Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Musculoskeletal Intervention Center, Okuno Clinic Tokyo, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan.
Cardiovasc Intervent Radiol. 2023 Oct;46(10):1375-1382. doi: 10.1007/s00270-023-03514-x. Epub 2023 Jul 31.
To assess the efficacy and safety of intra-arterial injection of imipenem/cilastatin sodium (IPM/CS) via a needle placed into the radial artery or ulnar artery (RA/UA) for distal interphalangeal and proximal interphalangeal joint osteoarthritis (DIP/PIP-OA).
This is a retrospective single-arm cohort study. Ninety-two patients [92% women, mean (SD) age 55(8.3) years] with a primary DIP/PIP-OA meet the American College of Rheumatology criteria for hand osteoarthritis with pain ≥ 4 on the 0-10 numeric rating scale (NRS) were enrolled. All procedures were performed by injecting IPM/CS through a 24-gauge needle percutaneously inserted into the RA/UA. Two procedures were planned; the second procedure was scheduled 1-2 months after the first. NRS, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, Patient Global Impression of Change (PGIC) scale, and procedure-related adverse events were evaluated.
Technical success, defined as injection of IPM/CS into the RA/UA, was achieved in all patients. Clinical success, defined as a reduction of 2 points or more in the NRS at 12 months, was 77% (95% confidence interval 68-85%). The NRS improved from the baseline to 3, 6, and 12 months (7.8 ± 1.6 vs. 3.8 ± 2.6, 3.9 ± 2.7, and 4.0 ± 2.8, respectively, all p < 0.001). The QuickDASH score improved from the baseline to 12 months (27 ± 15 vs. 19 ± 17, p < 0.001) respectively. No major adverse events were observed.
Intra-arterial injection of IPM/CS is a feasible treatment option for DIP/PIP-OA.
评估经桡动脉或尺动脉（RA/UA）置针至指间关节或近指间关节骨关节炎（DIP/PIP-OA）处行亚胺培南/西司他丁钠（IPM/CS）动脉内注射的疗效和安全性。
这是一项回顾性单臂队列研究。92 名（92%为女性，平均年龄 55[8.3]岁）符合美国风湿病学会手部骨关节炎标准的原发性 DIP/PIP-OA 患者，疼痛程度≥数字评定量表（NRS）的 4 分，纳入研究。所有患者均通过经皮穿刺 RA/UA 内的 24 号针注入 IPM/CS。计划进行 2 次治疗，第 2 次治疗在第 1 次治疗后 1-2 个月进行。评估 NRS、手臂、肩部和手残疾快速评估（QuickDASH）评分、患者整体变化印象（PGIC）量表和与治疗相关的不良事件。
所有患者均成功实现了 IPM/CS 注入 RA/UA（定义为技术成功）。12 个月时 NRS 降低 2 分或更多定义为临床成功（77%，95%置信区间 68-85%）。NRS 从基线分别改善至 3、6 和 12 个月（7.8±1.6 比 3.8±2.6、3.9±2.7 和 4.0±2.8，均 p<0.001）。QuickDASH 评分从基线改善至 12 个月（27±15 比 19±17，p<0.001）。未观察到重大不良事件。
IPM/CS 动脉内注射是 DIP/PIP-OA 的一种可行治疗选择。
