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Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Monoclonal Antibodies for Osteoarthritis of the Hip or Knee | CADTH.ca CADTH Document Viewer Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Table of Contents Search this document Monoclonal Antibodies for Osteoarthritis of the Hip or Knee July 2018 Summary Osteoarthritis (OA) is a common and chronic disease of the synovial joints caused by biomechanical factors, inflammation, and joint tissue damage. The current (...) therapeutic options include non-pharmacologic therapy and topical analgesics, followed by oral analgesics and injectable agents, followed by surgery for end-stage disease. OA typically affects the knees, hips, hands, spine, and feet. Treatment with anti-nerve growth factors monoclonal antibodies (anti-NGFs) may improve joint pain and physical function, as nerve growth factor is associated with chronic pain conditions, and is elevated in the joints of patients with osteoarthritis. Within the indication
, subchondral sclerosis, and osteophytes. Treatments are non-pharmacological and pharmacological. Joint replacement surgery is effective for controlling the pain of osteoarthritis in advanced disease. Definition Osteoarthritis (OA) is the result of mechanical and biological events that destabilise the normal process of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. It involves the entire joint, including the articular cartilage, subchondral bone (...) OsteoarthritisOsteoarthritis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Osteoarthritis Last reviewed: February 2019 Last updated: March 2018 Summary A degenerativejoint disorder; prevalence increases with age. Most commonly affected joints are the knee, hip, hands, and lumbar and cervical spine. Presents with joint pain and stiffness that is typically worse with activity. Radiographs show loss of joint space
Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial 29088393 2019 04 19 2019 04 19 1538-6724 98 1 2018 01 01 Physical therapy Phys Ther Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial. 16-27 10.1093/ptj/pzx104 Bove Allyn M AM Department of Physical Therapy, School of Health and Rehabilitation Sciences (...) States P30 AG024827 AG NIA NIH HHS United States Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. United States Phys Ther 0022623 0031-9023 AIM IM Aged Combined Modality Therapy Cost-Benefit Analysis Exercise Therapy economics methods Female Follow-Up Studies Health Care Costs statistics & numerical data Humans Male Middle Aged Musculoskeletal Manipulations economics methods Osteoarthritis, Knee economics
Cost-Utility Analysis of High Molecular Weight Hyaluronic Acid for Knee Osteoarthritis in Everyday Clinical Care in Patients at a Working Age: An Economic Evaluation of a Randomized Clinical Trial Knee osteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for nonsteroidal antiinflammatory drugs, which are known (...) for their serious side-effects. The cost-utility of intraarticular HMW-HA treatment in these patients is unknown, however, and was assessed in this study.Secondary care patients ages 18-65 years with knee OA were randomized to usual care plus HMW-HA (intervention group) or to usual care only (control group). A cost-utility analysis over 52 weeks from the societal and health care perspective was performed. Uncertainty for costs, effects, and cost-utility ratio was analyzed by nonparametric bootstrapping
followup (week 24) end points. Patients were allocated to either a 10-week iCBT program for depression added to treatment as usual (TAU) or to a TAU control group. Primary outcomes were depression symptoms (9-Item Patient Health Questionnaire [PHQ-9]) and psychological distress (Kessler-10 [K-10]). Secondary outcomes included arthritis self-efficacy (Arthritis Self-Efficacy Scale [ASES]), OA pain, stiffness, physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC (...) Internet Cognitive-Behavioral Therapy for Depression in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial To determine the efficacy of an internet-based cognitive-behavioral therapy (iCBT) program for depression in older adults with osteoarthritis (OA) of the knee and comorbid major depressive disorder (MDD).We conducted a randomized controlled trial in 69 adults (ages ≥50 years) meeting criteria for MDD and OA of the knee with 1-week postintervention (week 11) and 3-month
Prospective, Multicenter, Randomized, Crossover Clinical Trial Comparing the Safety and Effectiveness of Cooled Radiofrequency Ablation With Corticosteroid Injection in the Management of Knee Pain From OsteoarthritisOsteoarthritis (OA) of the knee affects the aging population and has an associated influence on the health care system. Rigorous studies evaluating radiofrequency ablation for OA-related knee pain are lacking. This study compared long-term clinical safety and effectiveness (...) of cooled radiofrequency ablation (CRFA) with intra-articular steroid (IAS) injection in managing OA-related knee pain.This is a prospective, multicenter, randomized trial with 151 subjects with chronic (≥6 months) knee pain that was unresponsive to conservative modalities. Knee pain (Numeric Rating Scale [NRS]), Oxford Knee Score, overall treatment effect (Global Perceived Effect), analgesic drug use, and adverse events were compared between CRFA and IAS cohorts at 1, 3, and 6 months after
Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions (...) on knee pain, disability, and psychosocial variables.Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery.Significant and clinically relevant
