要终点方面与LX-T疗效相当。在ITT分析中,两组间差异为12.6%[95%置信区间,-1.7%至26.9%]。两组在任何次要疗效结局方面均未发现显著差异。LX-P组不良事件发生率较低;然而,差异无统计学意义。LX-P组未报告严重不良事件,而LX-T组报告了1例。基于本研究,对于膝骨关节炎患者,局部应用洛索洛芬贴剂不劣于口服洛索洛芬。

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