Khangulov Victor, Zhang Xuan, Munson Sibyl H, Peyerl Fred, Rey Francoise
Department of Health Economics and Outcomes Research, Boston Strategic Partners, Inc., Boston, MA, USA.
Sanofi, Paris, France.
Open Access Rheumatol. 2020 Jun 3;12:79-85. doi: 10.2147/OARRR.S245766. eCollection 2020.
Knee osteoarthritis (OA) is a painful condition affecting >250 million people worldwide and is a leading cause of disability. Intra-articular (IA) corticosteroids and/or oral opioids are often recommended for the management of knee OA pain. There are, however, concerns regarding their safety and tolerability.
Do patients diagnosed with knee OA show a decrease in opioids or IA corticosteroid injections prescribed/administered in hospitals following hylan G-F 20 treatment?
This case-crossover, retrospective study using Health Facts, a de-identified electronic health records database, enrolled patients ≥18 years with knee OA treated with hylan G-F 20 between January 1, 2000 and March 31, 2016, with data within 6 months before/after treatment.
Primary endpoints compared days on opioids, amounts of opioids, and number of IA corticosteroid injections before/after hylan G-F 20 treatment via paired -tests.
A total of 513 patients were qualified for analysis. In the opioid cohort, the average total number of days on opioids (N = 50; 5.0 vs 13.5 days; P = 0.007) and average total amount of opioids (N = 44; 165.4 morphine mg equivalents [MME] vs 493.7 MME; P = 0.013) were lower 6 months after hylan G-F 20 treatment than 6 months before treatment. In the IA corticosteroid cohort, the average number of IA corticosteroid injections decreased after hylan G-F 20 treatment (N = 36; 0.56 in the 6-month follow-up vs 1.39 before treatment; P < 0.0001). Additional time frames of 1-5 months before and after treatment were examined; similar conclusions were drawn for patients with >2 months of data.
Patients with knee OA previously treated with opioids or IA corticosteroid injections who received hylan G-F 20 demonstrated statistically significant decreases in these medications >2 months following hylan G-F 20 treatment versus >2 months before treatment.
膝关节骨关节炎（OA）是一种疼痛性疾病，全球有超过2.5亿人受其影响，是导致残疾的主要原因。关节内（IA）注射皮质类固醇和/或口服阿片类药物常被推荐用于治疗膝关节OA疼痛。然而，人们对其安全性和耐受性存在担忧。
接受玻璃酸钠G-F 20治疗后，被诊断为膝关节OA的患者在医院开具/使用的阿片类药物或IA皮质类固醇注射剂是否减少？
本病例交叉回顾性研究使用了Health Facts，一个经过去识别处理的电子健康记录数据库，纳入了2000年1月1日至2016年3月31日期间接受玻璃酸钠G-F 20治疗的≥18岁膝关节OA患者，并收集了治疗前后6个月内的数据。
主要终点通过配对t检验比较玻璃酸钠G-F 20治疗前后使用阿片类药物的天数、阿片类药物的用量以及IA皮质类固醇注射次数。
共有513名患者符合分析条件。在阿片类药物队列中，玻璃酸钠G-F 20治疗后6个月使用阿片类药物的平均总天数（N = 50；5.0天对13.5天；P = 0.007）和阿片类药物的平均总量（N = 44；165.4吗啡毫克当量[MME]对493.7 MME；P = 0.013）低于治疗前6个月。在IA皮质类固醇队列中，玻璃酸钠G-F 20治疗后IA皮质类固醇注射的平均次数减少（N = 36；6个月随访时为0.56次对治疗前的1.39次；P < 0.0001）。还检查了治疗前后1 - 5个月的其他时间框架；对于有超过2个月数据的患者得出了类似结论。
先前接受过阿片类药物或IA皮质类固醇注射治疗的膝关节OA患者，在接受玻璃酸钠G-F 20治疗后>2个月，与治疗前>2个月相比，这些药物的使用量在统计学上有显著下降。