in men [ ; ]. Obesity — increases the load on weight-bearing joints; increases the risk of developing knee osteoarthritis more than threefold, and accelerates disease progression [ ; ]. High bone density — increases risk for development of osteoarthritis [ ]. Low bone density — increases risk for rapid progression of knee and hip osteoarthritis [ ]. Biomechanical Joint injury and damage — damage to bone, cartilage, or ligaments; history of inflammatory arthropathy can adversely affect joint (...) that lines the joint capsule). In some people, these repair processes may alleviate symptoms, but in others they cannot fully compensate for the joint damage, and symptoms of pain and stiffness may occur. Any synovial joint can be involved, and the most commonly affected peripheral joints are the knees, then the hips, and the small joints of the hand. [ ; ; ] Prevalence How common is it? Osteoarthritis is the most common jointdisease worldwide, affecting an estimated 10% of men and 18% of women over 60
The effect of pregabalin or duloxetine on arthritis pain: a clinical and mechanistic study in people with hand osteoarthritisOsteoarthritis (OA) is the most prevalent arthritis worldwide and is characterized by chronic pain and impaired physical function. We hypothesized that heightened pain in hand OA could be reduced with duloxetine or pregabalin. In this prospective, randomized clinical study, we recruited 65 participants, aged 40-75 years, with a Numerical Rating Scale (NRS) for pain (...) , the pregabalin group showed improvement for NRS pain (P=0.023), AUSCAN pain (P=0.008), and AUSCAN function (P=0.009), but no difference between duloxetine and placebo (P>0.05) was observed. In the per protocol analysis, NRS pain was reduced for pregabalin (P<0.0001) and duloxetine (P=0.029) compared to placebo. We conclude that centrally acting analgesics improve pain outcomes in people with hand arthritis, offering new treatment paradigms for OA pain.
Efficacy of Vibrating Gloves for Chronic Hand Pain due to Osteoarthritis This study investigated the efficacy of vibration technology for women with hand pain due to osteoarthritis (OA) to see if mild compression and small vibrating motors were beneficial with periodic use.Sixty-nine (N = 69) women with OA hand pain were randomized into two groups, one that used vibrating gloves once a day for 20 minutes (Experimental, N = 34) and one that was monitored for three months without gloves (Control (...) helpful in reducing hand pain in women with OA (53.5%), and most expressed willingness to use the gloves (71.4%) and use the pain app (55.8%) in the future. Additional studies to determine the mechanism of action of the gloves in managing pain would be recommended.
Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with knee osteoarthritis: A randomized clinical trial Osteoarthritis is a common degenerativedisease. Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders.To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with knee osteoarthritis (KOA).Fifty-two adults (...) with painful primary knee osteoarthritis for at least three months were randomized to intra- and peri-articular injection groups. Prolotherapy was done twice with two week intervals. The outcome measures included the Oxford Knee Scale (OKS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS), which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks.There were no statistically
Clinical Outcomes of Knee Osteoarthritis Treated With an Autologous Protein Solution Injection: A 1-Year Pilot Double-Blinded Randomized Controlled Trial Osteoarthritis (OA) is a debilitating disease resulting in substantial pain and functional limitations. A novel blood derivative has been developed to concentrate both growth factors and antagonists of inflammatory cytokines, with promising preliminary findings in terms of safety profile and clinical improvement.To investigate if one intra (...) -articular injection of autologous protein solution (APS) can reduce pain and improve function in patients affected by knee OA in a multicenter, randomized, double-blind, saline-controlled study.Randomized controlled trial; Level of evidence, 2.Forty-six patients with unilateral knee OA (Kellgren-Lawrence 2 or 3) were randomized into the APS group (n = 31), which received a single ultrasound-guided injection of APS, and the saline (control) group (n = 15), which received a single saline injection
The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients.Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However (...) , various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy.A randomised clinical trial design.The sample consisted of patients (n = 96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard
Treatment of knee osteoarthritis: platelet-derived growth factors vs. hyaluronic acid. A randomized controlled trial Aim of this trial was to compare efficacy of activated platelet-rich plasma against hyaluronic acid as intra-articular injections to people with osteoarthritis of the knee.Phase-2 randomized controlled trial, with blind patients and outcome assessors.Outpatient rehabilitation service; years 2011-2013.Patients with knee osteoarthritis grades 2-3 at magnetic resonance imaging (MRI (...) Universities Osteoarthritis Index (WOMAC), Lysholm, Tegner, American Knee Society Score (AKSS), Lequesne, visual analogue scale (VAS) for pain).Overall, 30 patients were randomized to intervention and 28 to control group. For primary outcome, 28 patients (29 knees) in the intervention and 22 (25 knees) in the control group were available. Patients with at least 1 grade improvement at repeat MRI were 14 (48.3%) in the intervention and 2 (8%) in the control group ( P < 0.003). Improvement in symptoms
