!!
Accelerated Knee #Osteoarthritis is Characterized by Destabilizing #Meniscal Tears and Pre‐Radiographic Structural Disease Burden
https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40826
At 1 year before the index visit, >75% of adults with AKOA had meniscal damage in ≥2 regions (vs typical KOA: OR=3.19, 95%CI=1.70 to 5.97). By the index visit, meniscal damage in >2 regions was ubiquitous in AKOA; including 42% with a destabilizing meniscal tear (typical KOA=14%). These changes corresponded to larger BMLs and greater cartilage loss.
Conclusion
AKOA is characterized by destabilizing meniscal tears in a knee compromised by meniscal damage in >2 regions, large BMLs, and cartilage loss
Accelerated Knee #Osteoarthritis is Characterized by Destabilizing #Meniscal Tears and Pre‐Radiographic Structural Disease Burden
https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40826
At 1 year before the index visit, >75% of adults with AKOA had meniscal damage in ≥2 regions (vs typical KOA: OR=3.19, 95%CI=1.70 to 5.97). By the index visit, meniscal damage in >2 regions was ubiquitous in AKOA; including 42% with a destabilizing meniscal tear (typical KOA=14%). These changes corresponded to larger BMLs and greater cartilage loss.
Conclusion
AKOA is characterized by destabilizing meniscal tears in a knee compromised by meniscal damage in >2 regions, large BMLs, and cartilage loss
!!
The Effect of Low- #Carbohydrate and Low-Fat Diets on Pain in Individuals with Knee #Osteoarthritis
https://academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnz022/5380130?redirectedFrom=fulltext
(low-carbohydrate [LCD], low-fat [LFD]) or continue to eat as usual (control [CTRL]) over 12 weeks.
Osteoarthritis is the most prominent form of arthritis, affecting approximately 15% of the population in the United States. Knee osteoarthritis (KOA) has become one of the leading causes of disability in older adults. Besides knee replacement, there are no curative treatments for KOA, so persistent pain is commonly treated with opioids, acetaminophen, and nonsteroidal anti-inflammatory drugs. However, these drugs have many unpleasant side effects, so there is a need for alternative forms of pain management. We sought to test the efficacy of a dietary intervention to reduce KOA.
We present evidence suggesting that oxidative stress may be related to functional pain, and lowering it through our LCD intervention could provide relief from pain and be an opioid alternative.
The Effect of Low- #Carbohydrate and Low-Fat Diets on Pain in Individuals with Knee #Osteoarthritis
https://academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnz022/5380130?redirectedFrom=fulltext
(low-carbohydrate [LCD], low-fat [LFD]) or continue to eat as usual (control [CTRL]) over 12 weeks.
Osteoarthritis is the most prominent form of arthritis, affecting approximately 15% of the population in the United States. Knee osteoarthritis (KOA) has become one of the leading causes of disability in older adults. Besides knee replacement, there are no curative treatments for KOA, so persistent pain is commonly treated with opioids, acetaminophen, and nonsteroidal anti-inflammatory drugs. However, these drugs have many unpleasant side effects, so there is a need for alternative forms of pain management. We sought to test the efficacy of a dietary intervention to reduce KOA.
We present evidence suggesting that oxidative stress may be related to functional pain, and lowering it through our LCD intervention could provide relief from pain and be an opioid alternative.
OUP Academic
Effect of Low-Carbohydrate and Low-Fat Diets on Pain in Individuals with Knee Osteoarthritis
AbstractObjective. Osteoarthritis is the most prominent form of arthritis, affecting approximately 15% of the population in the United States. Knee osteoarthri
!!
Duration of Symptom Relief and Early Trajectory of Adverse Events for Oral #NSAIDs in Knee #Osteoarthritis: A Systematic Review and Meta‐analysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23884
NSAIDs demonstrated moderate, statistically significant effects on pain that peaked at 2 weeks (SMD ‐0.43 ‐0.48, ‐0.38), but the magnitude of the effects decreased over time. The results for function were similar. The incidence of GI AEs was significantly higher in NSAID users than placebo users as early as 4 weeks (RR 1.38 1.21, 1.57). The incidence of CV AEs in NSAID users was not significantly different from placebo. Most GI and CV AEs were transient and of minor severity.
Conclusion
NSAIDs produced significant pain and function improvements that peaked at 2 weeks but decreased over time. The incidence of minor GI and CV AEs consistently rose, reaching significance as early as 4 weeks. Clinicians should weigh the durability of efficacy with the early onset of minor AEs along with patient tolerability and preferences when formulating an NSAID regimen.
