Orthopedics and Traumatology Service, Universidad Autónoma de Nuevo León, University Hospital ''Dr. José Eleuterio González'', Monterrey, México.
Endocrinology Division, Universidad Autónoma de Nuevo León, University Hospital ''Dr, José Eleuterio González'', Monterrey, México.
Int J Rheum Dis. 2019 Sep;22(9):1607-1615. doi: 10.1111/1756-185X.13658. Epub 2019 Jul 22.
We performed a systematic review and meta-analysis from randomized controlled trials to examine the efficacy and safety of avocado-soybean unsaponifiables (ASU) in patients with hip or knee osteoarthritis (OA).
Medline, SCOPUS, Web of Science, and Google Scholar databases were searched for randomized placebo-controlled trials.
Original studies were randomized placebo-controlled trials evaluating the effect of orally administered ASU on knee or hip OA symptoms using the Lequesne index, visual analog scale (VAS) and/or joint space width (JSW).
Meta-analysis was conducted using a random-effects model and generic inverse variance method. Heterogeneity was tested using the I statistic index.
Avocado-soybean unsaponifiables therapy had a significant reduction on pain by VAS assessment (weighted mean difference [WMD]: -9.64 mm, 95% CI: -17.43, -1.84; P = .02; I = 92%). A subanalysis according to the type of OA showed that ASU significantly decreased both VAS and Lequesne index in knee OA (WMD: -17.36, 95% CI: -25.91, -8.82; P < .0001; I = 87% and WMD: -2.33, 95% CI: -2.88, -1.78; P < .00001; I = 18%, respectively) but not in hip OA. Finally, ASU supplementation showed no significant differences for adverse events compared to placebo (relative risk: 1.02, 95% CI: 0.83, 1.25; P = .88; I = 0%).
Results of this meta-analysis suggest a beneficial effect of ASU treatment in symptomatic knee OA but not in hip OA. Additionally, adverse events were similar in patients receiving ASU therapy or placebo.
我们进行了一项系统综述和荟萃分析，纳入了随机对照试验，以评估在髋或膝关节骨关节炎（OA）患者中，牛油果-大豆不皂化物（ASU）的疗效和安全性。
我们检索了 Medline、SCOPUS、Web of Science 和 Google Scholar 数据库，以寻找评估口服 ASU 对膝或髋 OA 症状影响的随机安慰剂对照试验。
纳入的原始研究为评估口服 ASU 治疗膝或髋 OA 症状的效果的随机安慰剂对照试验，使用 Lequesne 指数、视觉模拟评分（VAS）和/或关节间隙宽度（JSW）作为评估指标。
使用随机效应模型和通用倒数方差法进行荟萃分析。使用 I ²统计量检验异质性。
ASU 治疗可显著减轻 VAS 评估的疼痛（加权均数差 [WMD]：-9.64mm，95%置信区间：-17.43，-1.84；P=0.02；I ²=92%）。根据 OA 类型的亚组分析显示，ASU 可显著降低膝 OA 患者的 VAS 和 Lequesne 指数（WMD：-17.36，95%置信区间：-25.91，-8.82；P<0.0001；I ²=87%和 WMD：-2.33，95%置信区间：-2.88，-1.78；P<0.00001；I ²=18%），但对髋 OA 无显著影响。最后，与安慰剂相比，ASU 补充剂在不良反应方面无显著差异（相对风险：1.02，95%置信区间：0.83，1.25；P=0.88；I ²=0%）。
这项荟萃分析的结果表明，ASU 治疗对有症状的膝 OA 有效，但对髋 OA 无效。此外，接受 ASU 治疗或安慰剂的患者的不良反应相似。
