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Tian Y, Liu ZY, Wang JH, Qian JH. The efficacy and safety of Baduanjin exercise as complementary therapy for pain reduction and functional improvement in knee osteoarthritis: A meta-analysis of randomized controlled trials. Complement Ther Med 2025; 88:103127. [PMID: 39828222 DOI: 10.1016/j.ctim.2025.103127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 10/21/2024] [Accepted: 01/07/2025] [Indexed: 01/22/2025] Open
Abstract
OBJECTIVES To systematically evaluate the efficacy and safety of Baduanjin exercise in patients with knee osteoarthritis through meta-analysis. While Baduanjin exercise, a traditional Chinese exercise therapy, is part of complementary and alternative medicine, its therapeutic value for knee osteoarthritis remains uncertain due to limited supporting evidence. This study seeks to address this gap. METHODS The study protocol has been registered in PROSPERO(CRD42024501559). A systematic review and meta-analysis were conducted by searching six databases up to January 2024 (PubMed, Cochrane Library, EBSCO, Web of Science and CNKI, and Wanfang Medical), including RCTs that assessed Baduanjin exercise for KOA treatment. Two reviewers independently selected studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias tool (RoB2). Meta-analyses were performed using RevMan version 5.4.1 software. The outcome indicators included the WOMAC knee pain score, stiffness score, and physical function score, as well as the total score and adverse events. For summary results, weighted mean difference (MD) and 95 % confidence intervals (CI) were used. RESULTS Twelve RCTs involving 846 participants were included. Baduanjin exercise significantly improved WOMAC pain score (MD=-2.59, 95 % CI: -4.20 to -0.97, P = 0.002), stiffness score (MD=-2.42, 95 % CI: -3.75 to - 1.08, P = 0.004), physical function score (MD=-4.42, 95 % CI: -5.67 to -3.17, P < 0.00001), and total score (MD=-11.27, 95 % CI: -14.26 to -8.28, P < 0.00001) compared to controls. Subgroup analyses revealed significant improvements regardless of intervention duration, frequency, or location. No adverse events were reported. However, high heterogeneity and methodological biases were observed. CONCLUSION Baduanjin exercise appears to be an effective and safe complementary therapy for improving pain and function in patients with KOA. High-quality RCTs are needed to confirm these findings and explore optimal intervention parameters. Future research should address the identified methodological limitations.
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Affiliation(s)
- Ye Tian
- Beijing Sport University, Beijing, China; Affiliated Sport Hospital of Chengdu Sport University, Chengdu, China
| | | | - Jia-Hao Wang
- Affiliated Sport Hospital of Chengdu Sport University, Chengdu, China
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Halliwell C, O’Brien M, Moyer R. Moderate-To-Vigorous Physical Activity Independent of Stationary Time Is Associated With Better Functional Outcomes Over Four-Years in Individuals With or at Risk of Knee Osteoarthritis. Musculoskeletal Care 2025; 23:e70046. [PMID: 39763150 PMCID: PMC11704334 DOI: 10.1002/msc.70046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 12/17/2024] [Accepted: 12/23/2024] [Indexed: 01/11/2025]
Abstract
INTRODUCTION Osteoarthritis is a progressive joint disease that causes pain and disability, impairing physical function. Moderate-to-vigorous physical activity (MVPA) is recommended for knee osteoarthritis, while stationary time, independent of activity, may negatively impact health outcomes. We hypothesised that individuals with the highest MVPA and lowest stationary time would have better long-term function compared to those with the lowest MVPA and highest stationary time, as well as those with high levels of both MVPA and stationary time. METHODS Data included 442 participants, with an average age of 66-years and 190-females from the Osteoarthritis Initiative who wore accelerometers to assess MVPA and stationary time. Participants were grouped into tertiles of MVPA and stationary time normalised to total accelerometer wear time. The three groups were: highest activity, lowest stationary (HALS), highest activity, highest stationary (HAHS), and lowest activity, highest stationary (LAHS). Gait speed, the 400 m walk test, and five-time repeated chair stand were assessed at baseline and four-year follow-up. RESULTS Compared to the LAHS group, the HALS and HAHS groups had better performance in gait speed p < 0.001, d = 0.96-1.06, 400m walk time p < 0.001, d = 1.21-1.36, and five-time repeated chair stand p < 0.001, d = 0.54-0.81 at baseline and four-year follow-up. No differences were found between the HALS and HAHS groups at either timepoint. CONCLUSION Higher levels of MVPA were associated with better lower-limb functional outcomes in individuals with or at risk of knee osteoarthritis. Higher levels of stationary time do not negatively influence functional performance as long as higher numbers of MVPA levels (∼30 min/day) are achieved.
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Affiliation(s)
- Carson Halliwell
- School of PhysiotherapyFaculty of HealthDalhousie UniversityHalifaxCanada
- Department of MedicineFaculty of Medicine and Health ScienceSherbrooke UniversitySherbrookeCanada
- Faculty of Medicine and Health ScienceCentre de Formation Médicale du Nouveau‐BrunswickMonctonCanada
| | - Myles O’Brien
- Department of MedicineFaculty of Medicine and Health ScienceSherbrooke UniversitySherbrookeCanada
- Faculty of Medicine and Health ScienceCentre de Formation Médicale du Nouveau‐BrunswickMonctonCanada
| | - Rebecca Moyer
- School of PhysiotherapyFaculty of HealthDalhousie UniversityHalifaxCanada
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Budarick AR, Hubley‐Kozey CL, Li LC, Theou O, Stanish WD, Moyer RF. Quality of Non-Surgical and Non-Pharmacological Knee Osteoarthritis Care in the Maritimes. Musculoskeletal Care 2025; 23:e70047. [PMID: 39780279 PMCID: PMC11711289 DOI: 10.1002/msc.70047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 12/19/2024] [Accepted: 12/23/2024] [Indexed: 01/11/2025]
Abstract
OBJECTIVES To evaluate the quality and types of care individuals with mild-to-moderate knee osteoarthritis receive in the Canadian Maritime provinces, and determine associations with demographic, social, and patient-reported factors. METHODS Individuals with knee osteoarthritis were invited to complete a healthcare quality survey based on the British Columbia Osteoarthritis (BC OA) survey. The cross-sectional descriptive observational survey assessed four healthcare quality indicators: advice to exercise, advice to lose weight, assessment of ambulatory function, and assessment of non-ambulatory function. Pass-rates were calculated overall and for each quality indicator. Binary logistic regressions determined associations between quality indicators and demographic, social, and patient-reported outcomes. Patient-reported use of exercise and diet as arthritis treatments were added to the quality indicator eligibility criteria as a sensitivity analysis. RESULTS Participants (n = 241) had a mean age of 67 (7) years, body mass index of 30.7 (7.5) kg/m2 and were 77% female. The overall pass rate was 42.9% using the BC OA criteria, and 49.3% in the sensitivity analysis. Individual quality indicator pass-rates ranged from 4.3% for non-ambulatory function to 85.7% for ambulatory function assessments. The sensitivity analysis increased pass-rates for advice to exercise (61.9%-69.3%) and advice to lose weight (27.9%-35.1%). Pass-rates were not driven by demographic, social, or patient-reported factors. CONCLUSIONS Over half of individuals with mild-to-moderate knee osteoarthritis did not receive recommended core treatments in the Maritimes, highlighting a need to improve care for this patient group. Quality indicators should be routinely evaluated to determine whether clinical care aligns with best practice guidelines.
