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曲安奈德、透明质酸及二者联合单次关节内注射治疗警犬骨关节炎疗效的初步研究

A Pilot Study on the Efficacy of a Single Intra-Articular Administration of Triamcinolone Acetonide, Hyaluronan, and a Combination of Both for Clinical Management of Osteoarthritis in Police Working Dogs.

作者信息

Alves João C, Santos Ana, Jorge Patrícia, Lavrador Catarina, Carreira L Miguel

机构信息

Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal.

MED-Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Évora, Portugal.

出版信息

Front Vet Sci. 2020 Nov 6;7:512523. doi: 10.3389/fvets.2020.512523. eCollection 2020.

Abstract

To describe and compare the use and effectiveness of a single intra-articular injection (IA) of triamcinolone acetonide (TA), hyaluronan (HA), and a combination of both (TA+HA) in police working dogs with natural occurring hip osteoarthritis (OA). Prospective, randomized, single-blinded study. Thirty animals with naturally occurring hip OA. Animals were randomly divided in three groups: GT, treated with 20 mg of TA per hip joint; GH, treated with treated 20 mg of HA per hip joint; and GTH, treated with a combination of 20 mg of TA and 20 mg of HA per hip joint. Response to treatment, measured by the Canine Brief Pain Inventory (divided in Pain Interference Score-PIS and Pain Severity Score-PSS) and the Hudson Visual Analog Scale (HVAS), was evaluated in seven different time points: T0 (before treatment), T1 (after 15 days), T2, T3, T4, T5, and T6 (after 1, 2, 3, 4, and 5 months, respectively). Results were compared using a Kruskal-Wallis test or a Wilcoxon signed ranks test, and < 0.05 was set. Comparing results of the different time points considered with T0, significant differences were registered in GH at T1 for HVAS ( = 0.03) and PIS ( = 0.04); and in GTH at T1 ( = 0.05 for HVAS and < 0.05 for PIS), T2 ( < 0.04 for PIS), T3 ( < 0.03 for HVAS and = 0.05 for PIS), T4 ( < 0.03 for HVAS and < 0.05), and T5 ( < 0.05 for HVAS). No significant differences were found between groups when comparing scores in each time point. Individual treatment is considered successful with a reduction of ≥1 for PSS or ≥2 for PIS. In GTH, treatment was successful in four animals between T1 and T5 (40%, = 10) and three at T6-T7 (30%, = 10) for PSS and three animals of GTH at T1 (30%), two at T2 (20%), three between T3 and T4 (30%), and two between T5 and T7 (20%). This study provides direct information on the use of these treatment modalities in patients with hip OA. Intra-articular injection with TA and HA may be a treatment option for dogs with naturally occurring OA, particularly when simultaneously used, as they provide significant improvements of PIS and HVAS scores. Individual scores improved in some animals with PIS, PSS, and HVAS.

摘要

描述并比较曲安奈德(TA)、透明质酸(HA)及二者联合(TA+HA)单次关节内注射(IA)用于患有自然发生的髋关节骨关节炎(OA)的警犬的使用情况及疗效。前瞻性、随机、单盲研究。30只患有自然发生的髋关节OA的动物。动物被随机分为三组:GT组,每髋关节注射20mg TA;GH组,每髋关节注射20mg HA;GTH组,每髋关节注射20mg TA与20mg HA的组合。通过犬简短疼痛量表(分为疼痛干扰评分-PIS和疼痛严重程度评分-PSS)和哈德逊视觉模拟量表(HVAS)测量治疗反应,在七个不同时间点进行评估:T0(治疗前)、T1(15天后)、T2、T3、T4、T5和T6(分别在1、2、3、4和5个月后)。使用Kruskal-Wallis检验或Wilcoxon符号秩检验比较结果,设定P<0.05。将不同时间点的结果与T0进行比较,GH组在T1时HVAS(P=0.03)和PIS(P=0.04)有显著差异;GTH组在T1(HVAS为P=0.05,PIS<0.05)、T2(PIS<0.04)、T3(HVAS<0.03,PIS=0.05)、T4(HVAS<0.03,PIS<0.05)和T5(HVAS<0.05)有显著差异。在比较各时间点的评分时,组间未发现显著差异。若PSS降低≥1或PIS降低≥2,则认为个体治疗成功。在GTH组,对于PSS,在T1至T5期间有4只动物治疗成功(40%,n=10),在T6-T7时有3只(30%,n=10);对于GTH组的PIS,在T1时有3只动物(30%)、T2时有2只(20%)、T3至T4期间有3只(30%)以及T5至T7期间有2只(20%)治疗成功。本研究提供了关于这些治疗方式在髋关节OA患者中应用的直接信息。关节内注射TA和HA可能是患有自然发生的OA的犬的一种治疗选择,特别是当同时使用时,因为它们能显著改善PIS和HVAS评分。一些动物的PIS、PSS和HVAS个体评分有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/337f/7690322/77582c90eb26/fvets-07-512523-g0001.jpg

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