Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Clinical benefit of intra-articular saline as a comparator in clinical trials of knee osteoarthritis treatments: A systematic review and meta-analysis of randomized trials

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Defining the optimal biological monotherapy in rheumatoid arthritis: A systematic review and meta-analysis of randomised trials

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Biological agents in polyarticular juvenile idiopathic arthritis: A meta-analysis of randomized withdrawal trials

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. The Effectiveness and Cost-Effectiveness of Screening for HIV in Migrants in the EU/EEA: A Systematic Review

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  2. Why prescribe exercise as therapy in type 2 diabetes? We have a pill for that!

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  3. 2018 update of the EULAR recommendations for the management of Behçet's syndrome

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVES: Hyaluronic acid and corticosteroids are common intra-articular (IA) therapies widely used for the management of mild to moderate knee osteoarthritis (OA). Many trials evaluating the efficacy of IA administered therapies commonly use IA saline injections as a placebo comparator arm. Using a systematic review and meta-analysis, our objective was to assess the clinical benefit associated with use of IA saline in trials of IA therapies in the treatment of patients with painful knee OA.

METHODS: MEDLINE and Embase databases were searched for articles published up to and including August 14th, 2014. Two reviewers assessed the eligibility of potential reports and the risk of bias of included trials. We analyzed short (≤3 months) and long-term (6-12 months) pain reduction of the saline arm of included trials using standardized mean differences (SMDs; estimated assuming a null effect in a comparator group) that were combined and weighted using a random effects model. Treatment-related adverse events (AEs) were tabulated and presented using descriptive statistics.

RESULTS: From 40 randomized controlled trials (RCTs) eligible for inclusion only 38 provided sufficient data to be included in the meta-analysis. Based on data with moderate inconsistency IA saline was found to significantly improve short-term knee pain in 32 studies involving 1705 patients (SMD = -0.68; 95% CI: -0.78 to -0.57; P < 0.001; I(2) = 50%). Long-term knee pain was significantly decreased following IA injection with saline in 19 studies involving 1445 patients (SMD = -0.61; 95% CI: -0.76 to -0.45; P < 0.001) with a substantial degree of inconsistency (I(2) = 74%). Overall, 29 of the included trials reported on adverse events, none of which found any serious treatment-related AEs following IA injection with saline.

CONCLUSIONS: Pain relief observed with IA saline should prompt health care providers to consider the additional effectiveness of current IA treatments that use saline comparators in clinical studies, and challenges of identifying IA saline injection as a "placebo."

OriginalsprogEngelsk
TidsskriftSeminars in Arthritis and Rheumatism
Vol/bind46
Tidsskriftsnummer2
Sider (fra-til)151-9
Antal sider9
ISSN0049-0172
DOI
StatusUdgivet - okt. 2016

ID: 49024262