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Affiliation(s)
| | | | - Linda C. Li
- Department of Physical TherapyUniversity of British ColumbiaVancouverCanada
- Arthritis Research Centre of CanadaVancouverCanada
| | - Olga Theou
- School of PhysiotherapyDalhousie UniversityHalifaxCanada
| | - William D. Stanish
- Department of SurgeryDivision of OrthopaedicsDalhousie UniversityHalifaxCanada
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Azizi F, Gorji N, Jokar R, Rezghi M, Shirafkan H, Moeini R. The effects of Pistacia atlantica Desf. Fruit oil on primary knee osteoarthritis: A randomized controlled clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2025; 342:119387. [PMID: 39855435 DOI: 10.1016/j.jep.2025.119387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 10/10/2024] [Accepted: 01/19/2025] [Indexed: 01/27/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Pistacia atlantica Desf. (Baneh) is a native tree in many areas of Iran such as Zagros mountains and Sistan va Baluchestan Province. It is famous mostly due to its oleo-gum resin and there are many studies on its effects on gastrointestinal disorders and musculoskeletal problems. However, the oil from its fruits is also of use in local communities as a part of their food and for therapeutic purposes such as analgesic effects on joint pains. AIM OF THE STUDY Osteoarthritis is a widespread form of joint pain in older adults. This double-blinded randomized clinical trial aimed to compare the effects of Baneh fruit oil on knee osteoarthritis with topical diclofenac. MATERIAL AND METHODS Ninety-two patients with primary knee osteoarthritis were randomly divided into two groups and asked to rub a fingertip of Baneh ointment or diclofenac on their knee 3 times a day for four weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analog Scale (VAS) were completed at the beginning, fourth and eighth weeks. The data was analyzed in SPSS software and intention to treat (ITT) analysis was performed. A P-value less than 0.05 was considered statistically significant. RESULTS After 4 weeks, all parameters improved significantly in both groups but the pain (based on VAS and KOOS), activity, and quality-of-life showed statistically more improvement in the Baneh group (P = 0.001, P < 0.001, and P = 0.009, respectively). Four weeks after stopping the interventions, all parameters in both groups were still significantly better than the baseline (P ≤ 0.05). However, improvement in pain (VAS and KOOS) and activity was stayed better in the Baneh group (P = 0.028, P = 0.001, and P = 018, respectively). Only one case of temporary itching was reported. CONCLUSION This study revealed that Baneh oil had a positive effect on relieving the symptoms of knee osteoarthritis, however, more clinical trials with longer duration of treatment and larger sample sizes are recommended.
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Affiliation(s)
- Fatemeh Azizi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
| | - Narjes Gorji
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Rahmatollah Jokar
- Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran; Department of Orthopedic Surgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
| | - Maedeh Rezghi
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Reihaneh Moeini
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Sun Y, Sheng J, Wang K, Feng N. New insights into the association between arthritis and overactive bladder in NHANES 2005-2020. Sci Rep 2025; 15:5310. [PMID: 39939697 PMCID: PMC11822026 DOI: 10.1038/s41598-025-89926-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Accepted: 02/10/2025] [Indexed: 02/14/2025] Open
Abstract
Arthritis and overactive bladder (OAB) are both common diseases, but the association between them remains unclear. The aim of our research is to investigate the possible link with regard to arthritis and OAB. Our study's data was sourced from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2020. The Overactive Bladder Symptom Score (OABSS) was used to diagnose OAB, while the health questionnaire was used to diagnose arthritis. This research utilized weighted logistic regression to evaluate the correlation between OAB and arthritis. To ensure the robustness of these results, subgroup analyses along with interaction tests were performed. Our research comprised 24,436 participants. After correcting for all covariates, we found a positive association between arthritis and OAB (OR = 1.37, 95% CI: 1.22, 1.54). Stratified by arthritis type, there was a positive association between osteoarthritis (OA) and OAB (OR = 1.40, 95% CI: 1.22, 1.62). Rheumatoid arthritis (RA) (OR = 1.20, 95% CI: 0.99, 1.46) and psoriatic arthritis (OR = 1.40, 95% CI: 0.75, 2.60) were not significantly correlated with OAB. This research demonstrated that arthritis was closely related to OAB. Additional research is required to confirm this association.
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Affiliation(s)
- Yifan Sun
- Department of Urology, Jiangnan University Medical Center, Wuxi, China
| | - Jiayi Sheng
- Department of Urology, Jiangnan University Medical Center, Wuxi, China
| | - Ke Wang
- The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| | - Ninghan Feng
- Department of Urology, Jiangnan University Medical Center, Wuxi, China.
- Wuxi School of Medicine, Jiangnan University, Wuxi, China.
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Belba A, Vanneste T, Vanlinthout LE, Kallewaard J, Van Kuijk SM, Kimman M, Emans P, Van Boxem K, Santana Pineda MM, Thevissen K, Van Zundert J, Vankrunkelsven P, Vanhove AC. Radiofrequency treatment for chronic knee pain in people with knee osteoarthritis. Cochrane Database Syst Rev 2025; 2:CD015865. [PMID: 39918064 PMCID: PMC11803711 DOI: 10.1002/14651858.cd015865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2025]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of radiofrequency treatment of the genicular nerves in people with chronic knee pain due to knee osteoarthritis.
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Affiliation(s)
- Amy Belba
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Multidisciplinary Pain Center, Hospital Oost-limburg, Genk, Belgium
| | - Thibaut Vanneste
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Multidisciplinary Pain Center, Hospital Oost-limburg, Genk, Belgium
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Luc E Vanlinthout
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jan Kallewaard
- Department of Anesthesiology, Rijnstate Hospital, Arnhem, Netherlands
- Anesthesiology, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Sander Mj Van Kuijk
- Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Merel Kimman
- Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Pieter Emans
- Department of Orthopedic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Koen Van Boxem
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Multidisciplinary Pain Center, Hospital Oost-limburg, Genk, Belgium
| | | | - Kristof Thevissen
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Rheumatology, Hospital Oost-Limburg, Genk, Belgium
| | - Jan Van Zundert
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Multidisciplinary Pain Center, Hospital Oost-limburg, Genk, Belgium
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Patrik Vankrunkelsven
- Belgian Centre for Evidence-Based Medicine - Cochrane Belgium, Leuven, Belgium
- Academisch Centrum voor Huisartsgeneeskunde, Catholic University of Leuven, Leuven, Belgium
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Carrillo-Norte JA, Gervasini-Rodríguez G, Santiago-Triviño MÁ, García-López V, Guerrero-Bonmatty R. Oral administration of hydrolyzed collagen alleviates pain and enhances functionality in knee osteoarthritis: Results from a randomized, double-blind, placebo-controlled study. Contemp Clin Trials Commun 2025; 43:101424. [PMID: 39839727 PMCID: PMC11745964 DOI: 10.1016/j.conctc.2024.101424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 12/12/2024] [Accepted: 12/29/2024] [Indexed: 01/23/2025] Open
Abstract
Osteoarthritis (OA) is a major source of chronic pain and disability, representing a significant global health concern that affects 10-15 % of individuals aged over 60, with a higher prevalence among females than males. This investigation aimed to evaluate the impact of a dietary supplement containing collagen peptides (MW 1-3 kDa) on knee OA symptoms and inflammatory biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Adults aged 30-81 years (50 % female) with grade II or III OA and a minimum pain score of 40 on the 0 to 100 visual analogue scale (VAS) were enrolled. Participants were randomly assigned to receive either 10 g of the test product (verum group) or placebo and were assessed at baseline (T0, pre-treatment) and after a six-month follow-up period (T6). Baseline characteristics were comparable between groups. At T6, the verum group exhibited significant reductions in VAS pain scores, Lequesne algofunctional index (LAI) scores, CRP levels (mg/L), and ESR (mm/h) compared to placebo (p < 0.001). No adverse effects were reported during the study, and the supplement demonstrated good tolerability and yielded satisfactory safety and acceptability. These findings suggest that the dietary supplement may serve as a complement to drug therapy for knee OA by alleviating osteoarticular pain, improving locomotor function and potentially reducing reliance on analgesic and anti-inflammatory medications. This study provides valuable insights into the efficacy and safety of collagen peptides in managing knee OA symptoms.
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Affiliation(s)
- Juan Antonio Carrillo-Norte
- Department of Medical and Surgical Therapeutics, Division of Clinical Pharmacology, School of Medicine, University of Extremadura, Badajoz, Spain
| | - Guillermo Gervasini-Rodríguez
- Department of Medical and Surgical Therapeutics, Division of Clinical Pharmacology, School of Medicine, University of Extremadura, Badajoz, Spain
| | | | - Virginio García-López
- Department of Medical and Surgical Therapeutics, Division of Clinical Pharmacology, School of Medicine, University of Extremadura, Badajoz, Spain
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Naber WJ, Scribner D, Kalpakjian CZ, Bakshi R. Association Between Corticosteroid Dose and Pain Reduction After Sacroiliac Joint Injections. Am J Phys Med Rehabil 2025; 104:152-154. [PMID: 38917434 DOI: 10.1097/phm.0000000000002558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVE Sacroiliac joint-mediated back pain has proven therapeutic benefit from fluoroscopically guided sacroiliac joint corticosteroid injections. We examined corticosteroid dose and pain relief after fluoroscopically guided sacroiliac joint injections to better understand their relationship. DESIGN This is a retrospective observational cohort analysis of electronic health record data on 661 patients who received unilateral fluoroscopically guided sacroiliac joint intraarticular corticosteroid injection with 40 mg versus 80 mg of methylprednisolone from 2012 and 2019. Patients were injected by fellowship trained proceduralists after diagnosis by board-certified physiatrists in an academic physiatry practice. Absolute change in pain scores (postprocedure and first follow-up) was modeled using linear regression of methylprednisolone dosage (40 mg vs. 80 mg) controlling for age, sex, body mass index, baseline pain scores, and follow-up time. RESULTS Linear regression indicated that dosage of methylprednisolone, age, and body mass index were not statistically significantly associated with change in pain scores. Sex approached significance ( P = 0.0501) indicating that females may have a lower degree of pain resolution than males. CONCLUSIONS Practitioners should consider corticosteroid dose when performing these beneficial procedures. This could reduce cost and potential side effects associated with larger doses, while still providing therapeutic benefit. This pilot study can guide future research and dosing guidelines for fluoroscopic spine injections.
