Dietary intervention for osteoarthritis: Clinical trials after the ' B one and J oint D ecade'
Dietary intervention for osteoarthritis: Clinical trials after the ' B one and J oint D ecade'
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骨关节炎的饮食干预：“B 1 和联合十年”后的临床试验
DOI：
10.1111/nbu.12154
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发表时间：
2015
影响因子：
3.3
通讯作者：
Davidson R
中科院分区：
文献类型：
--
作者：
Davidson R
骨关节炎 (OA) 是一种重大的社会和经济负担，在全球范围内持续增长，但目前尚无有效的疾病缓解疗法。目前解决疼痛的治疗策略在很大程度上是不够的，并且针对终末期疾病的关节置换是不可持续的。由于平衡慢性病疗效和毒性的复杂性，药物开发特别困难且昂贵。发生 OA 的主要危险因素是年龄增长和肥胖。饮食与后者有明显的联系，但也对衰老过程产生强烈影响。研究膳食生物活性物质及其对 OA 疾病模型影响的临床前数据并不缺乏。然而，使用相关试验设计和经过验证的结果指标来测试这些数据的临床试验很少。目前的试验重点是维生素 D、鱼油欧米茄脂肪酸和姜黄素。本综述审查了最近完成的、当前的或拟议的膳食生物活性物质的临床试验及其在开发 OA 治疗策略（预防性或作为 OA 管理手段）方面的效用。正在进行的科学高质量试验数量很少。饮食干预临床试验的投资需求尚未得到满足，以开发疾病生物标志物（生化和影像学）并完善 OA 的定义，以便改善临床相关的结果测量。
Osteoarthritis (OA) is a major social and economic burden that continues to grow globally with no effective disease modifying therapies in the pipeline. Current therapeutic strategies to address pain are largely insufficient and joint replacement for end stage disease is unsustainable. Drug development is particularly difficult and expensive due to the complexity of balancing efficacy and toxicity for chronic diseases. The main risk factors for developing OA are increasing age and obesity. Diet has a clear link to the latter, but also impacts strongly on the ageing process. There is no paucity of pre‐clinical data investigating dietary bioactives and their impact on OA disease models. However clinical trials that test these data using relevant trial design and validated outcome measures are scarce. Current trials focus on vitamin D, fish oil omega fatty acids and curcumin. This review examines recently completed, current or proposed clinical trials of dietary bioactives and their utility in developing an OA therapeutic strategy either prophylactically or as a means of OA management. The number of scientifically high quality trials in the pipeline is low. There is an unmet need for investment in clinical trials of dietary intervention, for developing disease biomarkers (both biochemical and imaging) and refining the definition of OA so that clinically relevant outcome measures can be improved.