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骨关节炎双盲偏好与依从性多中心研究:每日一次治疗

Double-blind preference and compliance multicentre study in osteoarthritis: once-a-day treatment.

作者信息

Marcolongo R, Giordano N, Bassi G P, Giannini R, Borghi C, Francucci B M, Camarri E, Mordini M, Cocco F, Neri D

出版信息

Clin Rheumatol. 1985 Sep;4(3):267-77. doi: 10.1007/BF02031606.

Abstract

Two-hundred-and-three female patients (mean age: 58 yrs; SD: 8.2 yrs) suffering from osteoarthritis entered this late phase IV multicentre, stratified according to previous therapy (e.g. ketoprofen, naproxen, aspirin, indomethacin or indoprofen), randomized, double-blind, between within-patient trial of 2-week duration. Each patient received either diclofenac SR 100 mg/day (D), piroxicam 20 mg/day (P), or placebo (P1 by oral route. Clinical evaluation (functional class; pain assessment; osteoarthritic condition; joint motility and stiffness) was performed at entry, as well as after the first and the second week. Patient compliance and reported signs and symptoms were recorded after the first week and at the end of the trial. Patient preference, as regards previous therapy, and global evaluation (both by the physicians and the patients) were checked at the end of the trial. The clinical evaluation showed a superiority of D and P over P1. No difference was seen between the two active drugs. Placebo effect was very strong. Global evaluation was significantly in favour of D and P. Patient compliance was extremely good (greater than or equal to 95%). Diclofenac was preferred to naproxen, aspirin and indomethacin, while piroxicam and placebo were preferred only to aspirin. The tolerability of the two active drugs was good and comparable. A significantly lower number of patients complaining of unwanted effects (u.e.) was detected in the placebo group. The number of patients withdrawn for u.e. was similar in the three trial groups.

摘要

203名患有骨关节炎的女性患者(平均年龄:58岁;标准差:8.2岁)进入了这项晚期IV期多中心研究,根据先前的治疗方法(如酮洛芬、萘普生、阿司匹林、吲哚美辛或茚洛芬)进行分层,随机、双盲,进行为期2周的患者内试验。每位患者每天口服双氯芬酸缓释片100毫克(D组)、吡罗昔康20毫克(P组)或安慰剂(P1组)。在入组时以及第一周和第二周后进行临床评估(功能分级;疼痛评估;骨关节炎状况;关节活动度和僵硬程度)。在第一周后和试验结束时记录患者的依从性以及报告的体征和症状。在试验结束时检查患者对先前治疗的偏好以及总体评估(医生和患者的评估)。临床评估显示D组和P组优于P1组。两种活性药物之间未观察到差异。安慰剂效应非常强。总体评估明显有利于D组和P组。患者依从性非常好(大于或等于95%)。双氯芬酸比萘普生、阿司匹林和吲哚美辛更受青睐,而吡罗昔康和安慰剂仅比阿司匹林更受青睐。两种活性药物的耐受性良好且相当。安慰剂组中抱怨有不良反应的患者数量明显较少。因不良反应而退出的患者数量在三个试验组中相似。

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