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Affiliation(s)
- William J Naber
- From the Department of Physical Medicine and Rehabilitation, University of Michigan Health, Ann Arbor, Michigan (WJN, DS, CZK, RB)
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Shi Y, Lu M, He F, Chen J, Zheng C, Lu L. Association Between Homocysteine and All-Cause Mortality Among Osteoarthritis Patients: A Cohort Study from the NHANES Database. Horm Metab Res 2025; 57:134-143. [PMID: 39662882 DOI: 10.1055/a-2460-7718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2024]
Abstract
This study explored the association between serum Hcy level and the all-cause mortality among osteoarthritis (OA) patients. This cohort study included patients diagnosed as OA from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Abbott Homocysteine assay, a fully automated fluorescence polarization immunoassay (FPIA) method, was used to measure the level of serum Hcy. Covariates included sociodemographic information, lifestyles, history of diseases and medications were extracted from the database. The weighted univariate, multivariate Cox proportional hazard models and restricted cubic splines (RCS) were utilized to explore the association between Hcy level and all-cause mortality in OA patients, with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses based on different age, gender, duration of OA, complications and C-reactive protein (CRP) were further assessed by this association. Totally 1384 OA patients were included in this study, of which 817 (59.03%) died by 31 December 2019. After adjusting all covariates, high Hcy level was associated with the high all-cause mortality among OA patients (HR=1.31, 95%CI: 1.02-1.67), especially in females (HR=1.43, 95%CI: 1.07-1.91), aged >60 years (HR=1.49, 95%CI: 1.14-1.94), duration of OA >10 years (HR=1.40, 95%CI: 1.01-1.95), with the history of hypertension (HR=1.37, 95%CI: 1.03-1.80), without the history of diabetes (HR=1.36, 95%CI: 1.01-1.82) or CRP >0.29 mg/l (HR=1.51, 95%CI: 1.04-2.19). High serum Hcy level was associated with high risk of all-cause mortality in OA patients. Our results suggest that serum Hcy is a promising biomarker for the prognosis of OA patients.
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Affiliation(s)
- Yu Shi
- Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Minan Lu
- Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Feng He
- Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Jinzhong Chen
- Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Chuanchuan Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Lu Lu
- Department of Orthopedic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
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Kim YI, Ryu JS, Kim JK, Oh BH, Shin YH. Quantitative Bone SPECT/CT Parameters Could Predict the Success of the Conservative Treatment for Symptomatic Basal Joint Arthritis of the Thumb. Clin Nucl Med 2025; 50:150-155. [PMID: 39601062 DOI: 10.1097/rlu.0000000000005576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
PURPOSE The aim of this study was to evaluate the role of quantitatively assessed bone SPECT/CT parameters for predicting the success of conservative treatment for symptomatic basal joint arthritis of the thumb. PATIENTS AND METHODS Seventy-eight patients (128 hands) with symptomatic basal joint arthritis of the thumb who underwent bone SPECT/CT scans within 4 weeks after their initial visit and completed conservative treatment for more than 6 months between April 2019 and April 2023 were retrospectively enrolled. PRWHE (patient-rated wrist/hand evaluation) was evaluated in all patients before and after the treatment. The SUV max from bone SPECT/CT was measured in the 4 peritrapezial joints, and the highest uptake was used for analysis. RESULTS On the basis of the minimal clinically important difference in PRWHE scores, 64 hands (50.0% of 128 hands) were classified as the treatment success group and 64 hands (50.0% of 128 hands) were failure group. In multivariate logistic regression analysis, only high SUV max (odds ratio, 1.097; 95% confidence interval, 1.027-1.172; P = 0.006) was a factor significantly associated with the success of conservative treatment. In receiver operating characteristics curve analysis, the area under the curve of SUV max was 0.649 (95% confidence interval, 0.554-0.744; P = 0.002). As a prognostic parameter for the success of conservative treatment, SUV max showed a sensitivity of 56.3% and specificity of 70.3% with a cutoff of 9.52. CONCLUSIONS High initial SUV max on bone SPECT/CT was significantly associated with the success of conservative treatment for symptomatic basal joint arthritis of the thumb.
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Affiliation(s)
- Yong-Il Kim
- From the Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin-Sook Ryu
- From the Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Kwang Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byung Hun Oh
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Ho Shin
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Xu H, Qiu Y, Wang Y, Song K, Guo X, Wang L, Zhang Y. Effect of Mind Mapping Combined With Behavior Rating Scale on Medical Compliance Behavior of Atrial Fibrillation Patients Underwent Radiofrequency Ablation. Brain Behav 2025; 15:e70332. [PMID: 39935219 DOI: 10.1002/brb3.70332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 01/05/2025] [Accepted: 01/17/2025] [Indexed: 02/13/2025] Open
Abstract
BACKGROUND Atrial fibrillation (AF) patients undergoing radiofrequency ablation require diligent postoperative care for optimal outcomes. This study investigated the impact of combining mind mapping with behavior rating scales on medical compliance behavior in this population. METHODS A total of 108 AF patients post-radiofrequency ablation were randomly assigned to a control group (n = 54) or an intervention group (n = 54). Both groups received standard education, while the intervention group additionally received education using mind mapping and behavior rating scales. Compliance was assessed using a medical compliance behavior scale at baseline, discharge, and 1- to 3-month follow-ups. RESULTS The intervention group demonstrated significantly higher medication compliance rates at discharge (86.9% vs. 65.9%, p = 0.027), 1 month (73.9% vs. 46.8%, p = 0.011), and 3 months (60.9% vs. 36.2%, p = 0.023) compared to the control group. They also scored higher in medical compliance behavior across all dimensions and had improved quality of life scores at 3 months post-discharge. CONCLUSIONS Integrating mind mapping with behavior rating scales into post-radiofrequency ablation care significantly enhances medication compliance, medical compliance behavior, and quality of life among AF patients.
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Affiliation(s)
- Huan Xu
- Fourth Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Yuncheng Qiu
- Operating Room, Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou, Hebei, China
| | - Yanshan Wang
- Fourth Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Kunqing Song
- Fourth Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xuemin Guo
- Fourth Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Li Wang
- Fourth Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Yonglou Zhang
- Fourth Department of Cardiovascular Medicine, Cangzhou Central Hospital, Cangzhou, Hebei, China
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Zhou Q, Chen J, Yu W, Cao D, Ye Y, Shen J. A critical overview of systematic reviews and meta-analyses of intra-articular injection of platelet rich plasma versus hyaluronic acid for knee osteoarthritis. Clin Rheumatol 2025; 44:547-571. [PMID: 39738804 DOI: 10.1007/s10067-024-07264-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 11/08/2024] [Accepted: 12/03/2024] [Indexed: 01/02/2025]
Abstract
This study is to summarize and evaluate the available evidence for the efficacy of platelet-rich plasma (PRP) and hyaluronic acid (HA) for knee osteoarthritis (KOA). Eight databases were searched from inception to September 15, 2024. All systematic reviews (SRs)/meta-analyses (MAs) treated with PRP versus HA for KOA were collected. Literature screening and data extraction were independently performed by two reviewers. The methodological quality, reporting quality, risk of bias, evidence quality, and evidence overlap rate of the included studies were evaluated by using AMSTAR 2, PRISMA 2020, ROBIS, GRADE, and GROOVE systems. Seventeen SRs were included. The results showed that the effectiveness and safety of PRP in the treatment of KOA may be superior to HA. The methodological quality of all 17 documents was extremely low quality. Sixteen of them had poor reporting quality, and there were relatively serious information deficiencies. All SRs were determined to be at high risk. Among the 221 outcome indicators, there were two medium-quality evidences, 30 low-quality evidences, and 189 extremely low-quality evidences. It was found that there was a very high overlap among the included articles. Currently, the quality of SRs on the treatment of KOA with PRP versus HA is relatively low. Future authors of SRs should adhere to quality assessment tool criteria, expand sample sizes to reduce overlap, and evaluate the quality of evidence for merged study results, in order to provide more reliable and rigorous evidence-based support for clinical practice.
