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抗白细胞介素-1疗法治疗膝骨关节炎的疗效:2000年至2023年随机对照试验的系统评价和荟萃分析

Efficacy of Anti-Interleukin-1 Therapeutics in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials from the Years 2000 to 2023.

作者信息

Knapik Michalina, Żelazo Daniel Aleksander, Osowiecka Karolina, Krajewska-Włodarczyk Magdalena

机构信息

Department of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Wojska Polskiego 30, 10-719 Olsztyn, Poland.

Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland.

出版信息

J Clin Med. 2024 May 13;13(10):2859. doi: 10.3390/jcm13102859.

Abstract

: This study aimed to evaluate the efficacy of anti-interleukin-1 therapeutics for treating knee osteoarthritis (KOA). Our research included interleukin-1 (IL-1) inhibitors, IL-1 antibodies and IL-1 receptor antagonists (IL-1 Ras). : We systematically searched PubMed and Mendeley to find randomized control trials (RCTs) or clinical trials (CTs) of anti-interleukin-1 therapeutics in KOA from 2000 to 2023. The outcomes were changes in pain, function and stiffness scores. The research was conducted between November 2023 and January 2024. The risk of bias was assessed using Cochrane Risk of Bias tool RoB 2. : Analysis of the nine included studies showed a statistically significant difference in terms of the pain relief group (SMD = -0.20, 95% CI: -0.39 to -0.01, = 0.0348), physical function improvement (SMD = -0.20, 95% CI: -0.39 to 0.00, = 0.0479) and stiffness reduction (SMD = -0.22, 95% CI: -0.43 to 0.00, = 0.0475) between anti-IL-1 therapeutics and placebo or nonsteroidal anti-inflammatory drugs (NSAIDs). However, when we separately analysed placebo and NSAIDs subgroups, the statistical significance was observed only in the placebo group. Our article was limited by the quality of the included RCTs. Two of the included trials were of poor methodological quality, and five showed selective reporting. : The results of our study suggest that anti-IL-1 therapeutics might have better efficacy in KOA treatment than placebo or NSAIDs; yet, taking into account the limited availability of studies and data concerning anti-IL-1 in osteoarthritis treatment, we think that more high-quality RCTs on this subject are needed.

摘要

本研究旨在评估抗白细胞介素-1疗法治疗膝关节骨关节炎(KOA)的疗效。我们的研究包括白细胞介素-1(IL-1)抑制剂、IL-1抗体和IL-1受体拮抗剂(IL-1 Ras)。我们系统检索了PubMed和Mendeley,以查找2000年至2023年期间抗白细胞介素-1疗法治疗KOA的随机对照试验(RCT)或临床试验(CT)。结局指标为疼痛、功能和僵硬评分的变化。研究于2023年11月至2024年1月进行。使用Cochrane偏倚风险工具RoB 2评估偏倚风险。对纳入的9项研究的分析表明,在疼痛缓解组(标准化均数差[SMD]=-0.20,95%可信区间[CI]:-0.39至-0.01,P=0.0348)、身体功能改善(SMD=-0.20,95%CI:-0.39至0.00,P=0.0479)和僵硬减轻(SMD=-0.22,95%CI:-0.43至0.00,P=0.0475)方面,抗IL-1疗法与安慰剂或非甾体抗炎药(NSAIDs)之间存在统计学显著差异。然而,当我们分别分析安慰剂和NSAIDs亚组时,仅在安慰剂组中观察到统计学显著性。我们的文章受到纳入RCT质量的限制。纳入的试验中有两项方法学质量较差,五项存在选择性报告。我们研究的结果表明,抗IL-1疗法在KOA治疗中可能比安慰剂或NSAIDs具有更好的疗效;然而,考虑到关于抗IL-1在骨关节炎治疗方面的研究和数据有限,我们认为需要更多关于该主题的高质量RCT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3b6/11121880/a079d59560cb/jcm-13-02859-g001.jpg

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