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关节腔内注射LMWF-5A治疗膝骨关节炎的初步试验

Preliminary Trial of Intra-articular LMWF-5A for Osteoarthritis of the Knee.

作者信息

Schwappach John, Dryden Sara M, Salottolo Kristin M

出版信息

Orthopedics. 2017 Jan 1;40(1):e49-e53. doi: 10.3928/01477447-20160926-02. Epub 2016 Sep 30.

Abstract

This study was conducted to investigate the safety and efficacy of 3 intraarticular injections of the low-molecular-weight fraction of 5% human serum albumin (LMWF-5A) administered every 2 weeks for knee pain as a result of osteoarthritis. This single-center, randomized, vehicle-controlled, double-blind, phase II study was designed to ensure the safety of multiple intra-articular injections of LMWF-5A and to explore its efficacy in reducing pain as a result of knee osteoarthritis. Patients were randomized 1:1 to receive 3 biweekly intra-articular knee injections of either 4 mL LMWF-5A or vehicle control (saline), administered at weeks 0 (baseline), 2, and 4. Safety was examined as the incidence and severity of adverse events. Efficacy was assessed by the mean (SD) change between treatment groups in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score from baseline to week 20. A total of 40 patients were randomized and received treatment. No drug-related serious adverse events and no deaths were reported. Adverse events were similar in patients who received saline (18, 90%) and LMWF-5A (19, 95%). Those treated with LMWF-5A had a significant decrease in pain at 20 weeks compared with the saline group (-1.41 [SD, 0.81] vs -0.85 [SD, 0.64], P=.02), corresponding to improvement in pain at week 20 of 64% with LMWF-5A compared with 40% with saline. This preliminary clinical trial showed that repeated intra-articular injections of LMWF-5A are safe when administered at 2-week intervals and are effective in providing relief of the pain of osteoarthritis of the knee at 20 weeks. [Orthopedics. 2017; 40(1):e49-e53.].

摘要

本研究旨在调查每2周关节腔内注射3次5%人血清白蛋白低分子量组分(LMWF-5A)治疗骨关节炎所致膝关节疼痛的安全性和有效性。这项单中心、随机、赋形剂对照、双盲的II期研究旨在确保多次关节腔内注射LMWF-5A的安全性,并探索其减轻膝关节骨关节炎所致疼痛的疗效。患者按1:1随机分组,在第0周(基线)、第2周和第4周接受每2周1次的4 mL LMWF-5A或赋形剂对照(生理盐水)关节腔内膝关节注射。将不良事件的发生率和严重程度作为安全性检查指标。通过比较治疗组从基线到第20周的西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛评分的均值(标准差)变化来评估疗效。共有40例患者被随机分组并接受治疗。未报告与药物相关的严重不良事件和死亡病例。接受生理盐水治疗的患者(18例,90%)和接受LMWF-5A治疗的患者(19例,95%)的不良事件相似。与生理盐水组相比,接受LMWF-5A治疗的患者在20周时疼痛显著减轻(-1.41 [标准差,0.81] 对 -0.85 [标准差,0.64],P = 0.02),LMWF-�A组在第20周时疼痛改善率为64%,而生理盐水组为40%。这项初步临床试验表明,每2周间隔关节腔内重复注射LMWF-5A是安全的,并且在20周时能有效缓解膝关节骨关节炎的疼痛。[《骨科学》。2017;40(1):e49-e53。]

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