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Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon.


ABSTRACT: 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.

SUBMITTER: Beaudart C 

PROVIDER: S-EPMC7716887 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon.

Beaudart C C   Lengelé L L   Leclercq V V   Geerinck A A   Sanchez-Rodriguez D D   Bruyère O O   Reginster J Y JY  

Drugs 20201201 18


<h4>Introduction</h4>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.<h4>Methods</h4>Medline, Scopus, and Cochrane database of systematic reviews were searched for randomized controlled trials published up to August 2019 and asses  ...[more]

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