Duration of Symptom Relief and Early Trajectory of Adverse Events for Oral #NSAIDs in Knee #Osteoarthritis: A Systematic Review and Meta‐analysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23884
NSAIDs demonstrated moderate, statistically significant effects on pain that peaked at 2 weeks (SMD ‐0.43 ‐0.48, ‐0.38), but the magnitude of the effects decreased over time. The results for function were similar. The incidence of GI AEs was significantly higher in NSAID users than placebo users as early as 4 weeks (RR 1.38 1.21, 1.57). The incidence of CV AEs in NSAID users was not significantly different from placebo. Most GI and CV AEs were transient and of minor severity.
Conclusion
NSAIDs produced significant pain and function improvements that peaked at 2 weeks but decreased over time. The incidence of minor GI and CV AEs consistently rose, reaching significance as early as 4 weeks. Clinicians should weigh the durability of efficacy with the early onset of minor AEs along with patient tolerability and preferences when formulating an NSAID regimen.
!!
Comorbidities in #Osteoarthritis: A systematic review and meta‐analysis of observational studies
https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.24008
Pooled prevalence of any comorbidity was 67% (95%CI: 57%‐74%) in people with OA versus 56% (95%CI: 44%‐68%) in people without OA. The pooled PR for any comorbidity was 1.21 (95%CI: 1.02‐1.45). The PR increased from 0.73 (95%CI: 0.43‐1.25) for one comorbidity, to 1.58 (95%CI: 1.03‐2.42) for two, and 1.94 (95%CI 1.45‐ 2.59) for three or more comorbidities. The key comorbidities associated with OA were stroke (PR 2.61; 95%CI: 2.13‐3.21), peptic ulcer (PR 2.36; 95%CI: 1.71‐3.27) and metabolic syndrome (PR 1.94; 95%CI 1.21‐3.12).
Conclusions
People with OA are more likely to have other chronic conditions. The association is dose‐dependent in terms of the number of comorbidities, suggesting multimorbidities. Further studies on the causality of this association and clinical implications are needed.
Comorbidities in #Osteoarthritis: A systematic review and meta‐analysis of observational studies
https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.24008
Pooled prevalence of any comorbidity was 67% (95%CI: 57%‐74%) in people with OA versus 56% (95%CI: 44%‐68%) in people without OA. The pooled PR for any comorbidity was 1.21 (95%CI: 1.02‐1.45). The PR increased from 0.73 (95%CI: 0.43‐1.25) for one comorbidity, to 1.58 (95%CI: 1.03‐2.42) for two, and 1.94 (95%CI 1.45‐ 2.59) for three or more comorbidities. The key comorbidities associated with OA were stroke (PR 2.61; 95%CI: 2.13‐3.21), peptic ulcer (PR 2.36; 95%CI: 1.71‐3.27) and metabolic syndrome (PR 1.94; 95%CI 1.21‐3.12).
Conclusions
People with OA are more likely to have other chronic conditions. The association is dose‐dependent in terms of the number of comorbidities, suggesting multimorbidities. Further studies on the causality of this association and clinical implications are needed.
Wiley
Comorbidities in Osteoarthritis: A systematic review and meta‐analysis of observational studies - Swain - - Arthritis Care & Research…
!!
Effect of Intra-Articular #Sprifermin vs Placebo on Femorotibial Joint Cartilage Thickness in Patients With #Osteoarthritis
..Among participants with symptomatic radiographic knee osteoarthritis, the intra-articular administration of 100 μg of sprifermin every 6 or 12 months vs placebo resulted in an improvement in total femorotibial joint cartilage thickness after 2 years that was statistically significant, but of uncertain clinical importance; there was no significant difference for 30 μg of sprifermin every 6 or 12 months vs placebo. Durability of response also was uncertain.
https://jamanetwork.com/journals/jama/article-abstract/2752470 jiu
Effect of Intra-Articular #Sprifermin vs Placebo on Femorotibial Joint Cartilage Thickness in Patients With #Osteoarthritis
..Among participants with symptomatic radiographic knee osteoarthritis, the intra-articular administration of 100 μg of sprifermin every 6 or 12 months vs placebo resulted in an improvement in total femorotibial joint cartilage thickness after 2 years that was statistically significant, but of uncertain clinical importance; there was no significant difference for 30 μg of sprifermin every 6 or 12 months vs placebo. Durability of response also was uncertain.
https://jamanetwork.com/journals/jama/article-abstract/2752470 jiu
!!