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Affiliation(s)
- Qinxin Zhou
- Department of Orthopaedic Surgery, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, No. 641, Renmin Middle Road, Yuecheng District, Shaoxing City, 312000, Zhejiang Province, China.
| | - Jixin Chen
- Department of Orthopaedic Surgery, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, No. 641, Renmin Middle Road, Yuecheng District, Shaoxing City, 312000, Zhejiang Province, China
| | - Weijie Yu
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China
| | - Dongdong Cao
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China
| | - Yuntian Ye
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China
| | - Jianzeng Shen
- Department of Orthopaedic Surgery, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, No. 641, Renmin Middle Road, Yuecheng District, Shaoxing City, 312000, Zhejiang Province, China.
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13
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Basu N. The quest for targetable pain mechanisms in 2024. Nat Rev Rheumatol 2025; 21:69-70. [PMID: 39587302 DOI: 10.1038/s41584-024-01195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Affiliation(s)
- Neil Basu
- School of Infection and Immunity, University of Glasgow, Glasgow, UK.
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14
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Peng X, Chen X, Zhang Y, Tian Z, Wang M, Chen Z. Advances in the pathology and treatment of osteoarthritis. J Adv Res 2025:S2090-1232(25)00072-4. [PMID: 39889821 DOI: 10.1016/j.jare.2025.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 01/27/2025] [Accepted: 01/27/2025] [Indexed: 02/03/2025] Open
Abstract
BACKGROUND Osteoarthritis (OA), a widespread degenerative joint disease, predominantly affects individuals from middle age onwards, exhibiting non-inflammatory characteristics. OA leads to the gradual deterioration of articular cartilage and subchondral bone, causing pain and reduced mobility. The risk of OA increases with age, making it a critical health concern for seniors. Despite significant research efforts and various therapeutic approaches, the precise causes of OA remain unclear. AIM OF REVIEW This paper provides a thorough examination of OA characteristics, pathogenic mechanisms at various levels, and personalized treatment strategies for different OA stages. The review aims to enhance understanding of disease mechanisms and establish a theoretical framework for developing more effective therapeutic interventions. KEY SCIENTIFIC CONCEPTS OF REVIEW This review systematically examines OA through multiple perspectives, integrating current knowledge of clinical presentation, pathological mechanisms, and associated signaling pathways. It assesses diagnostic methods and reviews both pharmacological and surgical treatments for OA, as well as emerging tissue engineering approaches to manage the disease. While therapeutic strategies such as exercise, anti-inflammatory drugs, and surgical interventions are employed to manage symptoms and modify joint structure, none have been able to effectively halt OA's advancement or achieve long-lasting symptom relief. Tissue engineering strategies, such as cell-seeded scaffolds, supportive matrices, and growth factor delivery, have emerged as promising approaches for cartilage repair and OA treatment. To combat the debilitating effects of OA, it is crucial to investigate the molecular basis of its pathogenesis and seek out innovative therapeutic targets for more potent preventive and treatment strategies.
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Affiliation(s)
- Xueliang Peng
- Provincial Key Laboratory of Biotechnology of Shaanxi, Key Laboratory of Resource Biology and Modern Biotechnology in Western China, Faculty of Life Science, Northwest University, 229 North Taibai Road, Xi'an, Shaanxi Province 710069, China
| | - Xuanning Chen
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200215, China
| | - Yifan Zhang
- Provincial Key Laboratory of Biotechnology of Shaanxi, Key Laboratory of Resource Biology and Modern Biotechnology in Western China, Faculty of Life Science, Northwest University, 229 North Taibai Road, Xi'an, Shaanxi Province 710069, China
| | - Zhichao Tian
- Provincial Key Laboratory of Biotechnology of Shaanxi, Key Laboratory of Resource Biology and Modern Biotechnology in Western China, Faculty of Life Science, Northwest University, 229 North Taibai Road, Xi'an, Shaanxi Province 710069, China
| | - Meihua Wang
- Provincial Key Laboratory of Biotechnology of Shaanxi, Key Laboratory of Resource Biology and Modern Biotechnology in Western China, Faculty of Life Science, Northwest University, 229 North Taibai Road, Xi'an, Shaanxi Province 710069, China
| | - Zhuoyue Chen
- Provincial Key Laboratory of Biotechnology of Shaanxi, Key Laboratory of Resource Biology and Modern Biotechnology in Western China, Faculty of Life Science, Northwest University, 229 North Taibai Road, Xi'an, Shaanxi Province 710069, China.
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Chen Y, Lin J, Lin J, Gao T, Cai Q, Zhang C, Zhu H, Shen L, Wang Q. Comparison of the effectiveness of intra-infrapatellar fat pad and intra-articular glucocorticoid injection in knee osteoarthritis patients with Hoffa's synovitis: protocol for a multicentre randomised controlled trial. BMJ Open 2025; 15:e087785. [PMID: 39880431 PMCID: PMC11781145 DOI: 10.1136/bmjopen-2024-087785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 12/30/2024] [Indexed: 01/31/2025] Open
Abstract
INTRODUCTION The infrapatellar fat pad and synovium are the sites of immune cell infiltration and the origin of proinflammation. Studies have shown that Hoffa's synovitis may be a sign of early-stage osteoarthritis (OA). However, there have been no effective interventions specifically for Hoffa's synovitis. METHODS AND ANALYSIS We will conduct a multicentre, multi-blind (participant, physician, outcome assessor and data analyst blinded) randomised controlled trial to compare the effectiveness of an intra-infrapatellar fat glucocorticoid versus an intra-articular injection for Hoffa's synovitis in patients with knee OA. We will recruit 236 knee OA patients with Hoffa's synovitis at outpatient clinics in three centres. We will randomly allocate them to two groups in a 1:1 ratio. One group will receive ultrasound-guided injection of 40 mg (1 mL) triamcinolone acetonide into the infrapatellar fat pad; the other group will receive ultrasound-guided injection of 40 mg (1 mL) triamcinolone acetonide into the knee joint cavity. All patients will be followed up at 2, 4, 8, 12 and 24 weeks after the injection. Primary outcomes are (1) Hoffa's synovitis improvement rate, measured with the MRI Osteoarthritis Knee Score system (superiority outcome) at 24 weeks and (2) pain intensity, measured with the Western Ontario and McMasters University Osteoarthritis Index (WOMAC) at 2 weeks post-injection. Secondary outcomes include Hoffa's synovitis score at 2 weeks post-injection, pain intensity with the numerical rating scale, WOMAC questionnaire score improvements (function, joint stiffness and total score), improvement rates in effusion synovitis at 2 and 24 weeks, articular cartilage thickness changes at 2 and 24 weeks, Intermittent and Constant Osteoarthritis Pain score, quality of life measured with the EuroQol-5D, OARSI-OMERACT response indicators, co-interventions and side effects at 2, 4, 8, 12 and 24 weeks. ETHICS AND DISSEMINATION Ethical approval has been granted by the Medical Ethics Committee of the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (2023-178). Written informed consent will be obtained from all patients prior to data collection. The findings of this research will be shared through presentations at academic conferences and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2400080474.
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Affiliation(s)
- Yiwei Chen
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junqing Lin
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiali Lin
- Shanghai Medical college, Fudan university, Shanghai, China
| | - Tao Gao
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianying Cai
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Changqing Zhang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyi Zhu
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Longxiang Shen
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiuke Wang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Nurmesa A, Zakiyah N, Insani WN. Clinical Presentations and Characteristics of NSAIDs Hypersensitivity in a Tertiary Care Hospital in Indonesia: A Case Series. Int Med Case Rep J 2025; 18:163-171. [PMID: 39881781 PMCID: PMC11776529 DOI: 10.2147/imcrj.s488796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 01/15/2025] [Indexed: 01/31/2025] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely administered in all age groups due to their effectiveness in reducing fever, relieving pain, and reducing inflammation. However, they have also been identified as the second most common cause of drug-induced hypersensitivity reactions, after beta-lactam antibiotics. Adverse reactions to NSAIDs can range from expected pharmacological side effects such as gastritis to severe allergies, including anaphylaxis. It is important to distinguish true hypersensitivity reactions from other side effects to ensure proper management and patient safety. Four patients aged 35-60 years were treated with NSAIDs for pain management and subsequently developed hypersensitivity reactions to NSAIDs such as ketorolac, ketoprofen, and diclofenac sodium in the type of allergic reactions such as NSAIDs-induced urticaria/angioedema (NIUA). This case series provides valuable insights into the clinical presentations and potential mechanisms of NSAID hypersensitivity in the documented cases in one of the hospitals in Indonesia. It highlights important areas for future investigation, including the need for larger, controlled studies to better understand incidence, risk factors, and generalizability to broader populations.
