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聚丙烯酰胺水凝胶注射治疗膝骨关节炎的有效性和安全性:一项开放标签研究 12 个月随访结果。

Effectiveness and safety of polyacrylamide hydrogel injection for knee osteoarthritis: results from a 12-month follow up of an open-label study.

机构信息

The Parker Institute, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Ndr. Fasanvej 57, 2000, Copenhagen, Frederiksberg, Denmark.

Rheumatolog i Odense, Odense, Denmark.

出版信息

J Orthop Surg Res. 2024 May 2;19(1):274. doi: 10.1186/s13018-024-04756-2.

Abstract

OBJECTIVE

There are few effective osteoarthritis (OA) therapies. A novel injectable polyacrylamide hydrogel (iPAAG) previously demonstrated efficacy and safety up to week 26 in an open-label study of knee OA. Here we report longer-term effectiveness and safety data.

METHODS

This multi-centre, open-label study included patients with symptomatic and radiographic knee OA. Primary outcome was WOMAC pain (0-100 scale) at 13 weeks, and patients continued to 26 weeks before entering a further 26-week extension phase. Secondary efficacy outcomes included WOMAC stiffness and function subscales, Patient Global Assessment (PGA) and proportion of OMERACT-OARSI responders. Safety outcomes were adverse events (AEs).

RESULTS

49 participants (31 women, mean age 70) received an ultrasound-guided, intra-articular injection of 6 ml iPAAG; 46 completed the extension phase to 52 weeks. There was a significant reduction in the WOMAC pain score from baseline to 52 weeks (- 17.7 points (95% CI - 23.1; - 12.4); p < 0.0001). Similar sustained improvements were observed for WOMAC stiffness (11.0 points; 95% CI - 17.0; - 4.9), physical function (18.0 points; 95% CI - 19.1; - 10.6), and PGA (16.3 points; 95% CI - 23.1; - 9.4). At 52 weeks 62.2% of patients were OMERACT-OARSI responders. From 26 to 52 weeks, 8 adverse effects (AE), including 1 serious AE (cerebrovascular accident) were reported in 5 subjects. None of the new adverse events were thought to be device related.

CONCLUSION

This open-label study suggests persistent benefits and safety of iPAAG through 52 weeks after a single injection.

TRIAL REGISTRATION

Clinicaltrials.gov NCT04179552.

摘要

目的

目前治疗骨关节炎(OA)的有效方法较少。一种新型可注射聚丙烯酰胺水凝胶(iPAAG)在一项开放性膝关节 OA 研究中,在第 26 周前表现出疗效和安全性。在此,我们报告其长期有效性和安全性数据。

方法

这项多中心、开放性研究纳入了有症状和放射学膝关节 OA 的患者。主要终点是 13 周时 WOMAC 疼痛(0-100 量表),患者在进入 26 周的扩展阶段前继续接受治疗 26 周。次要疗效终点包括 WOMAC 僵硬和功能子量表、患者整体评估(PGA)和 OMERACT-OARSI 应答者的比例。安全性终点为不良事件(AEs)。

结果

49 名参与者(31 名女性,平均年龄 70 岁)接受了超声引导下的关节内注射 6ml iPAAG;46 名参与者完成了扩展阶段至 52 周。与基线相比,WOMAC 疼痛评分在 52 周时显著降低(-17.7 分(95%CI-23.1;-12.4);p<0.0001)。WOMAC 僵硬(11.0 分;95%CI-17.0;-4.9)、躯体功能(18.0 分;95%CI-19.1;-10.6)和 PGA(16.3 分;95%CI-23.1;-9.4)也有类似的持续改善。在 52 周时,62.2%的患者为 OMERACT-OARSI 应答者。从第 26 周到第 52 周,5 名患者报告了 8 起不良事件(AE),包括 1 起严重不良事件(脑血管意外)。没有一个新的不良事件被认为与设备有关。

结论

这项开放性研究表明,单次注射后 52 周内,iPAAG 持续有效且安全。

试验注册

Clinicaltrials.gov NCT04179552。

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