Results of a 6-week treatment with 10 mg prednisolone in patients with hand #osteoarthritis (HOPE): a double-blind, randomised, placebo-controlled trial
The mean change between baseline and week 6 on VAS-reported finger pain was −21·5 (SD 21·7) in the prednisolone group and −5·2 (24·3) in the placebo group, with a mean between-group difference (of prednisolone vs placebo) of −16·5 (95% CI −26·1 to −6·9; p=0·0007). The number of non-serious adverse events was similar between the groups. Five serious adverse events were reported during our study: one serious adverse event in the prednisolone group (a myocardial infarction) and four serious adverse events in the placebo group (an infected traumatic leg haematoma that required surgery, bowel surgery, atrial fibrillation that required a pacemaker implantation, and symptomatic uterine myomas that required a hysterectomy). Four (4%) patients discontinued the study because of an adverse event: one (2%) patient receiving prednisolone (for a myocardial infarction) and three (7%) patients receiving placebo (for surgery of the bowel and for an infected leg haematoma and for Lyme disease arthritis of the knee).
Interpretation
Treatment with 10 mg prednisolone for 6 weeks is efficacious and safe for the treatment of patients with painful hand osteoarthritis and signs of inflammation. The results of our study provide clinicians with a new short-term treatment option for patients with hand osteoarthritis who report a flare-up of their disease.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32489-4/fulltext
Results of a 6-week treatment with 10 mg prednisolone in patients with hand #osteoarthritis (HOPE): a double-blind, randomised, placebo-controlled trial
The mean change between baseline and week 6 on VAS-reported finger pain was −21·5 (SD 21·7) in the prednisolone group and −5·2 (24·3) in the placebo group, with a mean between-group difference (of prednisolone vs placebo) of −16·5 (95% CI −26·1 to −6·9; p=0·0007). The number of non-serious adverse events was similar between the groups. Five serious adverse events were reported during our study: one serious adverse event in the prednisolone group (a myocardial infarction) and four serious adverse events in the placebo group (an infected traumatic leg haematoma that required surgery, bowel surgery, atrial fibrillation that required a pacemaker implantation, and symptomatic uterine myomas that required a hysterectomy). Four (4%) patients discontinued the study because of an adverse event: one (2%) patient receiving prednisolone (for a myocardial infarction) and three (7%) patients receiving placebo (for surgery of the bowel and for an infected leg haematoma and for Lyme disease arthritis of the knee).
Interpretation
Treatment with 10 mg prednisolone for 6 weeks is efficacious and safe for the treatment of patients with painful hand osteoarthritis and signs of inflammation. The results of our study provide clinicians with a new short-term treatment option for patients with hand osteoarthritis who report a flare-up of their disease.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32489-4/fulltext
!!
Efficacy and tolerability of #duloxetine in patients with knee #osteoarthritis: a meta‐analysis of randomised controlled trials
..Duloxetine achieved significant reductions in primary outcomes including Brief Pain Inventory 24‐h average pain score (weighted mean difference (WMD) = −0.74, 95% confidence interval (CI) = −0.92 to −0.57), weekly mean of the 24‐h average pain score (WMD = −0.76, 95% CI = −0.96 to −0.56), WOMAC stiffness score (WMD = −0.47, 95% CI = −0.60 to −0.34) and WOMAC physical function score (WMD = −4.44, 95% CI = −5.24 to −3.64). Furthermore, duloxetine demonstrated a higher number of treatment‐emergent adverse events (risk ratio (RR) = 1.31, 95% CI = 1.20–1.44) and discontinuations (RR = 2.26, 95% CI = 1.63–3.12); however, no difference in serious adverse events (RR = 0.92, 95% CI = 0.40–2.11) was observed.
Conclusion
Duloxetine is effective in the management of chronic pain and loss of physical function in knee OA with acceptable adverse events despite having no advantage in treating joint stiffness. Future trials should focus on determining the optimal treatment regimen
https://bit.ly/2PJH6NV
Efficacy and tolerability of #duloxetine in patients with knee #osteoarthritis: a meta‐analysis of randomised controlled trials
..Duloxetine achieved significant reductions in primary outcomes including Brief Pain Inventory 24‐h average pain score (weighted mean difference (WMD) = −0.74, 95% confidence interval (CI) = −0.92 to −0.57), weekly mean of the 24‐h average pain score (WMD = −0.76, 95% CI = −0.96 to −0.56), WOMAC stiffness score (WMD = −0.47, 95% CI = −0.60 to −0.34) and WOMAC physical function score (WMD = −4.44, 95% CI = −5.24 to −3.64). Furthermore, duloxetine demonstrated a higher number of treatment‐emergent adverse events (risk ratio (RR) = 1.31, 95% CI = 1.20–1.44) and discontinuations (RR = 2.26, 95% CI = 1.63–3.12); however, no difference in serious adverse events (RR = 0.92, 95% CI = 0.40–2.11) was observed.