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Affiliation(s)
- Adi Nurmesa
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia
- Department of Pharmacy, Dr Rivai Abdullah Regional General Hospital, Banyuasin, 30961, Indonesia
| | - Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, 40132, Indonesia
| | - Widya Norma Insani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, 40132, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, 40132, Indonesia
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17
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Pei W, Xu L, Zhong H, Wang Z, Yao R, Zhang L, Yang J, Li J, Feng Y, Lin Q, Li D, Zhou X, Pei D, Guo Y, Ma L, Luo Y, Zuo S, Wang L, Yan R, Su Y. Clinical features of inflammatory arthritis in daily practice-China's perspective. Clin Rheumatol 2025:10.1007/s10067-024-07262-2. [PMID: 39853560 DOI: 10.1007/s10067-024-07262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 11/21/2024] [Accepted: 12/02/2024] [Indexed: 01/26/2025]
Abstract
OBJECTIVE This study aimed to analyze and compare the proportion of patients with different types of inflammatory arthritis and investigate the clinical characteristics, including symptoms and signs, medication choices, and disease activity, in the daily clinical practice of China. METHODS Patients with inflammatory arthritis were recruited from 16 Grade-A tertiary hospitals between August 2021 and April 2022. The medical profiles, encompassing sociodemographic characteristics, clinical and laboratory date, were collected. RESULTS This study included 2,693 patients with arthritis, with rheumatoid arthritis (RA) accounting for the highest proportion (50.50%). Significant differences were observed in terms of age, gender, body mass index (BMI), disease duration, smoking and family history among patients with different types of inflammatory arthritis. Physical activity and cold exposure were identified as the main predisposing factors for RA, psoriatic arthritis (PsA), osteoarthritis (OA), and ankylosing spondylitis (AS), while alcohol consumption was the most common inducing factor for gout. Hypertension and hyperlipidemia were the primary concomitant diseases in RA, OA, and AS, whereas hyperuricemia and hypertension were mainly associated with gout, psoriasis and diabetes were the most common comorbidities in PsA. Peripheral joints were predominantly affected in PsA, RA, OA, and gout, while axial joints were mainly affected in AS. Methotrexate and leflunomide were the main therapeutic drugs for RA, while biologics were commonly prescribed for PsA and AS. OA and gout patients mainly utilized nonsteroidal anti-inflammatory drugs (NSAIDs). CONCLUSION Patients with different types of inflammatory arthritis exhibited varying predisposing factors, joint inflammation, concomitant diseases, and medication choices, highlighting the importance of individualized approaches in the clinic. Key Points • 2,693 patients classified and diagnosed with inflammatory arthritis were recruited in this study from 16 Grade-A tertiary hospitals in China between August 2021 and April 2022. • This study analyzed and compared the proportion of patients with different types of arthritis in routine clinical practice in China. • Joint inflammation, comorbidities, and medication choices were assessed among patients with the most common types of arthritis in this study. • This study also provided some epidemiologically relevant information about inflammatory arthritis patients in China.
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Affiliation(s)
- Wenwen Pei
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Liling Xu
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Hua Zhong
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Ziye Wang
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Ranran Yao
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Lei Zhang
- Department of Rheumatology and Immunology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Yang
- Department of Rheumatology and Immunology, Mianyang Central Hospital, Mianyang, China
| | - Jingyang Li
- Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, China
| | - Yuan Feng
- Department of Rheumatology and Immunology, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Qi Lin
- Department of Rheumatism and Immunology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Dongsheng Li
- Department of Rheumatology, Ganzhou People's Hospital, Ganzhou, China
| | - Xinyao Zhou
- Division of Rheumatology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongxue Pei
- Department of Rheumatology, Jilin Hospital of Integrated Traditional Chinese and Western Medicine, Jilin, China
| | - Yanqiu Guo
- Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Li Ma
- Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China
| | - Yaping Luo
- Department of Rheumatology, Hebei Provincial Hospital of Traditional Chinese Medicine, Hebei, China
| | - Shufei Zuo
- Department of Rheumatology and Immunology, Xinxiang Central Hospital, Xinxiang, China
| | - Lin Wang
- Department of Rheumatology, Shaoyang Central Hospital, Shaoyang, China
| | - Rui Yan
- Department of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, China
| | - Yin Su
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China.
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China.
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Abat F, Torras J, Garcia A, Jordán E, Roby M, Yáñez R, De la Fuente C. Pain Decrement Using Radiofrequency Therapy After Knee Platelet-Rich Plasma Injections Within First 72 h in Active Populations with Patellar Chondropathy. J Clin Med 2025; 14:544. [PMID: 39860552 PMCID: PMC11765801 DOI: 10.3390/jcm14020544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Revised: 12/17/2024] [Accepted: 01/02/2025] [Indexed: 01/27/2025] Open
Abstract
Objective: To determine whether 448 kHz capacitive-resistive monopolar radiofrequency (CRMR) after platelet-rich-plasma (PRP) injections can further reduce pain sensation within the first 72 h in an active population with patellar chondropathy. Methods: One-hundred fifty-three active patients with patellar chondropathy grade II-III were followed for three days after PRP injections with and without CRMR under a control-placebo study. They were clinically evaluated for pain sensation using a visual analog scale ranging from zero (no pain sensation) to ten (highest pain sensation). Pain sensation was described using medians and analyzed through the Friedman and Conover test for within-group comparison (pre-intervention, and 24, 48, and 72 h post-intervention) and the Mann-Whitney test for between-group comparisons (Intervention vs. Placebo) with α = 5% and 1-β = 80%. Results: The placebo group showed statistical significance between pre-intervention and 24 h (Δ = -2.0 pts, p < 0.001), baseline and 48 h (Δ = -2.0 pts, p < 0.001), baseline and 72 h (Δ = -3.0 pts, p < 0.001), 24 h and 48 h (Δ = 0.0 pts, p < 0.016), and 24 h and 72 h (Δ = -1.0 pts, p < 0.001). The radiofrequency group showed statistical significance between baseline and 24 h (Δ = -7.0 pts, p < 0.001), baseline and 48 h (Δ = -7.0 pts, p < 0.001), baseline and 72 h (Δ = -8.0 pts, p < 0.001), 24 h and 72 h (Δ = -1.0 pts, p < 0.001), and 48 h and 72 h (Δ = -1.0 pts, p < 0.001). The placebo and radiofrequency groups were significantly different at 24 h (Δ = 4.0 pts, p < 0.001), 48 h (Δ = 4.0 pts, p < 0.001), and 72 h (Δ = 4.0 pts, p < 0.001). Conclusions: CRMR therapy administered after knee intra-articular injections of PRP within the first 72 h in active populations with patellar chondropathy reduces pain sensation with a median difference of 8.0 pts compared to baseline and 4.0 pts compared to placebo group.
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Affiliation(s)
- Ferran Abat
- GRACIS Research Group (GRC 01604), Sports Orthopaedic Department, ReSport Clinic, Higher School of Health Sciences Tecnocampus, Pompeu Fabra University, 08029 Barcelona, Spain
| | - Jordi Torras
- Physiotherapy Department, ReSport Clinic, Blanquerna School of Health Science, Universitat Ramon Llull, 08022 Barcelona, Spain; (J.T.); (A.G.); (E.J.)
| | - Alba Garcia
- Physiotherapy Department, ReSport Clinic, Blanquerna School of Health Science, Universitat Ramon Llull, 08022 Barcelona, Spain; (J.T.); (A.G.); (E.J.)
| | - Enrique Jordán
- Physiotherapy Department, ReSport Clinic, Blanquerna School of Health Science, Universitat Ramon Llull, 08022 Barcelona, Spain; (J.T.); (A.G.); (E.J.)
