Espinosa-Salas Santiago, Bagherzadeh Leila, Wafford Q Eileen, Witte Graeme, Schnitzer Thomas J
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, United States.
Galter Health Sciences Library and Learning Center, Northwestern University, United States.
Osteoarthr Cartil Open. 2024 Feb 10;6(1):100438. doi: 10.1016/j.ocarto.2024.100438. eCollection 2024 Mar.
To determine whether sex influences the analgesic efficacy of systemic pharmacological treatment in patients with knee osteoarthritis.
A systematic review, guided by Cochrane methods, sourced studies from Medline, Cochrane Library, Embase, and CINAHL Plus with Full Text as of October 10, 2022. Eligible studies were double-blind RCTs evaluating systemic pharmacological treatments for knee osteoarthritis in adults, with minimum 30-day treatment duration, reporting sex-specific results or mentioning sex subgroup analysis for analgesic efficacy. The risk of bias was assessed using the Cochrane Risk of Bias tool version 2 (RoB 2).
9 studies (5201 participants) met inclusion criteria, analyzing drugs including duloxetine, etoricoxib, tapentadol, naproxcinod, lutikizumab, and rofecoxib. Only one study reported sex-specific results. Review findings suggested no significant sex-based differences in treatment efficacy, however, data were limited due to a lack of sex-specific reporting or inclusion of sex in subgroup analyses.
Current evidence does not support the existence of sex differences in the analgesic efficacy of systemic knee osteoarthritis treatments. However, this conclusion is substantially limited by the paucity of sex-specific reporting of results or subgroup analyses in most primary studies, emphasizing the need for future research to report on sex-stratified data to allow for comprehensive, personalized treatment strategies.
确定性别是否会影响膝骨关节炎患者全身药物治疗的镇痛效果。
一项系统评价，采用Cochrane方法进行指导，检索截至2022年10月10日来自Medline、Cochrane图书馆、Embase和CINAHL Plus全文数据库的研究。符合条件的研究为双盲随机对照试验，评估成人膝骨关节炎的全身药物治疗，治疗持续时间至少30天，报告性别特异性结果或提及镇痛效果的性别亚组分析。使用Cochrane偏倚风险工具第2版（RoB 2）评估偏倚风险。
9项研究（5201名参与者）符合纳入标准，分析的药物包括度洛西汀、依托考昔、曲马多、萘普生辛酯、鲁替单抗和罗非昔布。只有一项研究报告了性别特异性结果。综述结果表明，治疗效果在性别上无显著差异，然而，由于缺乏性别特异性报告或亚组分析中未纳入性别因素，数据有限。
目前的证据不支持膝骨关节炎全身治疗的镇痛效果存在性别差异。然而，这一结论在很大程度上受到大多数原始研究中性别特异性结果报告或亚组分析匮乏的限制，强调未来研究需要报告性别分层数据，以制定全面、个性化的治疗策略。
