Clinical effect of intramuscular calcitonin compared with oral celecoxib in the treatment of knee bone marrow lesions: a retrospective study
Clinical effect of intramuscular calcitonin compared with oral celecoxib in the treatment of knee bone marrow lesions: a retrospective study
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肌注降钙素与口服塞来昔布治疗膝关节骨髓病变临床疗效的回顾性研究
DOI：
10.1186/s13018-020-01746-y
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发表时间：
2020-06-23
影响因子：
2.6
通讯作者：
Xue, Yuan
中科院分区：
文献类型：
--
作者：
Zhou, Jiaming;Xiong, Wuyi;Xue, Yuan
背景骨髓损害(BMLS)是骨性关节炎(OA)患者的常见发现，是与软骨损伤相关的疾病进展和疼痛的预测指标。本研究的目的是比较肌肉注射降钙素和口服塞来昔布治疗膝关节BMLS的近期临床疗效。方法回顾2016年1月至2018年12月期间肌肉注射降钙素或口服塞来昔布治疗膝关节BMLS的临床资料。采用视觉模拟评分(VAS)和西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)分别评估膝关节疼痛和功能。通过MRI扫描对BMLS进行评估，并用改良的全器官MRI评分(WORMS)进行评分。结果123例符合条件的患者接受降钙素治疗(n=66)和塞来昔布治疗(n=57)。所有患者均获得3个 月的临床和放射学随访。随访4周和3个月时，降钙素组VAS和WOMAC评分均低于塞来昔布组，差异有统计学意义。对于BMLS，降钙素组的蠕虫评分显著低于塞来昔布组。降钙素组MRI改善率在术后4周(21.21%vs.7.01%；P=0.039)和3个月随访期(37.88%vs.15.79%；P=0.006)明显高于塞来昔布组(37.88%vs.15.79%；P=0.006)。结论降钙素50 IU肌肉注射治疗膝关节骨髓性白血病近期疗效优于口服塞来昔布200 mg/d。
BackgroundBone marrow lesions (BMLs) are a common finding in patients with osteoarthritis (OA), which are predictors of progression and pain related to cartilage damage in OA. The objective of the present research was to compare the short-term clinical effect of intramuscular calcitonin and oral celecoxib in treating knee BMLs.Patients and methodsBetween January 2016 and December 2018, the medical records of patients with knee BMLs treated by intramuscular calcitonin or oral celecoxib were reviewed. Visual analog scale (VAS) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to assess knee pain and function, respectively. BMLs were assessed by MRI scans and were scored by the modified Whole-Organ MRI Score (WORMS). The safety of these two medications was also evaluated.ResultsA total of 123 eligible patients who received calcitonin treatment (n= 66) or celecoxib treatment (n= 57) were included. All patients were followed up clinically and radiographically for 3 months. The VAS and WOMAC scores were lower statistically in calcitonin group than celecoxib group at 4-week and 3-month follow-up. For BMLs, the WORMS scores in the calcitonin group were significantly lower than the celecoxib group. Besides, statistically higher MRI improvement rates were found in the calcitonin group compared with the celecoxib group at 4-week follow-up (21.21% vs. 7.01%;P= 0.039) and 3-month follow-up (37.88% vs. 15.79%;P= 0.006).ConclusionIntramuscular calcitonin 50 IU once daily demonstrated a better short-term effect for knee BML patients compared with oral celecoxib 200 mg twice per day.