| | - Matías Roby
- Innovation Center, Clínica MEDS, Santiago 7550615, Chile;
- Knee Orthopedics Service, Clínica MEDS, Santiago 7550615, Chile;
| | - Roberto Yáñez
- Knee Orthopedics Service, Clínica MEDS, Santiago 7550615, Chile;
| | - Carlos De la Fuente
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
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Shen G, Zhu L, Ying J, Shan S, Luo Z, Jiang D, Wu J, Zhu Y. Analysis of burden and equality of lower extremity peripheral artery disease in people aged 40 and above in the Belt and Road partner countries from 1990 to 2021. Zhejiang Da Xue Xue Bao Yi Xue Ban 2025:1-12. [PMID: 39815617 DOI: 10.3724/zdxbyxb-2024-0540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2025]
Abstract
OBJECTIVES To analyze the disease burden and inequalities of lower extremity peripheral artery disorders (LEPAD) among people aged 40 and above in the Belt and Road partner countries from 1990 to 2021. METHODS Data were retrieved from the Global Burden of Disease 2021 database. The age-standardized prevalence rates, mortality rates, and the annual rate of years lived with disability (YLDs) of LEPAD were analyzed. Trends were measured using the estimated annual percentage change (EAPC), and the slope index of inequality (SII) and concentration index were used to quantify the absolute and relative inequalities. RESULTS In 2021, the age-standardized prevalence and mortality rates of LEPAD were 3168.26/105 and 3.09/105, increasing by 4.30% and 19.31% compared to 1990, and YLDs rates decreased by 4.00%. Females had higher age-standardized prevalence and YLDs rates, while males had higher mortality rates. The EAPC for prevalence rates was slightly higher in males (0.22%) than in females (0.17%); while the EAPC of age-standardized mortality rate was 2.02% for females, compared to 1.45% for males. From 1990 to 2021, the age-standardized YLDs rates decreased from 16.23/105 to 15.58/105, with a faster decline in females (-0.12%) than in males (-0.06%). LEPAD prevalence varied across countries, with higher burdens in Europe and faster growth in Gulf states. Higher socio-demographic index countries had higher prevalence. Inequity improved, with the SII at 52.90/105 and concentration index at 0.038 in 2021. Gender disparities persisted, with concentration index rising to 0.058 in females and falling to -0.026 in males. CONCLUSIONS LEPAD prevalence and mortality among people aged 40 and above in the Belt and Road partner countries were risen, while YLDs rates were decreased from 1990 to 2021. Significant differences exist among peoples with different gender and countries, highlighting the need for enhanced screening, health education, and shared public health strategies across the Belt and Road partner countries.
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Affiliation(s)
- Guangdian Shen
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, International Health Institute of Zhejiang University, Yiwu 322000, Zhejiang Province, China.
| | - Longzhu Zhu
- School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Jiayao Ying
- School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Shiyi Shan
- School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Zeyu Luo
- School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Denan Jiang
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, International Health Institute of Zhejiang University, Yiwu 322000, Zhejiang Province, China
| | - Jing Wu
- School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Yuefeng Zhu
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, International Health Institute of Zhejiang University, Yiwu 322000, Zhejiang Province, China.
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
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Liu G, Wu J, Wang Y, Xu Y, Xu C, Fang G, Li X, Chen J. The Differential Expressions and Associations of Intracellular and Extracellular GRP78/Bip with Disease Activity and Progression in Rheumatoid Arthritis. Bioengineering (Basel) 2025; 12:58. [PMID: 39851332 PMCID: PMC11761566 DOI: 10.3390/bioengineering12010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Revised: 12/31/2024] [Accepted: 01/09/2025] [Indexed: 01/26/2025] Open
Abstract
GRP78/BiP, a stress-induced protein and autoantigen in rheumatoid arthritis (RA), exhibits different expressions in various biological fluids and tissues, including blood, synovial fluid (SF), and synovium, all of which are pertinent to the disease activity and progression of RA; however, there is a scarcity of data linking both intracellular and extracellular GRP78/Bip to disease activity and progression of RA. This study was undertaken to investigate the differential expression of GRP78/Bip in blood, SF, and synovium, and to determine their association with disease activity and progression of RA. Patients with RA, osteoarthritis (OA), and traumatic meniscal injury (TMI) without radiographic OA were consecutively recruited for the study. Among patients with RA, six different subgroups were established based on their disease activity and progression. Disease activity was measured using the DAS28 (Disease activity scores in 28 joints) criterion, while disease progression was evaluated using the Steinbrocker classification grade. The levels of GRP78/Bip, TNF-α, and IL-10 were significantly elevated in the serum, SF, and synovium of patients with RA when compared to both the control (CON, TMI Patients) and the inflammation control (iCON, OA Patients) groups (p < 0.05). In terms of disease activity status, as opposed to remission status in RA, the levels of GRP78/Bip, TNF-α, and IL-10 were all elevated in serum and synovium (p < 0.05). However, GRP78/Bip and IL-10 levels were found to be reduced in SF, while TNF-α levels remained elevated. With respect to disease progression in RA, GRP78/Bip levels exhibited a positive correlation with both the stage of RA and the levels of TNF-α and IL-10 in serum and synovium. Nonetheless, a negative correlation was observed between GRP78/Bip levels and the stage of RA in SF, while positive correlations with the levels of TNF-α and IL-10 persisted. The differential expression of GRP78/Bip in blood, SF, and synovium indicated that the potential role and function of GRP78/Bip might vary depending on its specific location within these biological fluids and tissues. The presence of intracellular and extracellular GRP78/Bip was associated with disease activity and progression of RA, suggesting the involvement of GRP78/Bip in the pathogenesis and development of this debilitating autoimmune disorder, as well as its potential as a biomarker for monitoring disease activity and progression of RA.
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Affiliation(s)
- Guoyin Liu
- Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing 211166, China; (G.L.); (Y.X.)
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jianping Wu
- Department of Obstetrics, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing 211166, China;
| | - Yongqiang Wang
- Department of Rehabilitation, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing 211166, China;
| | - Yuansheng Xu
- Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing 211166, China; (G.L.); (Y.X.)
| | - Chun Xu
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China;
| | - Guilin Fang
- Department of Rheumatology, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing 211166, China;
| | - Xin Li
- Department of Orthopedics, Central Military Commission Joint Logistics Support Force 904th Hospital, Wuxi 214044, China
| | - Jianmin Chen
- Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing 211166, China; (G.L.); (Y.X.)
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21
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Figueroa-Valdés AI, Luz-Crawford P, Herrera-Luna Y, Georges-Calderón N, García C, Tobar HE, Araya MJ, Matas J, Donoso-Meneses D, de la Fuente C, Cuenca J, Parra E, Lillo F, Varela C, Cádiz MI, Vernal R, Ortloff A, Nardocci G, Castañeda V, Adasme-Vidal C, Kunze-Küllmer M, Hidalgo Y, Espinoza F, Khoury M, Alcayaga-Miranda F. Clinical-grade extracellular vesicles derived from umbilical cord mesenchymal stromal cells: preclinical development and first-in-human intra-articular validation as therapeutics for knee osteoarthritis. J Nanobiotechnology 2025; 23:13. [PMID: 39806427 PMCID: PMC11730155 DOI: 10.1186/s12951-024-03088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 12/30/2024] [Indexed: 01/16/2025] Open
Abstract
Osteoarthritis (OA) is a joint disease characterized by articular cartilage degradation. Persistent low-grade inflammation defines OA pathogenesis, with crucial involvement of pro-inflammatory M1-like macrophages. While mesenchymal stromal cells (MSC) and their small extracellular vesicles (sEV) hold promise for OA treatment, achieving consistent clinical-grade sEV products remains a significant challenge. This study aims to develop fully characterized, reproducible, clinical-grade batches of sEV derived from umbilical cord (UC)-MSC for the treatment of OA while assessing its efficacy and safety. Initially, a standardized, research-grade manufacturing protocol was established to ensure consistent sEV production. UC-MSC-sEV characterization under non-cGMP conditions showed consistent miRNA and protein profiles, suggesting their potential for standardized manufacturing. In vitro studies evaluated the efficacy, safety, and potency of sEV; animal studies confirmed their effectiveness and safety. In vitro, UC-MSC-sEV polarized macrophages to an anti-inflammatory M2b-like phenotype, through STAT1 modulation, indicating their potential to create an anti-inflammatory environment in the affected joints. In silico studies confirmed sEV's immunosuppressive signature through miRNA and proteome analysis. In an OA mouse model, sEV injected intra-articularly (IA) induced hyaline cartilage regeneration, validated by histological and μCT analyses. The unique detection of sEV signals within the knee joint over time highlights its safety profile by confirming the retention of sEV in the joint. The product development of UC-MSC-sEV involved refining, standardizing, and validating processes in compliance with GMP standards. The initial assessment of the safety of the clinical-grade product via IA administration in a first-in-human study showed no adverse effects after a 12 month follow-up period. These results support the progress of this sEV-based therapy in an early-phase clinical trial, the details of which are presented and discussed in this work. This study provides data on using UC-MSC-sEV as local therapy for OA, highlighting their regenerative and anti-inflammatory properties and safety in preclinical and a proof-of-principle clinical application.
