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一项多中心、随机对照试验的亚组分析:关节内注射凝胶-200 单次治疗膝关节骨关节炎的疗效优于磷酸盐缓冲盐水,6 个月时更有效。

A Single Intra-Articular Injection of Gel-200 for Treatment of Symptomatic Osteoarthritis of the Knee Is More Effective than Phosphate Buffered Saline at 6 Months: A Subgroup Analysis of a Multicenter, Randomized Controlled Trial.

机构信息

R&D Planning Department, Research & Development Division, Seikagaku Corporation, Chiyoda-ku, Tokyo, Japan.

Clinical Development Department, Research & Development Division, Seikagaku Corporation, Chiyoda-ku, Tokyo, Japan.

出版信息

Cartilage. 2019 Oct;10(4):417-422. doi: 10.1177/1947603518768015. Epub 2018 Apr 12.

Abstract

OBJECTIVE

Many clinical trials of viscosupplementation have been conducted, although only the Gel-200 (primary) trial included a different patient population. A subgroup analysis of a multicenter, randomized controlled trial comparing the efficacy of single intra-articular injections of Gel-200 with phosphate buffered saline (PBS) was performed to demonstrate its benefit as treatment of osteoarthritis of the knee in a population similar to those of other reported trials of viscosupplementation.

DESIGN

The subgroup population was defined as patients in the intention-to-treat (ITT) population who met the specified criteria. Changes from baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores following treatment with Gel-200 or PBS were derived from a longitudinal model and treatment differences compared between groups at weeks 12 and 26, and over 26 weeks.

RESULTS

The subgroup included 311 subjects (152 Gel-200; 159 PBS). Mean improvements from baseline in WOMAC pain subscores in the Gel-200 over PBS groups were statistically significant at week 12 ( = 0.031) and week 26 ( = 0.019. Treatment group differences in WOMAC stiffness and total scores were statistically significant at week 26 ( = 0.023 and = 0.036, respectively).

CONCLUSIONS

The efficacy of Gel-200 following a single injection for knee osteoarthritis was demonstrated in WOMAC pain, stiffness, and total scores as well as clinically important improvements in pain at 26 weeks in this subset of patients with comparable characteristics to populations evaluated in other viscosupplementation treatment trials.

摘要

目的

许多黏弹性补充治疗的临床试验已经开展,尽管只有 Gel-200(主要)试验纳入了不同的患者人群。对一项比较 Gel-200 与磷酸盐缓冲盐水(PBS)单次关节内注射疗效的多中心、随机对照试验进行了亚组分析,旨在证明其在膝骨关节炎治疗中的益处,该人群与其他黏弹性补充治疗试验报告的人群相似。

设计

亚组人群定义为符合特定标准的意向治疗(ITT)人群。Gel-200 或 PBS 治疗后,根据纵向模型得出 Western Ontario 和 McMaster 大学骨关节炎指数(WOMAC)评分与基线相比的变化,并且在第 12 周和第 26 周以及 26 周以上比较组间的治疗差异。

结果

该亚组纳入 311 例患者(Gel-200 组 152 例,PBS 组 159 例)。Gel-200 组相对于 PBS 组,WOMAC 疼痛子评分从基线的平均改善在第 12 周( = 0.031)和第 26 周( = 0.019)有统计学意义。WOMAC 僵硬和总分的治疗组差异在第 26 周有统计学意义( = 0.023 和 = 0.036)。

结论

在这个具有与其他黏弹性补充治疗试验评估人群相似特征的患者亚组中,单次膝关节注射 Gel-200 治疗膝骨关节炎,在 WOMAC 疼痛、僵硬和总分以及 26 周时疼痛的临床重要改善方面显示出疗效。

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