Moeda Frederico, Melo Xavier, Hatia Madjer, Pinho Sérgio, Calado Duarte, Branco Jaime C, Gonçalves Maria J
Physical Medicine and Rehabilitation, Centro Hospitalar de Lisboa Ocidental, Lisboa, PRT.
Rheumatology, Centro Hospitalar de Lisboa Ocidental, Lisboa, PRT.
Cureus. 2022 Aug 19;14(8):e28182. doi: 10.7759/cureus.28182. eCollection 2022 Aug.
Platelet-rich plasma injections have been a therapeutic option with exponential growth in several pathologies in the last decades, particularly musculoskeletal for their effect on improving pain and functionality. Rheumatoid arthritis is a chronic joint disease, which involves inflammation of the synovial membrane with cartilage and juxta-articular bone destruction. Conventional and biological disease-modifying anti-rheumatoid drugs are the cornerstone of the treatment of this disease. However, the use of intra-articular glucocorticoids is often necessary and the role of platelet-rich plasma injections in these patients remains uncertain. A literature review was carried out through the PubMed database, Cochrane and Google Scholar for the search terms "rheumatoid arthritis" and "platelet-rich plasma". Eleven studies have been included in this review: two of these are studies, five are animal studies, one case report, two case series and one randomized controlled trial. Most of the studies demonstrated a decrease in pain and inflammatory mediators and improvement of functional outcomes, with no severe adverse effects reported. However, the quantity and quality of literature about the effects and safety of plasma-rich plasma injections in rheumatoid arthritis patients are still scarce. It is essential that well-designed randomized controlled trials are made on this topic to understand if platelet-rich plasma may be useful as a coadjuvant therapy in rheumatoid arthritis.
在过去几十年中,富血小板血浆注射已成为一种治疗选择,在多种病症中呈指数增长,特别是在肌肉骨骼疾病方面,因其对改善疼痛和功能有作用。类风湿性关节炎是一种慢性关节疾病,涉及滑膜炎症以及软骨和关节周围骨质破坏。传统和生物性改善病情抗风湿药物是这种疾病治疗的基石。然而,关节内注射糖皮质激素常常是必要的,而富血小板血浆注射在这些患者中的作用仍不确定。通过PubMed数据库、Cochrane和谷歌学术进行了文献综述,搜索词为“类风湿性关节炎”和“富血小板血浆”。本综述纳入了11项研究:其中两项是研究,五项是动物研究,一项病例报告,两项病例系列和一项随机对照试验。大多数研究表明疼痛和炎症介质减少,功能结局得到改善,且未报告严重不良反应。然而,关于富血小板血浆注射对类风湿性关节炎患者的疗效和安全性的文献数量和质量仍然不足。必须针对该主题进行精心设计的确随机对照试验,以了解富血小板血浆是否可用作类风湿性关节炎的辅助治疗。