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Affiliation(s)
- Aliosha I Figueroa-Valdés
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Patricia Luz-Crawford
- Laboratorio de Inmunología Celular y Molecular, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Yeimi Herrera-Luna
- Laboratorio de Inmunología Celular y Molecular, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Nicolás Georges-Calderón
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Programa de Doctorado en Biomedicina, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Cynthia García
- Laboratorio de Inmunología Celular y Molecular, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Programa de Doctorado en Biomedicina, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Hugo E Tobar
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - María Jesús Araya
- Laboratorio de Inmunología Celular y Molecular, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Programa de Doctorado en Biomedicina, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - José Matas
- Centro de Terapia Celular, Clínica Universidad de los Andes, Santiago, Chile
- Departmento de Cirugía Ortopédica, Clínica Universidad de los Andes, Santiago, Chile
| | - Darío Donoso-Meneses
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Programa de Doctorado en Biomedicina, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | | | - Jimena Cuenca
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
- Cells for Cells, Santiago, Chile
| | - Eliseo Parra
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile
| | - Fernando Lillo
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile
| | - Cristóbal Varela
- Departmento de Radiología, Clínica Universidad de los Andes, Santiago, Chile
| | - María Ignacia Cádiz
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile
- Cells for Cells, Santiago, Chile
| | - Rolando Vernal
- Laboratorio de Biología Periodontal, Facultad de Odontología, Universidad de Chile, Santiago, Chile
| | - Alexander Ortloff
- Departamento de Ciencias Veterinarias y Salud Pública, Facultad de Recursos Naturales, Universidad Católica de Temuco, Temuco, Chile
| | - Gino Nardocci
- Laboratorio de Biología Molecular y Bioinformática, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
- Escuela de Medicina, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - Verónica Castañeda
- Laboratorio de Biología Molecular y Bioinformática, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- Programa de Doctorado en Biomedicina, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Catalina Adasme-Vidal
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Maximiliano Kunze-Küllmer
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile
- Cells for Cells, Santiago, Chile
- EVast Bio, Miami, FL, USA
| | - Yessia Hidalgo
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
| | - Francisco Espinoza
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
- Centro de Terapia Celular, Clínica Universidad de los Andes, Santiago, Chile
- Departmento de Reumatología, Clínica Universidad de los Andes, Santiago, Chile
| | - Maroun Khoury
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile.
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile.
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile.
- Cells for Cells, Santiago, Chile.
- EVast Bio, Miami, FL, USA.
| | - Francisca Alcayaga-Miranda
- Laboratorio de Medicina Nano-Regenerativa, Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile.
- Consorcio REGENERO, Chilean Consortium for Regenerative Medicine, Santiago, Chile.
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile.
- Cells for Cells, Santiago, Chile.
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22
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Lee D, Kim WH, Ha JH, Kim H, Kim J, Shin DW. Current Practices and Perceived Effectiveness of Clinicians Regarding Polynucleotide Injection for Knee Osteoarthritis: A Survey-Based Evaluation. Healthcare (Basel) 2025; 13:113. [PMID: 39857140 PMCID: PMC11764884 DOI: 10.3390/healthcare13020113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Revised: 01/03/2025] [Accepted: 01/07/2025] [Indexed: 01/27/2025] Open
Abstract
Aims: Intra-articular (IA) injection therapy, particularly IA hyaluronic acid (HA), is a common treatment for knee osteoarthritis, but it does have limitations. The injection of IA polynucleotide (PN) has emerged as an alternative, potentially offering superior clinical outcomes. This study investigates current practice patterns and the perceived effectiveness of PN among clinicians for treating knee osteoarthritis in the Republic of Korea. Methods: Based on a survey conducted among clinicians who use PN in clinical practice, we explored the current practices and assessed the perceived effectiveness of IA PN in treating knee osteoarthritis. Results: A total of 265 clinicians who used IA PN for knee osteoarthritis participated in the survey. Most clinicians (73.3%) used PN therapy for the treatment of chronic pain, with varying administration frequencies. In addition, 25.8% of clinicians used PN for the treatment of acute flare-ups. In cases of knee effusion, 55.5% of clinicians removed the effusion prior to administering PN. Clinicians rated PN as more effective than HA for both chronic pain and acute flare-ups, with higher scores for cushioning, anti-inflammatory effects, and delaying joint degeneration. The clinicians stated that patients expressed a higher satisfaction with IA PN compared with IA HA, noting improvement in joint smoothness, noise reduction, pain relief, and a reduction in heat sensation and swelling. Conclusions: The results of the present study highlight the extensive use and perceived benefits among clinicians of IA PN for knee osteoarthritis in the Republic of Korea. Further research is warranted to explore the effectiveness of PN in acute flare-ups and to validate these findings in broader populations.
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Affiliation(s)
- Dagyeong Lee
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea
| | - Wan-ho Kim
- Kim Wanho Orthopedic Clinic, Seoul 07702, Republic of Korea;
| | - Jeong Han Ha
- Ha Jeong Han Orthopedic Clinic, Seoul 07055, Republic of Korea;
| | - Hyungjin Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Junbae Kim
- Seoul NOW Hospital, Anyang 14058, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine, Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
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23
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Kjeken I, Bordvik DH, Osteras N, Haugen IK, Aasness Fjeldstad K, Skaalvik I, Kloppenburg M, Kroon FPB, Tveter AT, Smedslund G. Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review. RMD Open 2025; 11:e004963. [PMID: 39793978 PMCID: PMC11749855 DOI: 10.1136/rmdopen-2024-004963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 11/22/2024] [Indexed: 01/13/2025] Open
Abstract
BACKGROUND We aimed to update the 2018 systematic literature review on the efficacy and safety of treatments for hand osteoarthritis (OA), which was based on 126 studies. METHODS We performed a systematic literature search on randomised controlled trials from June 2017 up to 31 December 2023. Risk of bias was assessed using the RoB2 tool. Meta-analyses of previous and new studies regarding the efficacy for pain, function, grip strength and OMERACT/OARSI responders were performed. Certainty of evidence was judged using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool. RESULTS Sixty-five new studies were included. For non-pharmacological interventions, there was low-certainty evidence for a small long-term effect of hand exercises and a moderate long-term effect of thumb orthoses for pain, and moderate-certainty evidence that assistive devices had a moderate long-term effect on function. Concerning pharmacological interventions, there was low-certainty evidence for a moderate short-term effect of oral non-steroidal anti-inflammatory drugs (NSAIDs) on pain, high- and moderate-certainty evidence for a small short-term effect of topical NSAIDs and oral glucocorticoids on function, respectively, and low-certainty evidence that oral glucocorticoids had a small short-term effect on function. Further, there was low-certainty evidence that methotrexate had a small long-term effect on pain. The heterogeneity of studies did not allow for any meta-analyses on surgery. CONCLUSION The results largely support current treatment recommendations. However, there is a lack of interventions that efficiently improve grip strength, and the evidence for most current treatments is still limited. To better understand action mechanism of different treatments, future trials should include hand OA subtyping and be powered for subgroup analyses.
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Affiliation(s)
- Ingvild Kjeken
- Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | | | - Nina Osteras
- Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Kristine Aasness Fjeldstad
- Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Skaalvik
- Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway
| | - Margreet Kloppenburg
- Department of Rheumatology, Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Féline P B Kroon
- Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Anne Therese Tveter
- Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Geir Smedslund
- Health Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, Norway
- HTA Medical Devices, Norwegian Medical Products Agency, Oslo, Norway
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24
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Kloppenburg M, Namane M, Cicuttini F. Osteoarthritis. Lancet 2025; 405:71-85. [PMID: 39755397 DOI: 10.1016/s0140-6736(24)02322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 09/19/2024] [Accepted: 10/18/2024] [Indexed: 01/06/2025]
Abstract
Osteoarthritis is a heterogeneous disorder that is increasingly prevalent largely due to aging and obesity, resulting in a major disease burden worldwide. Knowledge about the underlying aetiology has improved, with increased understanding of the role of genetic factors, the microbiome, and existence of different pain mechanisms. However, this knowledge has not yet been translated into new treatment options. New evidence has questioned the efficacy of recommended treatments, such as therapeutic exercise programmes and the focus on weight loss, but managing obesity and maintaining activity remain important for the prevention and management of osteoarthritis. Approaches should consider individual and cultural preferences and resource availability to increase patient and community engagement, and optimise outcomes worldwide. Most of the focus has been on established osteoarthritis where management is primarily directed at relieving symptoms. The search for the much needed effective treatments that improve both symptoms and structure, often referred to as disease-modifying osteoarthritic drugs, is ongoing. Promising data indicate that targeting inflammation is effective in hand osteoarthritis.
