基于细胞的与皮质类固醇注射治疗骨关节炎的膝盖疼痛:一个随机的第三阶段试验
Ken Mautner1, Michael Gottschalk2, Scott D Boden2
1Department of Orthopaedics, Emory University, Atlanta, GA, USA. kmautne@emory.edu.
Nature medicine
|November 3, 2023
概括
这项研究没有发现任何证据表明细胞注射在一年后优于皮质类固醇注射来缓解膝关节关节炎疼痛. 在所有测试的整形生物学和皮质类固醇治疗中,安全性是可比的.
科学领域:
- 整形外科 整形外科 整形外科
- 再生医学是一种再生医学.
- 临床试验 临床试验
背景情况:
- 细胞注射在膝关节骨关节炎中越来越受欢迎,但缺乏对比疗效的数据.
- 现有的文献提供了有限的证据,证明不同细胞疗法与皮质类固醇注射相对有效.
研究的目的:
- 评估三种骨科生理注射与膝关节骨关节炎的皮质类固醇注射之间的安全性和有效性.
- 为了比较自身的骨髓吸附缩物,带组织衍生的介质细胞,和脂肪细胞的血管分数.
主要方法:
- 第三阶段,多中心,随机对照试验,涉及480名膝关节骨关节炎患者 (Kellgren-Lawrence II-IV).
- 四个手臂:三次脊椎生理注射和一个皮质类固醇注射 (CSI).
- 同一主终点:视觉模拟尺度和膝盖损伤和骨关节炎结局12个月后疼痛评分.
主要成果:
- 在1年的随访期内,没有一个体内生理注射显示出优于皮质类固醇注射的优势.
- 在任何组中都没有观察到磁共振成像骨关节炎得分的显著改善.
- 没有报告与程序相关的严重不良事件.
结论:
- 在注射后的一年,没有一个测试的脊椎生物学药物优于膝关节骨关节炎的皮质类固醇注射.
- 需要进一步的研究来确定不同基于细胞的疗法的长期疗效和比较益处.
相关概念视频
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...


