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奥泰灵治疗膝骨关节炎的临床疗效:一项在中国进行的前瞻性、多中心、非随机对照研究。

Clinical efficacy of Osteoking in knee osteoarthritis therapy: a prospective, multicenter, non-randomized controlled study in China.

作者信息

Zhou Jun, Zheng Zelu, Luo Yuxin, Dong Yawei, Yan Yan, Zhang Yi, Tang Kaiqiang, Quan Rui, Lin Jiaming, Zhang Kuayue, Dong Pengxuan, Wang Rongtian, He Haijun, Lin Na, Weng Xisheng, Mi Baohong, Zhang Yanqiong, Chen Weiheng

机构信息

Department of Mini-Invasive Joint surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.

Engineering Research Center of Chinese Orthopaedic and Sports Rehabilitation Artificial Intelligent, Ministry of Education, Beijing, China.

出版信息

Front Pharmacol. 2024 Jun 28;15:1381936. doi: 10.3389/fphar.2024.1381936. eCollection 2024.

Abstract

BACKGROUND

Osteoking has been extensively used for the treatment of knee osteoarthritis (KOA). However, it is lack of high-quality evidence on the clinical efficacy of Osteoking against KOA and the comparison with that of nonsteroidal anti-inflammatory drugs (NSAIDs).

AIMS

To evaluate the efficacy and safety of Osteoking in treating KOA.

METHODS

In the current study, a total of 501 subjects were recruited from 20 medical centers, and were divided into the Osteoking treatment group ( = 428) and the NSAIDs treatment group ( = 73). The Propensity Score Matching method was used to balance baseline data of different groups. Then, the therapeutic effects of Osteoking and NSAIDs against KOA were evaluated using VAS score, WOMAC score, EQ-5D-3L and EQ-VAS, while the safety of the two treatment were both assessed based on dry mouth, dizziness, diarrhea, etc.

RESULTS

After 8 weeks of treatment, the Osteoking group was compared with the NSAIDs group, the VAS score [2.00 (1.00, 3.00) vs. 3.00 (2.00, 4.00)], WOMAC pain score [10.00 (8.00, 13.00) vs. 11.00 (8.00, 16.00) ], WOMAC physical function score [32.00 (23.00, 39.00) vs. 39.07 ± 16.45], WOMAC total score [44.00 (31.00, 55.00) vs. 53.31 ± 22.47) ], EQ-5D-3L score [0.91 (0.73, 0.91) vs. 0.73 (0.63, 0.83) ] and EQ-VAS score [80.00 (79.00, 90.00) vs. 80.00 (70.00, 84.00) ] were improved by the treatment of Osteoking for 8 weeks more effectively than that by the treatment of NSAIDs. After 8 weeks of treatment with Osteoking, the VAS scores of KOA patients with the treatment of Osteoking for 8 weeks were reduced from 6.00 (5.00, 7.00) to 2.00 (1.00, 3.00) ( < 0.05), which was better than those with the treatment of NSAIDs starting from 2 weeks during this clinical observation. Importantly, further subgroup analysis revealed that the treatment of Osteoking was more suitable for alleviating various clinical symptoms of KOA patients over 65 years old, with female, KL II-III grade and VAS 4-7 scores, while the clinical efficacy of NSAIDs was better in KOA patients under 65 years old and with VAS 8-10 scores. Of note, there were no differences in adverse events and adverse reactions between the treatment groups of the two drugs.

CONCLUSION

Osteoking may exert a satisfying efficacy in relieving joint pain and improving life quality of KOA patients without any adverse reactions, especially for patients with KL II-III grades and VAS 4-7 scores.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/showproj.html?proj=55387, Identifier ChiCTR2000034475.

摘要

背景

骨痛克已被广泛用于治疗膝关节骨关节炎(KOA)。然而,关于骨痛克治疗KOA的临床疗效以及与非甾体抗炎药(NSAIDs)比较的高质量证据尚缺乏。

目的

评价骨痛克治疗KOA的疗效和安全性。

方法

在本研究中,共从20个医疗中心招募了501名受试者,分为骨痛克治疗组(n = 428)和NSAIDs治疗组(n = 73)。采用倾向得分匹配法平衡不同组的基线数据。然后,使用视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、欧洲五维健康量表(EQ-5D-3L)和EQ视觉模拟量表(EQ-VAS)评估骨痛克和NSAIDs治疗KOA的疗效,同时基于口干、头晕、腹泻等评估两种治疗的安全性。

结果

治疗8周后,将骨痛克组与NSAIDs组比较,骨痛克治疗8周在改善VAS评分[2.00(1.00,3.00)比3.00(2.00,4.00)]、WOMAC疼痛评分[10.00(8.00,13.00)比11.00(8,00,16.00)]、WOMAC身体功能评分[32.00(23.00,39.00)比39.07±16.45]、WOMAC总分[44.00(31.00,55.00)比53.31±22.47]、EQ-5D-3L评分[0.91(0.73,0.91)比0.73(0.63,0.83)]和EQ-VAS评分[80.00(79.00,90.00)比80.00(70.00,84.00)]方面比NSAIDs治疗更有效。骨痛克治疗8周后,KOA患者的VAS评分从6.00(5.00,7.00)降至2.00(1.00,3.00)(P<0.05),在此临床观察期间优于从第2周开始使用NSAIDs治疗的患者。重要的是,进一步的亚组分析显示,骨痛克治疗更适合缓解65岁以上、女性、KL II-III级且VAS评分4-7分的KOA患者的各种临床症状,而NSAIDs在65岁以下且VAS评分8-10分的KOA患者中临床疗效更好。值得注意的是,两种药物治疗组之间的不良事件和不良反应无差异。

结论

骨痛克在缓解KOA患者关节疼痛和提高生活质量方面可能发挥令人满意的疗效,且无任何不良反应,尤其对于KL II-III级且VAS评分4-7分的患者。

临床试验注册

https://www.chictr.org.cn/showproj.html?proj=55387,标识符ChiCTR2000034475。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b7d/11239513/dffda15bc88f/fphar-15-1381936-g001.jpg

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