Corticosteroid Injections for Symptomatic Treatment of Osteoarthritis of the Knee: A Pilot Blinded Randomized Trial.
Corticosteroid Injections for Symptomatic Treatment of Osteoarthritis of the Knee: A Pilot Blinded Randomized Trial.
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DOI：
10.1002/acr2.11596
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发表时间：
2023-10
影响因子：
3.4
通讯作者：
Scanzello, Carla R
中科院分区：
文献类型：
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作者：
Baker, Joshua F;Olave, Marianna;Leach, William;Doherty, Caleigh R;Gillcrist, Rachel L;White, Daniel K;Ogdie, Alexis;England, Bryant R;Wysham, Katherine;Quinones, Mercedes;Xiao, Rui;Neogi, Tuhina;Scanzello, Carla R
在膝关节骨关节炎（KOA）患者中，量化皮质类固醇与仅利多卡因注射相比12周的效果。KOA参与者被随机分配接受膝关节注射1 mL（40 mg）醋酸甲泼尼龙加2 mL利多卡因（1%）或1 mL生理盐水和2 mL利多卡因。使用不透明注射器对参与者和提供者进行治疗分配设盲。结局是12周内每隔2周评估的膝关节损伤和骨关节炎结局总评分（KOOS）（范围0 - 100）较基线的平均变化。参与者通过基于网络的平台在智能手机上收到KOOS问卷。我们使用具有稳健方差估计量的线性混合效应回归来评价干预与KOOS总量表和子量表变化之间的相关性（ClinicalTrials.gov标识符NCT 03835910;注册日期2019 - 02 - 11）。在33名随机化参与者中，31名被纳入最终分析。12周随访期间，皮质类固醇组总KOOS的预测平均（SE）变化为9.4（3.2），对照组为-1.3（1.4）（P = 0.003）。在参与者中，47%的参与者在干预组中实现了最小临床重要差异（16个单位）的变化，而利多卡因组的参与者为6%。此外，在KOOS子量表和患者报告结局测量信息系统（PROMIS）评估疼痛强度，行为和干扰方面，干预组有更大的改善。在12周的随访中，皮质类固醇注射显示KOA症状有临床意义的改善。这些数据支持更大规模的研究，以更好地量化短期效益。
To quantify the effect of corticosteroids compared to lidocaine‐only injections over 12 weeks among patients with knee osteoarthritis (KOA). Participants with KOA were randomized to receive a knee injection of methylprednisolone acetate 1 mL (40 mg) plus 2 mL lidocaine (1%) or 1 mL saline and 2 mL lidocaine. Participants and providers were blinded to treatment allocation using an opacified syringe. The outcome was the average change from baseline of the total Knee Injury and Osteoarthritis Outcome Score (KOOS) (range 0‐100) assessed at 2‐week intervals over 12 weeks. Participants received KOOS questionnaires on their smartphones through a web‐based platform. We used linear mixed‐effects regressions with robust variance estimators to evaluate the association between the intervention and change in KOOS total and subscales (ClinicalTrials.gov identifier NCT03835910; registered 2019‐02‐11). Of the 33 randomized participants, 31 were included in the final analysis. The predicted mean (SE) change in total KOOS over the 12‐week follow‐up was 9.4 (3.2) in the corticosteroids arm versus −1.3 (1.4) in the control arm (P = 0.003). Of participants, 47% achieved change as large as the minimal clinically important difference (16 units) in the intervention arm compared to 6% of participants in the lidocaine arm. Further, there were greater improvements in the intervention arm for KOOS subscales and for Patient Reported Outcomes Measurement Information System (PROMIS) assessments of pain intensity, behavior, and interference. Corticosteroid injections demonstrated clinically meaningful improvements in KOA symptoms over 12 weeks of follow‐up. These data support larger studies to better quantify short‐term benefits.
DOI：
10.4103/0970-9185.101940
发表时间：
2012-10
期刊：
Journal of anaesthesiology, clinical pharmacology
影响因子：
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作者：
Beyaz SG
通讯作者：
Beyaz SG