Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon.
Study Goal
The researchers aimed to assess the efficacy of prescription-grade chondroitin sulfate (pCS) on pain and physical function in patients with knee osteoarthritis.
Results Summary
The study found that pCS significantly reduced pain (SMD -0.26) in knee OA patients, though its effect on physical function was not explicitly mentioned in the abstract.
Population
Patients suffering from knee osteoarthritis (15,609 individuals for pain outcomes, 13,655 for function outcomes).
Effective Dosage
Not specified in the abstract.
Duration
6 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
intra-articular combination of hyaluronic acid and triamcinolone | decrease | pain | patients suffering from knee OA | SMD -0.49, 95% CrI -0.78; -0.19 | significant decrease | #1 |
vitamin D | decrease | pain | patients suffering from knee OA | SMD -0.31, 95% CrI -0.56; -0.06 | significant decrease | #2 |
intra-articular hyaluronic acid | decrease | pain | patients suffering from knee OA | SMD -0.29, 95% CrI -0.40; -0.17 | significant decrease | #3 |
prescription-grade crystalline glucosamine sulfate | decrease | pain | patients suffering from knee OA | SMD -0.29, 95% CrI -0.58; -0.004 | significant decrease | #4 |
prescription-grade chondroitin sulfate | decrease | pain | patients suffering from knee OA | SMD -0.26, 95% CrI -0.44; -0.08 | significant decrease | #5 |
prescription-grade crystalline glucosamine sulfate | increase | physical function | patients suffering from knee OA | SMD -0.44, 95% CrI -0.66; -0.21 | significant improvements | #6 |
vitamin D | increase | physical function | patients suffering from knee OA | SMD -0.30, 95% CrIs -0.49; -0.11 | significant improvements | #7 |
intra-articular hyaluronic acid | increase | physical function | patients suffering from knee OA | SMD -0.21, 95% CrIs -0.31; -0.11 | significant improvements | #8 |
INTRODUCTION: Several pharmacological treatments aiming at a better symptomatic control of osteoarthritis (OA) are used in daily practice but their efficacy is often disputed. The purpose of this network meta-analysis (NMA) is to assess the efficacy on pain and function of the drugs that are most widely prescribed against knee OA. METHODS: Medline, Scopus, and Cochrane database of systematic reviews were searched for randomized controlled trials published up to August 2019 and assessing the efficacy of knee OA treatments using a 6-month time horizon. Pain and function changes from baseline were the primary outcomes. A Bayesian network meta-analysis was run and standardized mean differences (SMDs) with 95% credibility intervals (95% CrIs) were calculated. RESULTS: 9697 references were identified and 80 RCTs were concordant with our inclusion criteria (79 studies involving 15,609 individuals reported pain outcomes and 55 studies involving 13,655 individuals reported function outcomes). A significant decrease in pain was observed for the intra-articular (IA) combination of hyaluronic acid (HA) and triamcinolone (SMD - 0.49, 95% CrI - 0.78; - 0.19), vitamin D (SMD - 0.31, 95% CrI - 0.56; - 0.06), IA HA (SMD - 0.29, 95% CrI - 0.40; - 0.17), prescription-grade crystalline glucosamine sulfate (pCGS) (SMD - 0.29, 95% CrI - 0.58; - 0.004), and prescription-grade chondroitin sulfate (pCS) (SMD - 0.26, 95% CrI - 0.44; - 0.08). Significant improvements in physical function were found with pCGS (SMD - 0.44, 95% CrI - 0.66; - 0.21), vitamin D (SMD - 0.30, 95% CrIs - 0.49; - 0.11) and IA HA (SMD - 0.21, 95% CrIs - 0.31; - 0.11). CONCLUSION: Six months of treatment with IA HA, pCGS, pCS, vitamin D and the combination of IA HA and triamcinolone improve pain and/or physical function in patients suffering from knee OA.