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口服白藜芦醇治疗膝骨关节炎成人患者的随机安慰剂对照试验(ARTHROL)

Oral resveratrol in adults with knee osteoarthritis: A randomized placebo-controlled trial (ARTHROL).

机构信息

Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France.

AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, Paris, France.

出版信息

PLoS Med. 2024 Aug 13;21(8):e1004440. doi: 10.1371/journal.pmed.1004440. eCollection 2024 Aug.

Abstract

BACKGROUND

Resveratrol is a natural compound found in red wine. It has demonstrated anti-inflammatory properties in preclinical models. We compared the effect of oral resveratrol in a new patented formulation to oral placebo for individuals with painful knee osteoarthritis.

METHODS AND FINDINGS

ARTHROL was a double-blind, randomized, placebo-controlled, Phase 3 trial conducted in 3 tertiary care centers in France. We recruited adults who fulfilled the 1986 American College of Rheumatology criteria for knee osteoarthritis and reported a pain intensity score of at least 40 on an 11-point numeric rating scale (NRS) in 10-point increments (0, no pain, to 100, maximal pain). Participants were randomly assigned (1:1) by using a computer-generated randomization list with permuted blocks of variable size (2, 4, or 6) to receive oral resveratrol (40 mg [2 caplets] twice a day for 1 week, then 20 mg [1 caplet] twice a day; resveratrol group) or matched oral placebo (placebo group) for 6 months. The primary outcome was the mean change from baseline in knee pain on a self-administered 11-point pain NRS at 3 months. The trial was registered at ClinicalTrials.gov: (NCT02905799). Between October 20, 2017 and November 8, 2021, we assessed 649 individuals for eligibility, and from November 9, 2017, we recruited 142 (22%) participants (mean age 61.4 years [standard deviation (SD) 9.6] and 101 [71%] women); 71 (50%) were randomly assigned to the resveratrol group and 71 (50%) to the placebo group. At baseline, the mean knee pain score was 56.2/100 (SD 13.5). At 3 months, the mean reduction in knee pain was -15.7 (95% confidence interval (CI), -21.1 to -10.3) in the resveratrol group and -15.2 (95% CI, -20.5 to -9.8) in the placebo group (absolute difference -0.6 [95% CI, -8.0 to 6.9]; p = 0.88). Serious adverse events (not related to the interventions) occurred in 3 (4%) in the resveratrol group and 2 (3%) in the placebo group. Our study has limitations in that it was underpowered and the effect size, estimated to be 0.55, was optimistically estimated.

CONCLUSIONS

In this study, we observed that compared with placebo, oral resveratrol did not reduce knee pain in people with painful knee osteoarthritis.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT02905799.

摘要

背景

白藜芦醇是一种存在于红酒中的天然化合物。它在临床前模型中表现出抗炎特性。我们比较了新专利配方的口服白藜芦醇和口服安慰剂对有疼痛性膝骨关节炎的个体的影响。

方法和发现

ARTHROL 是一项在法国 3 家三级护理中心进行的双盲、随机、安慰剂对照、3 期试验。我们招募了符合 1986 年美国风湿病学会膝骨关节炎标准并报告疼痛强度评分至少为 40/11 点数字评定量表(NRS)(0,无痛,至 100,最大疼痛)的成年人。参与者通过使用具有可变大小(2、4 或 6)的置换块的计算机生成的随机分组列表(1:1)随机分配,以接受口服白藜芦醇(每天两次 40 毫克[2 片]持续 1 周,然后每天两次 20 毫克[1 片];白藜芦醇组)或匹配的口服安慰剂(安慰剂组)治疗 6 个月。主要结局是 3 个月时自我管理的 11 点疼痛 NRS 从基线的平均变化。该试验在 ClinicalTrials.gov 上注册:(NCT02905799)。2017 年 10 月 20 日至 2021 年 11 月 8 日,我们评估了 649 名符合条件的个体,自 2017 年 11 月 9 日起,我们招募了 142 名(22%)参与者(平均年龄 61.4 岁[标准差(SD)9.6]和 101 名[71%]女性);71 名(50%)被随机分配到白藜芦醇组,71 名(50%)被分配到安慰剂组。基线时,膝关节疼痛评分平均为 56.2/100(SD 13.5)。3 个月时,白藜芦醇组膝关节疼痛平均减轻-15.7(95%置信区间(CI),-21.1 至-10.3),安慰剂组为-15.2(95% CI,-20.5 至-9.8)(绝对差值-0.6[95% CI,-8.0 至 6.9];p = 0.88)。白藜芦醇组有 3 例(4%)发生严重不良事件(与干预无关),安慰剂组有 2 例(3%)。我们的研究存在局限性,因为它的效力不足,估计的效应大小为 0.55,是乐观估计的。

结论

在这项研究中,我们观察到与安慰剂相比,口服白藜芦醇并没有减轻疼痛性膝骨关节炎患者的膝关节疼痛。

试验注册

ClinicalTrials.gov ID:NCT02905799。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/576e/11321588/552a5f847b75/pmed.1004440.g001.jpg

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