Stebbings Simon, Gray Andrew, Schneiders Anthony G, Sansom Andrew
Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
BMC Complement Altern Med. 2017 Aug 22;17(1):416. doi: 10.1186/s12906-017-1907-9.
Extracts from perna canaliculus, the Green Lipped Mussel (GLM) are widely used as a complimentary therapy by patients with osteoarthritis (OA). The current study investigated the potential of a novel GLM formulation as a treatment for OA. A randomized double-blind placebo-controlled trial was undertaken to assess potential impacts on pain and quality of life following 12 weeks of treatment.
Eighty patients with moderate to severe OA of the hip or knee were randomized to receive either 600 mg of BioLex®-GLM daily or placebo for 12 weeks. Entry criteria included a minimum 100 mm Visual Analogue Scale pain score (VAS) of 30 mm at baseline. The primary outcome was patient reported pain, measured by the Western Ontario and McMasters OA Index (WOMAC) pain subscale and VAS pain scale. Secondary outcomes included: quality of life (OAQol), total WOMAC score, WOMAC -20 responder criteria, and change in medication use over the study period. Participants were assessed at baseline, 12 weeks (end of therapy) and 15 weeks (3-weeks post-intervention).
At week 12, there were no significant differences in VAS or WOMAC pain subscale between active and placebo groups, nor significant improvement in the WOMAC-20 responder criteria or OAQol. Joint stiffness (measured by WOMAC-B stiffness) in the GLM group improved compared with placebo (p = 0.046). There was a significant difference in paracetamol use between the GLM treated group and the placebo group after week 12 (p = 0.001).
BioLex® -GLM extract did not confer clinical benefit in moderate to severe OA over the intervention period, however, a significant difference in paracetamol use in the post-intervention period was observed between the BioLex® -GLM group and placebo group. Higher doses and/or longer treatment periods are worthy of future investigation.
Australia and New Zealand Clinical Trials Registry: no. ACTRN12611000256976 .
绿唇贻贝(GLM)——新西兰绿唇鲍的提取物被骨关节炎(OA)患者广泛用作辅助治疗。本研究调查了一种新型GLM制剂治疗OA的潜力。开展了一项随机双盲安慰剂对照试验,以评估治疗12周后对疼痛和生活质量的潜在影响。
80例中重度髋或膝OA患者被随机分为两组,分别每日服用600mg BioLex®-GLM或安慰剂,为期12周。纳入标准包括基线时视觉模拟量表(VAS)疼痛评分至少为30mm(满分100mm)。主要结局是患者报告的疼痛,采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛子量表和VAS疼痛量表进行测量。次要结局包括:生活质量(OAQol)、WOMAC总分、WOMAC-20应答标准以及研究期间药物使用的变化。在基线、12周(治疗结束时)和15周(干预后3周)对参与者进行评估。
在第12周时,活性药物组和安慰剂组之间的VAS或WOMAC疼痛子量表无显著差异,WOMAC-20应答标准或OAQol也无显著改善。与安慰剂相比,GLM组的关节僵硬(通过WOMAC-B僵硬量表测量)有所改善(p = 0.046)。第12周后,GLM治疗组和安慰剂组之间对乙酰氨基酚的使用存在显著差异(p = 0.001)。
在干预期间,BioLex®-GLM提取物对中重度OA未显示出临床益处,然而,在干预后阶段,BioLex®-GLM组和安慰剂组之间对乙酰氨基酚的使用存在显著差异。更高剂量和/或更长治疗期值得未来研究。
澳大利亚和新西兰临床试验注册中心:编号ACTRN12611000256976 。