Autologous and micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis Chondral lesions of the knee represent a challenge for the orthopaedic surgeon. Several treatments have been proposed with variable success rate. Recently, new therapeutic approaches, such as the use of mesenchymal stem cells, have shown promising results. The adipose tissue is a good source of these naturally occurring regenerative cells, due to its abundance and easy access (...) . In addition, it can be used to provide cushioning and filling of structural defects. The 1-year safety and outcome of a single intra-articular injection of autologous and micro-fragmented adipose tissue in 30 patients affected by diffuse degenerative chondral lesions was evaluated.Micro-fragmented adipose tissue was obtained using a minimal manipulation technique in a closed system. The safety of the procedure was evaluated by recording type and incidence of any adverse event. The clinical outcomes were
A randomized controlled trial of a combined self-management and exercise intervention for elderly people with osteoarthritis of the knee: the PLE2NO program To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE2NO program) in elderly individuals with knee osteoarthritis.Randomized controlled trial.Four different community settings.Eighty individuals aged 60 years or older with clinical and radiographic knee osteoarthritis enrolled in the study.A combined (...) self-management and exercise intervention (treatment group) and an educational intervention (control group).The primary outcomes were pain and other knee osteoarthritis symptoms (swelling, crackling, limitation on movement, and stiffness), self-management behaviors (communication with physician and cognitive symptom management), and functional lower limb strength. Secondary outcomes were knee osteoarthritis-specific health-related quality of life, self-perceived health, aerobic capacity, lower
Effect of vitamin E on oxidative stress level in blood, synovial fluid, and synovial tissue in severe knee osteoarthritis: a randomized controlled study This study was performed to evaluate the antioxidative and anti-inflammatory effects of vitamin E on oxidative stress in the plasma, synovial fluid, and synovial tissue of patients with knee osteoarthritis.Seventy-two patients with late-stage knee osteoarthritis scheduled for total knee arthroplasty were randomized to take oral placebo (Group (...) A) or 400 IU of vitamin E (Group B) once a day for 2 months before undergoing surgery. The blood levels of endpoints indicating oxidative stress or antioxidant capacity, Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), and adverse effects were compared before and after the intervention between the two groups. At surgery, these redox endpoints and histological findings were compared between the synovial fluid and synovial tissue.In blood samples
Maintenance of the paraspinal muscles may protect against radiographic knee osteoarthritis Knee osteoarthritis (OA) is an increasing health problem worldwide. So far, only obesity and quadriceps weakness are identified as modifiable risk factors for knee OA. Core muscle strengthening is becoming increasingly popular among older adults because of its ability to enhance the activities of daily living during old age. This study investigated the associations of the size and quality of the abdominal (...) trunk muscles with radiographic knee osteoarthritis (RKOA).From 2012 to 2016, data were collected from 146 males and 135 females (age 63.9±13.4 years, BMI 23.2±3.8 kg/m2) at annual musculoskeletal examinations, including knee radiographs and body composition analyses, by dual-energy X-ray absorptiometry. Cross-sectional areas of abdominal trunk muscles were measured using a single-slice computed tomography scan image obtained at the level of the umbilicus.The prevalence of RKOA was 21.2% in males
Comparison of the efficacy and tolerability of chondroitin plus glucosamine and D-002 (beeswax alcohols) in subjects with osteoarthritis symptoms. Osteoarthritis (OA), the commonest joint disorder, is a leading cause of disability. Symptomatic slow-acting drugs for OA (SYSADOA), particularly glucosamine plus chondroitin sulphate (GS/CS), are effective for symptom relief, protect joint cartilage and delay OA progression, with a good safety profile. D-002, a mixture of beeswax alcohols (...) that inhibits both cyclooxygenase and 5-lipoxygenase activities, has been effective in experimental and clinical OA studies, showing also a chondroprotective effect.To compare the effects of D-002 and GS/SC administered for 12 weeks on OA symptoms.Participants were randomized to GS/CS (375/300 mg) or 50 mg D-002 once daily for 12 weeks. Symptoms were assessed by the Western Ontario and McMaster Individual Osteoarthritis Index (WOMAC) and the Visual Analogy Scale (VAS) scores. The primary outcome
Peri-talar re-alignment osteotomy for joint preservation in asymmetrical ankle osteoarthritis Various types of re-alignment surgery are used to preserve the ankle joint in cases of intermediate ankle arthritis with partial joint space narrowing.The short-term and mid-term results after re-alignment surgery are promising, with substantial post-operative pain relief and functional improvement that is reflected by high rates of patient satisfaction.In this context, re-alignment surgery can (...) preserve the joint and reduce the pathological load that acts on the affected area.Good clinical and radiological outcomes can be achieved in asymmetrical ankle osteoarthritis by understanding the specific deformities and appropriate indications for different surgical techniques. Cite this article: EFORT Open Rev 2017;2:324-331. DOI: 10.1302/2058-5241.2.160021.