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骨通贴膏对比 NSAIDs 治疗膝骨关节炎的疗效和安全性:中国真实世界、多中心、前瞻性队列研究。

Efficacy and safety of Gutong Patch compared with NSAIDs for knee osteoarthritis: A real-world multicenter, prospective cohort study in China.

机构信息

Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.

Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.

出版信息

Pharmacol Res. 2023 Nov;197:106954. doi: 10.1016/j.phrs.2023.106954. Epub 2023 Oct 12.

Abstract

The Gutong Patch (GTP) is common in clinical practice for bone diseases. This study compared the efficacy and safety of GTP and nonsteroidal anti-inflammatory drugs (NSAIDs) for KOA patients from 35 medical centers assigned to GTP, selective COX-2 inhibitor (SCI), GTP + SCI, non-selective COX-2 inhibitor (NSCI), and GTP + NSCI groups. The visual analog scale (VAS) pain score, EuroQol-VAS, EuroQol 5D-3 L, time to articular pain relief / disappearance, and joint motion recovery were the efficacy assessments. Safety assessments included contact dermatitis, gastrointestinal disorders, etc. The p-value < 0.05 was considered statistically significant. After statistical analysis, the SCI and GTP + SCI groups showed better improvement of VAS than the GTP group; the time to articular pain relief in the NSCI group was shorter than that in GTP and SCI group; the time to joint motion recovery in the GTP + NSCI group was longer than that in the SCI group. Additionally, the improvement of the quality of life in all groups was significant after treatments. While the incidence of gastrointestinal adverse events in the NSAIDs group was higher than that in the GTP and GTP + NSAIDs groups. GTP and NSAIDs are effective for KOA patients, and GTP is more suitable for KOA patients with cardiovascular and gastrointestinal comorbidities. This study was approved by the Ethics Committee at Peking Union Medical College Hospital (HS-1766) and registered in the Chinese Clinical Trial Registry (ChiCTR2100046391).

摘要

骨通贴膏(GTP)在临床治疗骨病中较为常见。本研究纳入 35 家医疗中心的膝骨关节炎(KOA)患者,比较 GTP 与非甾体抗炎药(NSAIDs)、选择性环氧化酶-2 抑制剂(SCI)、GTP+SCI、非选择性环氧化酶-2 抑制剂(NSCI)、GTP+NSCI 的疗效和安全性。采用视觉模拟评分(VAS)疼痛评分、欧洲五维健康量表(EQ-5D)VAS 评分、EQ-5D-3L 量表、关节疼痛缓解/消失时间、关节运动恢复时间进行疗效评估,采用接触性皮炎、胃肠道疾病等评估安全性。P 值<0.05 为差异有统计学意义。经统计学分析,SCI 组和 GTP+SCI 组 VAS 评分改善优于 GTP 组;NSCI 组关节疼痛缓解时间短于 GTP 组和 SCI 组;GTP+NSCI 组关节运动恢复时间长于 SCI 组。此外,各组治疗后生活质量均显著改善。但 NSAIDs 组胃肠道不良事件发生率高于 GTP 组和 GTP+NSAIDs 组。GTP 和 NSAIDs 均对 KOA 患者有效,GTP 更适合合并心血管和胃肠道疾病的 KOA 患者。本研究经北京协和医学院医院伦理委员会批准(HS-1766),并在中国临床试验注册中心(ChiCTR2100046391)注册。

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