Trêves R, Maheu E, Dreiser R L
Department of Rheumatology, Dupuytren Regional Teaching Hospital, Limoges, France.
Rev Rhum Engl Ed. 1995 Jun;62(6 Suppl 1):33S-41S.
Although common, hand osteoarthritis is controversial and rarely used as a model for clinical trials in osteoarthritis. We found only 13 therapeutic trials conducted in digital or trapeziometacarpal osteoarthritis between 1983 and 1994. Eleven of these trials were published. Seven were on nonsteroidal antiinflammatory drugs given either per os (two trials, meclofenamate and ibuprofen) or percutaneously (one trial each on etofenamate, ibuprofen, and ketoprofen gel, and two trials on niflumic acid gel), three were on symptomatic slow-acting drugs (glycosaminoglycanes in two trials and chondroitin sulfate in one), and three were on miscellaneous agents (the muscle relaxant idrocilamide, as a gel; the antisubstance P agent capsaicin, also as a gel; and a spa treatment). We have reviewed the methodology and findings of these trials with the goal of determining the optimal approach to realize better standardized trials in the next future for identifying symptomatic slow-acting drugs and/or "chondroprotective" agents with beneficial effects in digital osteoarthritis.
虽然手部骨关节炎很常见，但存在争议，很少被用作骨关节炎临床试验的模型。我们发现，1983年至1994年间，仅有13项针对手指或第一掌腕关节骨关节炎的治疗试验。其中11项试验已发表。7项试验针对非甾体抗炎药，给药方式为口服（两项试验，分别使用甲氯芬那酸和布洛芬）或经皮给药（一项试验使用依托芬那酯，一项试验使用布洛芬，两项试验使用酮洛芬凝胶，两项试验使用尼氟酸凝胶）；3项试验针对症状性慢作用药物（两项试验使用糖胺聚糖，一项试验使用硫酸软骨素）；3项试验针对其他药物（肌肉松弛剂伊多西酰胺，制成凝胶；P物质拮抗剂辣椒素，也制成凝胶；以及一种温泉疗法）。我们回顾了这些试验的方法和结果，目的是确定在未来更好地实现标准化试验的最佳方法，以便识别对手指骨关节炎有有益作用的症状性慢作用药物和/或“软骨保护剂”。
