Perry Thomas A, Parkes Matthew J, Hodgson Richard, Felson David T, O'Neill Terence W, Arden Nigel K
Arthritis Research UK Centre for Epidemiology, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Research in Osteoarthritis Manchester (ROAM), Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, School of Biological Sciences, Stopford Building, Oxford Road, Manchester, M13 9PT, UK.
NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK.
BMC Musculoskelet Disord. 2019 Feb 14;20(1):76. doi: 10.1186/s12891-019-2424-4.
Data from a recent clinical trial of vitamin D therapy in knee OA suggests that, compared to placebo, vitamin D therapy may be associated with a reduction in effusion-synovitis. Our aim was, using contrast-enhanced (CE) magnetic resonance imaging (MRI), to examine the effect of vitamin D therapy on synovial tissue volume (STV) and also subchondral bone marrow lesion (BML) volume in men and women with symptomatic knee OA.
Data was acquired from participants who took part in a randomised placebo-controlled trial (UK VIDEO) investigating the effect of vitamin D therapy (800 IU cholecalciferol daily) on radiographic joint space narrowing. A subsample had serial CE MRI scans acquired during the trial. Subjects with serial images were assessed (N = 50) for STV and subchondral BML volume. The difference in the mean change from baseline in these structural outcomes between intervention and placebo groups was assessed using random-effects modelling.
The mean age of the 50 subjects (24 active group, 26 placebo group) who contributed data to the analysis was 63.3 years (SD 6.5) and 74% were female. There was no significant difference at 2 years follow-up between the vitamin D and placebo groups in the mean change from baseline for STV (93.9 mm, 95% CI -1605.0 to 1792.7) and subchondral BML volume (- 313.5 mm, 95% CI -4244.7 to 3617.7).
Vitamin D supplementation does not appear to have an effect on synovitis or BML volume in patients with symptomatic knee OA.
VIDEO was registered with EudraCT: ref. 2004-000169-37. The protocol for the trial can be accessed at https://www.ctu.mrc.ac.uk/studies/all-studies/v/video/.
近期一项关于维生素D治疗膝骨关节炎的临床试验数据表明,与安慰剂相比,维生素D治疗可能与积液 - 滑膜炎的减轻有关。我们的目的是使用对比增强(CE)磁共振成像(MRI),研究维生素D治疗对有症状膝骨关节炎男性和女性的滑膜组织体积(STV)以及软骨下骨髓病变(BML)体积的影响。
数据来自参与一项随机安慰剂对照试验(英国VIDEO)的参与者,该试验研究维生素D治疗(每日800 IU胆钙化醇)对放射学关节间隙狭窄的影响。一个子样本在试验期间进行了连续的CE MRI扫描。对有连续图像的受试者(N = 50)评估STV和软骨下BML体积。使用随机效应模型评估干预组和安慰剂组之间这些结构结局相对于基线的平均变化差异。
为分析贡献数据的50名受试者(24名活性组,26名安慰剂组)的平均年龄为63.3岁(标准差6.5),74%为女性。在2年随访时,维生素D组和安慰剂组之间,STV相对于基线的平均变化(93.9 mm,95%置信区间 -1605.0至1792.7)和软骨下BML体积(-313.5 mm,95%置信区间 -4244.7至3617.7)无显著差异。
补充维生素D似乎对有症状膝骨关节炎患者的滑膜炎或BML体积没有影响。
VIDEO在欧洲临床试验数据库(EudraCT)注册:编号2004 - 000169 - 37。该试验方案可在https://www.ctu.mrc.ac.uk/studies/all-studies/v/video/获取。