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Published on: August 13, 2019
Meta-Analysis of Estrogen in Osteoarthritis: Clinical Status and Protective Effects
Context:
Osteoarthritis (OA) impacted over 5-million people worldwide in 2018, with an incidence second only to diabetes and hypertension. Clinical research has had difficulty in finding methods to treat OA quickly and effectively. More and more researchers have begun to explore the effects of estrogen (ER) on OA.
Objective:
The study intended to conduct a meta-analysis of studies using ER in OA, aiming to confirm the potential value of ER, laying a foundation for follow-up research, and providing new choices for the treatment of OA.
Design:
The research team performed a literature review searching PubMed for clinical studies on the application of ER for the OA treatment or on the improvement of joint pain that: (1) were published after the year 2000, and (2) had participants who used ER compared to other treatment methods. The research team selected studies for analysis after independent screening by two members of the team, based on inclusion and exclusion criteria and a methodological quality evaluation. The meta-analysis used RevMan V5.3 software.
Intervention:
The research team included eight studies with 11 689 participants, with 5776 participants who received ER treatments becoming the intervention group, and with 5913 participants who received other treatments becoming the control group.
Outcome Measures:
The outcome measures included the selected studies' results related: (1) to changes in the bone marker, collagen cross-linked C-telopeptide type I (CTX-1); (2) to the levels of bone Gla protein (BGP); (3) to joint-pain relief, and (4) to subjective scores on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a visual analogue scale (VAS) for pain, and the Short-Form 36 (SF-36).
Results:
The meta-analysis found that the CTX-II level was significantly lower (P < .0001) and the BGP level was significantly higher (P = .07) in the EG group than the levels in the control group. Similarly, the number of participants with joint pain in the ER group was significantly lower than that of the control group (P = .01), and a significant difference existed between the groups in the subjective scores (P = .02).
Conclusion:
ER can exert varying degrees of positive effects on OA and can effectively ameliorate the pathological process in OA patients, and it may become an alternative for OA treatment in the future, providing patients with better health and life quality.
