Dataset Information

The Clinical Use of Biologics in the Knee Lesions: Does the Patient Benefit?

ABSTRACT: PURPOSE OF REVIEW:Overview the outcomes of the latest use of platelet-rich plasma (PRP) for the treatment of knee lesions in the clinics and discuss the challenges and limitations. RECENT FINDINGS:Recent clinical studies mainly indicate there may be benefit of PRP usage for the treatment of knee lesions. As an autologous source of bioactive components, PRP has been shown to be typically safe, free of major adverse outcomes. The use of PRP has been continuously increasing, and some well-designed, double-blinded, placebo-controlled clinical trials have been published. Clinical outcomes relating to PRP usage are multifactorial and depend on the severity of the lesion and patient characteristics. Although PRP is safe to use and it can be easily applied in the clinics, case-specific considerations are needed to determine whether PRP could be beneficial or not. If the use of PRP is favored, then, the configuration/optimization of the preparation and administration/delivery strategy with or without a concomitant treatment may further enhance the clinical outcomes and patients' experience.

SUBMITTER: Cengiz IF

PROVIDER: S-EPMC6684695 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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The Clinical Use of Biologics in the Knee Lesions: Does the Patient Benefit?

Cengiz Ibrahim Fatih IF Pereira Hélder H Espregueira-Mendes João J Reis Rui L RL Oliveira Joaquim Miguel JM

Current reviews in musculoskeletal medicine 20190628

<h4>Purpose of review</h4>Overview the outcomes of the latest use of platelet-rich plasma (PRP) for the treatment of knee lesions in the clinics and discuss the challenges and limitations.<h4>Recent findings</h4>Recent clinical studies mainly indicate there may be benefit of PRP usage for the treatment of knee lesions. As an autologous source of bioactive components, PRP has been shown to be typically safe, free of major adverse outcomes. The use of PRP has been continuously increasing, and some ...[more]

PMID: 31254255

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Project description:ImportanceCurrent evidence remains ambiguous regarding whether biologics should be added to conventional treatment of rheumatoid arthritis for specific patients, which may cause potential overuse or treatment delay.ObjectivesTo estimate the benefit of adding biologics to conventional antirheumatic drugs for the treatment of rheumatoid arthritis given baseline characteristics.Data sourcesCochrane CENTRAL, Scopus, MEDLINE, and the World Health Organization International Clinical Trials Registry Platform were searched for articles published from database inception to March 2, 2022.Study selectionRandomized clinical trials comparing certolizumab plus conventional antirheumatic drugs with placebo plus conventional drugs were selected.Data extraction and synthesisIndividual participant data of the prespecified outcomes and covariates were acquired from the Vivli database. A 2-stage model was fitted to estimate patient-specific relative outcomes of adding certolizumab vs conventional drugs only. Stage 1 was a penalized logistic regression model to estimate the baseline expected probability of the outcome regardless of treatment using baseline characteristics. Stage 2 was a bayesian individual participant data meta-regression model to estimate the relative outcomes for a particular baseline expected probability. Patient-specific results were displayed interactively on an application based on a 2-stage model.Main outcomes and measuresThe primary outcome was low disease activity or remission at 3 months, defined by 3 disease activity indexes (ie, Disease Activity Score based on the evaluation of 28 joints, Clinical Disease Activity Index, or Simplified Disease Activity Index).ResultsIndividual participant data were obtained from 3790 patients (2996 female [79.1%] and 794 male [20.9%]; mean [SD] age, 52.7 [12.3] years) from 5 large randomized clinical trials for moderate to high activity rheumatoid arthritis with usable data for 22 prespecified baseline covariates. Overall, adding certolizumab was associated with a higher probability of reaching low disease activity. The odds ratio for patients with an average baseline expected probability of the outcome was 6.31 (95% credible interval, 2.22-15.25). However, the benefits differed in patients with different baseline characteristics. For example, the estimated risk difference was smaller than 10% for patients with either low or high baseline expected probability.Conclusions and relevanceIn this individual participant data meta-analysis, adding certolizumab was associated with more effectiveness for rheumatoid arthritis in general. However, the benefit was uncertain for patients with low or high baseline expected probability, for whom other evaluations were necessary. The interactive application displaying individual estimates may help with treatment selection.

Dataset Information

The Clinical Use of Biologics in the Knee Lesions: Does the Patient Benefit?

Publications

The Clinical Use of Biologics in the Knee Lesions: Does the Patient Benefit?

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