硫酸氨基葡萄糖治疗手骨关节炎患者的回顾性观察研究，与单独常规治疗相比。
A retrospective observational study of glucosamine sulfate in addition to conventional therapy in hand osteoarthritis patients compared to conventional treatment alone.
机构信息
Clinic for the Diagnosis and Management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy.
Scleroderma Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy.
出版信息
Aging Clin Exp Res. 2020 Jun;32(6):1161-1172. doi: 10.1007/s40520-019-01305-4. Epub 2019 Aug 19.
BACKGROUND
The optimal management of hand osteoarthritis (HOA) is still challenging.
AIM
To evaluate the effects of glucosamine sulfate (GS) in addition to conventional therapy compared to conventional therapy alone in HOA.
METHODS
This 6-month retrospective study included 108 patients with concomitant knee and hand OA. Fifty-five patients (GS Group) were treated for six consecutive months with crystalline GS (1500 mg once/day) in addition to conventional therapy for HOA [exercise combined with acetaminophen and/or non-steroidal anti-inflammatory drugs (NSAIDs)] and 53 patients (Control Group) with the conventional therapy alone. Primary outcomes were the difference between groups in the change of hand pain on a Visual Analogue Scale (VAS) and in the Functional Index for Hand Osteoarthritis (FIHOA) from baseline to 6 months. Secondary outcomes were Health Assessment Questionnaire (HAQ), medical outcomes study 36-item short form (SF-36) and symptomatic drug consumption.
RESULTS
The patients who received GS presented a significant decrease (p < 0.001) in VAS pain and FIHOA scores compared with the Control Group at 3 and 6 months. Furthermore, GS therapy was associated to a significant improvement of HAQ score and to a significant reduction of acetaminophen and NSAID consumption during the follow-up. No differences in the number of side effects were observed between the groups.
DISCUSSION
GS could represent a potential successful therapy for HOA and should be tried in large randomized placebo and active controlled trials.
CONCLUSIONS
The combination of GS with conventional treatment seems to be more effective in improving pain and function than conventional HOA treatment alone.
TRIAL REGISTRATION
ClinicalTrials.gov, http://www.clinicaltrials.gov date of registration: April 9, 2019, NCT03911570. The present trial was retrospectively registered.
背景
手部骨关节炎（HOA）的最佳治疗方法仍然具有挑战性。
目的
评估硫酸葡糖胺（GS）在常规治疗的基础上加用与单独常规治疗相比，对 HOA 的疗效。
方法
本 6 个月的回顾性研究纳入了 108 例膝和手部 OA 并存的患者。55 例患者（GS 组）在连续 6 个月内除了接受 HOA 的常规治疗（运动联合对乙酰氨基酚和/或非甾体抗炎药（NSAIDs））外，还接受结晶 GS（每天 1500mg 一次）治疗，53 例患者（对照组）仅接受常规治疗。主要结局为两组间基线至 6 个月时手部疼痛的变化，采用视觉模拟评分（VAS）和手部骨关节炎功能指数（FIHOA）评估。次要结局为健康评估问卷（HAQ）、医学结局研究 36 项简明量表（SF-36）和症状性药物消耗。
结果
与对照组相比，接受 GS 治疗的患者在 3 和 6 个月时 VAS 疼痛评分和 FIHOA 评分显著下降（p < 0.001）。此外，GS 治疗与 HAQ 评分的显著改善以及随访期间对乙酰氨基酚和 NSAID 消耗的显著减少相关。两组间不良反应的数量无差异。
讨论
GS 可能是 HOA 的一种潜在有效治疗方法，应在大型随机安慰剂和活性对照试验中进行尝试。
结论
GS 联合常规治疗在改善疼痛和功能方面似乎比单独常规治疗 HOA 更有效。
试验注册
ClinicalTrials.gov，http://www.clinicaltrials.gov 注册号：2019 年 4 月 9 日，NCT03911570。本试验为回顾性注册。
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