Conclusion
Duloxetine is effective in the management of chronic pain and loss of physical function in knee OA with acceptable adverse events despite having no advantage in treating joint stiffness. Future trials should focus on determining the optimal treatment regimen
https://bit.ly/2PJH6NV
Wiley Online Library
Efficacy and tolerability of duloxetine in patients with knee osteoarthritis: a meta‐analysis of randomised controlled trials
Background
Knee osteoarthritis (OA) is one of the most common joint diseases, and pharmacotherapy is necessary to control its symptoms.
Aim
To evaluate efficacy and tolerability of duloxetine in p...
Knee osteoarthritis (OA) is one of the most common joint diseases, and pharmacotherapy is necessary to control its symptoms.
Aim
To evaluate efficacy and tolerability of duloxetine in p...
Reasons why #osteoarthritis predicts mortality: path analysis within a Cox proportional hazards model
https://2medical.news/2020/03/22/reasons-why-osteoarthritis-predicts-mortality-path-analysis-within-a-cox-proportional-hazards-model/
To identify potentially modifiable factors that mediate the association between symptomatic osteoarthritis (OA) and premature mortality.. ..OA was significantly associated with mortality (TE-adjusted HR 1.14; 95% CI 1.00 to 1.29). The indirect effects for walking frequency were 1.05 (95% CI 1.04 to 1.06), depression 1.02 (95% CI 1.02 to 1.03), anxiety 1.01 (95% CI 1.00 to 1.02) and unrefreshed sleep 1.01 (95% CI 1.00 to 1.01). …
https://2medical.news/2020/03/22/reasons-why-osteoarthritis-predicts-mortality-path-analysis-within-a-cox-proportional-hazards-model/
To identify potentially modifiable factors that mediate the association between symptomatic osteoarthritis (OA) and premature mortality.. ..OA was significantly associated with mortality (TE-adjusted HR 1.14; 95% CI 1.00 to 1.29). The indirect effects for walking frequency were 1.05 (95% CI 1.04 to 1.06), depression 1.02 (95% CI 1.02 to 1.03), anxiety 1.01 (95% CI 1.00 to 1.02) and unrefreshed sleep 1.01 (95% CI 1.00 to 1.01). …
Association of intermittent and constant #knee pain patterns with knee pain severity, radiographic knee #osteoarthritis duration and severity
https://2medical.news/2020/04/14/association-of-intermittent-and-constant-knee-pain-patterns-with-knee-pain-severity-radiographic-knee-osteoarthritis-duration-and-severity/
..Intermittent and Constant OA Pain (ICOAP) scores were characterized as 1) no intermittent or constant pain; 2) intermittent pain only; 3) constant pain only; and 4) a combination of constant and intermittent pain. Knee pain severity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the Visual Analog Scale (VAS). Radiographic knee OA (ROA) severity was defined as Kellgren …
https://2medical.news/2020/04/14/association-of-intermittent-and-constant-knee-pain-patterns-with-knee-pain-severity-radiographic-knee-osteoarthritis-duration-and-severity/
..Intermittent and Constant OA Pain (ICOAP) scores were characterized as 1) no intermittent or constant pain; 2) intermittent pain only; 3) constant pain only; and 4) a combination of constant and intermittent pain. Knee pain severity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the Visual Analog Scale (VAS). Radiographic knee OA (ROA) severity was defined as Kellgren …
Subcutaneous #tanezumab for #osteoarthritis of the hip or knee: efficacy and safety results from a 24-week randomised phase III study with a 24-week follow-up period
https://2medical.news/2020/04/18/subcutaneous-tanezumab-for-osteoarthritis-of-the-hip-or-knee-efficacy-and-safety-results-from-a-24-week-randomised-phase-iii-study-with-a-24-week-follow-up-period/
..Patients were randomised to tanezumab 2.5 mg or 5 mg subcutaneously or matching placebo every 8 weeks (three doses). ..From March 2016 to December 2017, 849 patients were randomised and evaluated (placebo n=282, tanezumab 2.5 mg n=283, tanezumab 5 mg n=284). At week 24, there was a statistically significant improvement from baseline for tanezumab 5 mg compared with placebo for WOMAC Pain (least squares mean difference±SE –0.62±0.18, p=0.0006), WOMAC …
https://2medical.news/2020/04/18/subcutaneous-tanezumab-for-osteoarthritis-of-the-hip-or-knee-efficacy-and-safety-results-from-a-24-week-randomised-phase-iii-study-with-a-24-week-follow-up-period/
..Patients were randomised to tanezumab 2.5 mg or 5 mg subcutaneously or matching placebo every 8 weeks (three doses). ..From March 2016 to December 2017, 849 patients were randomised and evaluated (placebo n=282, tanezumab 2.5 mg n=283, tanezumab 5 mg n=284). At week 24, there was a statistically significant improvement from baseline for tanezumab 5 mg compared with placebo for WOMAC Pain (least squares mean difference±SE –0.62±0.18, p=0.0006), WOMAC …