经动脉注射亚胺培南/西司他丁钠治疗手部骨关节炎相关指间关节疼痛的有效性和安全性。

Effectiveness and Safety of Intra-arterial Imipenem/Cilastatin Sodium Infusion for Patients with Hand Osteoarthritis-Related Interphalangeal Joint Pain.

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.

Department of Medical Imaging, National Cheng Kung University, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Vasc Interv Radiol. 2023 Sep;34(9):1485-1492.e1. doi: 10.1016/j.jvir.2023.05.035. Epub 2023 Jun 7.

DOI:10.1016/j.jvir.2023.05.035

PMID:37295555

Abstract

PURPOSE

To evaluate the effectiveness and safety of intra-arterial imipenem/cilastatin sodium (IPM/CS) infusion for painful interphalangeal joint osteoarthritis (OA).

MATERIALS AND METHODS

Fifty-eight patients with interphalangeal joint OA who underwent intra-arterial IPM/CS infusion were retrospectively evaluated. Intra-arterial infusions were performed via percutaneous wrist arterial access. The Numerical Rating Scale (NRS), Functional Index for Hand Osteoarthritis (FIHOA), and Patient Global Impression of Change (PGIC) scale scores were assessed at intervals of 1, 3, 6, 12, and 18 months. Clinical success was evaluated based on PGIC.

RESULTS

All patients were followed up for at least 6 months after treatment. Of them, 30 and 6 patients were followed up for 12 and 18 months, respectively. No severe or life-threatening adverse events were encountered. The mean NRS score was 6.0 ± 1.4 at baseline, which significantly decreased to 2.8 ± 1.4, 2.2 ± 1.9, and 2.4 ± 1.9 at 1, 3, and 6 months after treatment, respectively (all P < .001). The mean NRS scores were 2.8 ± 1.7 and 2.9 ± 1.9 at 12 and 18 months, respectively, in the remaining patients. The mean FIHOA score significantly decreased from 9.8 ± 5.0 at the baseline to 4.1 ± 3.5 at 3 months (P < .001). The mean FIHOA score was 4.5 ± 3.3 at 12 months in the remaining 30 patients. The clinical success rates based on PGIC at 1, 3, 6, 12, and 18 months were 62.1%, 77.6%, 70.7%, 63.4%, and 50.0%, respectively.

CONCLUSIONS

Intra-arterial IPM/CS infusion is a potential treatment option for interphalangeal joint OA refractory to medical management.

摘要

目的

评估经动脉滴注亚胺培南/西司他丁钠（IPM/CS）治疗疼痛性指间关节骨关节炎（OA）的有效性和安全性。

材料和方法

回顾性评估了 58 例接受指间关节 IPM/CS 经动脉输注的 OA 患者。经皮腕部动脉入路进行经动脉输注。分别在 1、3、6、12 和 18 个月时评估数字评定量表（NRS）、手部骨关节炎功能指数（FIHOA）和患者整体变化印象（PGIC）评分。根据 PGIC 评估临床疗效。

结果

所有患者在治疗后至少随访 6 个月，其中 30 例和 6 例分别随访 12 个月和 18 个月。未发生严重或威胁生命的不良事件。基线时 NRS 评分的平均值为 6.0±1.4，治疗后 1、3 和 6 个月分别显著降至 2.8±1.4、2.2±1.9 和 2.4±1.9（均 P<.001）。其余患者在 12 个月和 18 个月时的 NRS 评分平均值分别为 2.8±1.7 和 2.9±1.9。FIHOA 评分从基线时的 9.8±5.0显著降至 3 个月时的 4.1±3.5（P<.001）。其余 30 例患者在 12 个月时的 FIHOA 评分平均值为 4.5±3.3。PGIC 在 1、3、6、12 和 18 个月时的临床有效率分别为 62.1%、77.6%、70.7%、63.4%和 50.0%。