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WOMAC 有意义的患者内变化:来自特立帕肽治疗髋或膝关节中重度骨关节炎 3 项研究的结果。

WOMAC Meaningful Within-patient Change: Results From 3 Studies of Tanezumab in Patients With Moderate-to-severe Osteoarthritis of the Hip or Knee.

机构信息

P.G. Conaghan, MB BS, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds, UK.

R.H. Dworkin, PhD, University of Rochester, Rochester, New York, USA.

出版信息

J Rheumatol. 2022 Jun;49(6):615-621. doi: 10.3899/jrheum.210543. Epub 2022 Mar 1.

Abstract

OBJECTIVE

To define meaningful within-patient change (MWPC) in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

METHODS

Data were analyzed separately from 3 phase III clinical trials (ClinicalTrials.gov: NCT02697773, NCT02709486, NCT02528188) of tanezumab, a novel treatment intended for the relief of signs and symptoms of moderate-to-severe osteoarthritis (OA), administered subcutaneously every 8 weeks. Patients with moderate-to-severe OA of the hip or knee completed the WOMAC and patient global assessment of OA (PGA-OA) at regular timepoints. A repeated measures longitudinal model with change in WOMAC Pain, Physical Function, or Stiffness domain score as the outcome and change in PGA-OA as the anchor was used to establish MWPC for WOMAC domains.

RESULTS

In the 3 studies, there were 688, 844, and 2948 subjects available for analyses, respectively. Analysis showed that a linear relationship between changes in WOMAC domains and changes in PGA-OA was supported and justified. Moreover, the relationships between these changes were very similar for 2 trials and close for the third. The estimated MWPC for the 3 WOMAC domains were from 0.84-1.16 (0-10 numerical rating scale) and from 12.50-16.23%, depending on study and domain, that corresponded to a 1-category change on PGA-OA. For a 2-category change those values were from 1.68-2.31 and from 25.01-32.46%, respectively.

CONCLUSION

These results establish MWPCs for WOMAC domains, at the individual patient level, for patients with moderate-to-severe OA of the hip or knee. [ClinicalTrials.gov: NCT02697773, NCT02709486, and NCT02528188].

摘要

目的

定义西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)中的有意义的患者内变化(MWPC)。

方法

分别对 3 项 III 期临床试验(ClinicalTrials.gov:NCT02697773、NCT02709486、NCT02528188)的数据进行了分析,这些试验均为一种新型治疗药物 tanezumab 的研究,用于缓解中度至重度骨关节炎(OA)的体征和症状,每 8 周皮下给药一次。中度至重度髋或膝关节 OA 患者定期完成 WOMAC 和患者 OA 总体评估(PGA-OA)。使用重复测量纵向模型,将 WOMAC 疼痛、身体功能或僵硬域评分的变化作为结果,PGA-OA 的变化作为锚点,建立 WOMAC 域的 MWPC。

结果

在 3 项研究中,分别有 688、844 和 2948 名受试者可用于分析。分析表明,WOMAC 域变化与 PGA-OA 变化之间的线性关系得到了支持和证实。此外,前两项试验之间的这些变化关系非常相似,而第三个试验则非常接近。3 项 WOMAC 域的估计 MWPC 范围为 0.84-1.16(0-10 数字评分量表)和 12.50-16.23%,具体取决于研究和域,相当于 PGA-OA 上的 1 个类别变化。对于 2 个类别变化,这些值分别为 1.68-2.31 和 25.01-32.46%。

结论

这些结果为髋或膝关节中度至重度 OA 患者建立了 WOMAC 域的 MWPC,以个体患者为单位。[ClinicalTrials.gov:NCT02697773、NCT02709486 和 NCT02528188]。

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