{"title":"单次关节内注射凝胶-200治疗膝关节骨性关节炎的两项多中心随机对照试验的汇总分析","authors":"Junko Takamura, Takayuki Seo, Vibeke Strand","doi":"10.1177/1179544118773068","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objective: </strong>To perform an integrated analysis of 2 randomized controlled trials (RCTs) to assess the efficacy and safety of a single intra-articular injection of Gel-200 compared with phosphate buffered saline (PBS) for treatment of osteoarthritis of the knee.</p><p><strong>Methods: </strong>Data from the intention-to-treat (ITT) populations of both RCTs were pooled for this integrated analysis. Mean changes from baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscores were assessed using a longitudinal model; treatment differences were compared between intra-articular Gel-200 and PBS injections. Analyses included secondary outcome measures repeated at individual time points. The safety populations of both RCTs were pooled for an integrated safety analysis to compare adverse events (AEs).</p><p><strong>Results: </strong>The pooled ITT population included 1184 subjects (649 Gel-200; 535 PBS); demographic characteristics were similar between treatment groups. Mean improvements in pain subscores from baseline to week 12 were -24.7 mm in Gel-200 and -21.8 mm in PBS groups, a statistically significant treatment group difference of -2.9 mm (<i>P</i> = .047). From weeks 3 to 26, mean improvements from baseline in pain subscores were -23.8 mm with Gel-200 and -20.8 mm with PBS; this treatment group difference of -3.0 mm was statistically significant (<i>P</i> = .017). The rate of AEs was similar between Gel-200 and PBS treatment groups.</p><p><strong>Conclusion: </strong>This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns.</p><p><strong>Trial registration: </strong>NCT00449696 and NCT00450112.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2018-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118773068","citationCount":"4","resultStr":"{\"title\":\"A Pooled Analysis of Two Multicenter, Randomized Controlled Trials of a Single Intra-articular Injection of Gel-200 for Treatment of Osteoarthritis of the Knee.\",\"authors\":\"Junko Takamura, Takayuki Seo, Vibeke Strand\",\"doi\":\"10.1177/1179544118773068\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objective: </strong>To perform an integrated analysis of 2 randomized controlled trials (RCTs) to assess the efficacy and safety of a single intra-articular injection of Gel-200 compared with phosphate buffered saline (PBS) for treatment of osteoarthritis of the knee.</p><p><strong>Methods: </strong>Data from the intention-to-treat (ITT) populations of both RCTs were pooled for this integrated analysis. Mean changes from baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscores were assessed using a longitudinal model; treatment differences were compared between intra-articular Gel-200 and PBS injections. Analyses included secondary outcome measures repeated at individual time points. The safety populations of both RCTs were pooled for an integrated safety analysis to compare adverse events (AEs).</p><p><strong>Results: </strong>The pooled ITT population included 1184 subjects (649 Gel-200; 535 PBS); demographic characteristics were similar between treatment groups. Mean improvements in pain subscores from baseline to week 12 were -24.7 mm in Gel-200 and -21.8 mm in PBS groups, a statistically significant treatment group difference of -2.9 mm (<i>P</i> = .047). From weeks 3 to 26, mean improvements from baseline in pain subscores were -23.8 mm with Gel-200 and -20.8 mm with PBS; this treatment group difference of -3.0 mm was statistically significant (<i>P</i> = .017). The rate of AEs was similar between Gel-200 and PBS treatment groups.</p><p><strong>Conclusion: </strong>This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns.</p><p><strong>Trial registration: </strong>NCT00449696 and NCT00450112.</p>\",\"PeriodicalId\":10443,\"journal\":{\"name\":\"Clinical Medicine Insights. 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引用次数: 4
摘要
背景和目的:对2项随机对照试验(RCTs)进行综合分析,以评估单次关节内注射Gel-200与磷酸盐缓冲盐水(PBS)治疗膝关节骨关节炎的疗效和安全性。方法:将两项随机对照试验的意向治疗(ITT)人群的数据汇总进行综合分析。使用纵向模型评估西安大略省和麦克马斯特大学关节炎指数(WOMAC)疼痛评分与基线的平均变化;比较关节内注射Gel-200和PBS的治疗差异。分析包括在个别时间点重复的次要结果测量。对两项随机对照试验的安全人群进行综合安全性分析,以比较不良事件(ae)。结果:ITT人群共纳入1184名受试者(649名Gel-200;535 PBS);治疗组间的人口学特征相似。从基线到第12周,凝胶-200组疼痛评分的平均改善为-24.7 mm, PBS组为-21.8 mm,治疗组差异有统计学意义-2.9 mm (P = 0.047)。从第3周到第26周,Gel-200组疼痛评分较基线的平均改善为-23.8 mm, PBS组为-20.8 mm;治疗组-3.0 mm差异有统计学意义(P = 0.017)。凝胶-200治疗组和PBS治疗组的ae发生率相似。结论:这项综合分析表明,与PBS相比,单次关节内注射Gel-200治疗膝关节骨关节炎的疗效超过26周,没有重大的安全性问题。试验注册号:NCT00449696和NCT00450112。
A Pooled Analysis of Two Multicenter, Randomized Controlled Trials of a Single Intra-articular Injection of Gel-200 for Treatment of Osteoarthritis of the Knee.
Background and objective: To perform an integrated analysis of 2 randomized controlled trials (RCTs) to assess the efficacy and safety of a single intra-articular injection of Gel-200 compared with phosphate buffered saline (PBS) for treatment of osteoarthritis of the knee.
Methods: Data from the intention-to-treat (ITT) populations of both RCTs were pooled for this integrated analysis. Mean changes from baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscores were assessed using a longitudinal model; treatment differences were compared between intra-articular Gel-200 and PBS injections. Analyses included secondary outcome measures repeated at individual time points. The safety populations of both RCTs were pooled for an integrated safety analysis to compare adverse events (AEs).
Results: The pooled ITT population included 1184 subjects (649 Gel-200; 535 PBS); demographic characteristics were similar between treatment groups. Mean improvements in pain subscores from baseline to week 12 were -24.7 mm in Gel-200 and -21.8 mm in PBS groups, a statistically significant treatment group difference of -2.9 mm (P = .047). From weeks 3 to 26, mean improvements from baseline in pain subscores were -23.8 mm with Gel-200 and -20.8 mm with PBS; this treatment group difference of -3.0 mm was statistically significant (P = .017). The rate of AEs was similar between Gel-200 and PBS treatment groups.
Conclusion: This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns.