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一项II期随机研究的初步结果,该研究旨在确定表达转化生长因子-β1的基因工程异体人软骨细胞对3级膝关节慢性退行性关节病患者的疗效和安全性。

Preliminary results of a phase II randomized study to determine the efficacy and safety of genetically engineered allogeneic human chondrocytes expressing TGF-β1 in patients with grade 3 chronic degenerative joint disease of the knee.

作者信息

Cherian J J, Parvizi J, Bramlet D, Lee K H, Romness D W, Mont M A

机构信息

Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.

Rothman Institute, Thomas Jefferson University, 925 Chestnut St 5th Fl, Philadelphia, PA 19107, USA.

出版信息

Osteoarthritis Cartilage. 2015 Dec;23(12):2109-2118. doi: 10.1016/j.joca.2015.06.019. Epub 2015 Jul 16.

Abstract

OBJECTIVE

The aim of this study was to preliminarily evaluate the efficacy and outcomes of injectable genetically engineered chondrocytes virally transduced with TGF-β1 (GEC-TGF-β1) compared to placebo.

DESIGN

A multi-center, double-blinded, placebo-controlled, randomized study of adults with knee osteoarthritis. A total of 102 patients were 2:1 randomized to GEC-TGF-β1 or placebo. Primary outcomes assessed were (1) function of the knee joint, scored using the International Knee Documentation Committee (IKDC); and (2) pain, measured by Visual Analog Scale (VAS). Secondary endpoints assessed were pain and analgesic use, quality of life (QOL), and adverse events (AEs) including need for total knee arthroplasty after treatment.

RESULTS

IKDC showed significant improvement in the GEC-TGF-β1 group over the placebo at week 12 (least mean square difference (LSMD): 10.3; P = 0.0342), week 52 (LSMD: 13.6; P = 0.0082), and overall (LSMD: 8.6; P = 0.0453). VAS Analysis showed a significant improvement in GEC-TGF-β1 group compared to placebo at weeks 12 (LSMD: -13.8; P = 0.0162), 52 (LSMD: -13.1; P = 0.0332), and overall (LSMD: -10.1; P = 0.0350). Reduction in pain severity at week 12 and 52, frequency at 24 h and week 52, and the percentage of patients in the GEC-TGF-β1 group receiving analgesics at week 4 (27 vs 40%) and 12 (27 vs 37%) was observed.

CONCLUSIONS

GEC-TGF-β1 patients had more positive responses on the IKDC, VAS, and were less likely to require analgesics.

TRIAL NUMBER

ClinicalTrials.gov (NCT01221441) - "Study of TG-C in Patients with Grade 3 Degenerative Joint Disease of the Knee".

摘要

目的

本研究旨在初步评估与安慰剂相比,经病毒转导转化生长因子-β1(GEC-TGF-β1)的注射用基因工程软骨细胞的疗效和结果。

设计

一项针对成年膝骨关节炎患者的多中心、双盲、安慰剂对照随机研究。共102例患者按2:1随机分为GEC-TGF-β1组或安慰剂组。评估的主要结果为:(1)膝关节功能,采用国际膝关节文献委员会(IKDC)评分;(2)疼痛,采用视觉模拟量表(VAS)测量。评估的次要终点为疼痛和镇痛药物使用情况、生活质量(QOL)以及不良事件(AE),包括治疗后全膝关节置换术的需求。

结果

IKDC显示,在第12周(最小均方差(LSMD):10.3;P = 0.0342)、第52周(LSMD:13.6;P = 0.0082)及总体上(LSMD:8.6;P = 0.0453),GEC-TGF-β1组较安慰剂组有显著改善。VAS分析显示,在第12周(LSMD:-13.8;P = 0.0162)、第52周(LSMD:-13.1;P = 0.0332)及总体上(LSMD:-10.1;P = 0.0350),GEC-TGF-β1组与安慰剂组相比有显著改善。观察到第12周和第52周疼痛严重程度降低、24小时和第52周疼痛频率降低,以及GEC-TGF-β1组在第4周(27%对40%)和第12周(27%对37%)接受镇痛药治疗的患者百分比降低。

结论

接受GEC-TGF-β1治疗的患者在IKDC、VAS上有更积极的反应,且需要镇痛药的可能性较小。

试验编号

ClinicalTrials.gov(NCT01221441)-“TG-C在膝关节3级退行性关节病患者中的研究”

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