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Affiliation(s)
- Margreet Kloppenburg
- Department of Rheumatology, Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.
| | - Mosedi Namane
- Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Flavia Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Department of Rheumatology, Alfred Hospital, Melbourne, VIC, Australia
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25
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Tang L, Wang MM, Wang HX, He XY, Jiang YS. mHealth-based exercise vs. traditional exercise on pain, functional disability, and quality of life in patients with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Front Physiol 2025; 15:1511199. [PMID: 39830024 PMCID: PMC11739084 DOI: 10.3389/fphys.2024.1511199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 12/12/2024] [Indexed: 01/22/2025] Open
Abstract
Objective This study aims to compare the efficacy of mHealth-based exercise interventions with traditional exercise in improving pain intensity, functional disability, and quality of life in patients suffering from knee osteoarthritis (OA). Method Randomized controlled trials (RCTs) published from their inception to 23 August 2024 were searched in Cochrane, Embase, Medline, Web of Science. Reviewer pairs independently extracted data and evaluated bias using the Cochrane Risk of Bias tool. Results Eleven studies, with a total of 800 participants with a mean age of 55.51 ± 6.88 years, were identified. All RCTs were performed from 2013 to 2024. There was no statistically significant difference between mHealth-supported exercise compared with the traditional exercise without mHealth in terms of pain reduction (standard mean differences [SMD] = -0.35; 95%CI: -0.74 to 0.04, P = 0.08), functional disability (SMD = -0.5; 95%CI: -0.1 to 0.01; P = 0.05), and quality of life (SMD = 0.11; 95%CI: -0.26 to 0.48; P = 0.56). However, a statistically significant difference was found between mHealth-supported exercise compared with unsupervised traditional exercise in terms of pain (SMD = -1.03; 95%CI: -1.49 to -0.57; P < 0.001) and functional disability (SMD = -0.89; 95%CI: -1.71 to -0.06; P = 0.04). Conclusion mHealth-based exercise was found to be more effective than unsupervised conventional exercise in promoting pain relief and enhancing functional disability in patients with OA. When face-to-face exercise intervention is not feasible, mHealth-based exercise should be considered a viable option in the recovery process for knee OA. Given the significant heterogeneity observed in this study, it is important to exercise caution when extrapolating the results. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024610393.
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Affiliation(s)
- Liang Tang
- College of Physical Education and Arts Humanities, China University of Petroleum (Beijing), Beijing, China
| | - Meng-Ming Wang
- Law School, Case Western Reserve University, Cleveland, OH, United States
| | - He-Xia Wang
- College of Physical Education and Arts Humanities, China University of Petroleum (Beijing), Beijing, China
| | - Xiao-Ya He
- Sports and Medicine Integrative Innovation Center, Capital University of Physical Education and Sports, Beijing, China
| | - Yue-Shuai Jiang
- College of Physical Education and Arts Humanities, China University of Petroleum (Beijing), Beijing, China
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26
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Genç AS, Yılmaz AK, Anıl B, Korkmaz Salkılıç E, Akdemir E, Sancaklı A, Mor A, Ermiş E, Baraz LS, Güzel N, Kehribar L. Effect of supplementation with type 1 and type 3 collagen peptide and type 2 hydrolyzed collagen on osteoarthritis-related pain, quality of life, and physical function: A double-blind, randomized, placebo-controlled study. Jt Dis Relat Surg 2025; 36:85-96. [PMID: 39719905 PMCID: PMC11734850 DOI: 10.52312/jdrs.2025.1965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 10/14/2024] [Indexed: 12/26/2024] Open
Abstract
OBJECTIVES The aim of this study was to assess the effect of Naturagen® 4 Joint product, containing type 1, 2, and 3 collagen, on pain associated with osteoarthritis (OA) and to evaluate its effects on quality of life and physical functioning. PATIENTS AND METHODS This double-blind, randomized, placebo-controlled clinical study included a total of 31 patients (8 males, 23 females; mean age: 53.5±9.1 years; range, 35 to 65 years) with Grade 2-3 OA according to the Kellgren-Lawrence (KL) classification system between June 2023 and November 2023. The patients were divided into two groups: a collagen group (n=16) and a placebo group (n=15). The Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS-PS), Oxford Knee Score (OKS), Tampa Scale for Kinesiophobia (TSK), Short Form Health Survey (SF-12), Foot Function Index (FFI), Timed Up and Go (TUG), 6-Min Walking Test (6MWT), Five Repetition Sit to Stand Test (5STS), Stair Climbing Test (SCT), and Berg Balance Scale (BBS) were used. All tests were performed before and after eight weeks of collagen supplementation. RESULTS Eight weeks of collagen supplementation yielded notable enhancements across all osteoarthritis-related pain and quality of life scales evaluated, including VAS, WOMAC, KOOS-PS, OKS, TSK, SF-12, and FFI scores (p<0.05). In functional evaluations, there were significant positive effects of collagen use in BBS and 6MWT results (p<0.05). In TUG, 5STS, and SCT tests, no significant difference was found between the groups (p>0.05). CONCLUSION Our study results suggest that the eight-week collagen-based supplement exerts a favorable effect on pain and quality of life levels, as well as some functional test results.
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Affiliation(s)
| | | | | | | | | | | | | | - Egemen Ermiş
- Ondokuz Mayıs Üniversitesi, Yaşar Doğu Spor Bilimleri Fakültesi, 55280 Atakum, Samsun, Türkiye.
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Vanneste T, Belba A, Oei GTML, Emans P, Fonkoue L, Kallewaard JW, Kapural L, Peng P, Sommer M, Vanneste B, Cohen SP, Van Zundert J. 9. Chronic knee pain. Pain Pract 2025; 25:e13408. [PMID: 39219017 PMCID: PMC11680467 DOI: 10.1111/papr.13408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Chronic knee pain is defined as pain that persists or recurs over 3 months. The most common is degenerative osteoarthritis (OA). This review represents a comprehensive description of the pathology, diagnosis, and treatment of OA of the knee. METHODS The literature on the diagnosis and treatment of chronic knee pain was retrieved and summarized. A modified Delphi approach was used to formulate recommendations on interventional treatments. RESULTS Patients with knee OA commonly present with insidious, chronic knee pain that gradually worsens. Pain caused by knee OA is predominantly nociceptive pain, with occasional nociplastic and infrequent neuropathic characteristics occurring in a diseased knee. A standard musculoskeletal and neurological examination is required for the diagnosis of knee OA. Although typical clinical OA findings are sufficient for diagnosis, medical imaging may be performed to improve specificity. The differential diagnosis should exclude other causes of knee pain including bone and joint disorders such as rheumatoid arthritis, spondylo- and other arthropathies, and infections. When conservative treatment fails, intra-articular injections of corticosteroids and radiofrequency (conventional and cooled) of the genicular nerves have been shown to be effective. Hyaluronic acid infiltrations are conditionally recommended. Platelet-rich plasma infiltrations, chemical ablation of genicular nerves, and neurostimulation have, at the moment, not enough evidence and can be considered in a study setting. The decision to perform joint-preserving and joint-replacement options should be made multidisciplinary. CONCLUSIONS When conservative measures fail to provide satisfactory pain relief, a multidisciplinary approach is recommended including psychological therapy, integrative treatments, and procedural options such as intra-articular injections, radiofrequency ablation, and surgery.
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Affiliation(s)
- Thibaut Vanneste
- Department of Anesthesiology, Intensive Care MedicineEmergency Medicine and Multidisciplinary Pain CenterGenkBelgium
- Department of Anesthesiology and Pain MedicineMaastricht University Medical Center+MaastrichtThe Netherlands
- MHeNs, Mental Health and Neuroscience Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Amy Belba
- Department of Anesthesiology, Intensive Care MedicineEmergency Medicine and Multidisciplinary Pain CenterGenkBelgium
- Department of Anesthesiology and Pain MedicineMaastricht University Medical Center+MaastrichtThe Netherlands
- Faculty of Medicine and Life SciencesHasselt UniversityHasseltBelgium
| | - Gezina T. M. L. Oei
- Department of Anesthesiology and Pain MedicineDijklander ZiekenhuisHoornThe Netherlands
- Department of AnesthesiologyAmsterdam UMC Locatie AMCAmsterdamThe Netherlands
| | - Pieter Emans
- Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary CareMaastricht University Medical Center+MaastrichtThe Netherlands
| | - Loic Fonkoue
- Department of Morphology, Experimental and Clinical Research InstituteUniversité Catholique de LouvainBrusselsBelgium
- Neuro‐Musculo‐Skeletal Department, Experimental and Clinical Research InstituteUniversite Catholique de LouvainBrusselsBelgium
| | - Jan Willem Kallewaard
- Department of AnesthesiologyAmsterdam UMC Locatie AMCAmsterdamThe Netherlands
- Department of AnesthesiologyRijnstate HospitalArnhemThe Netherlands
| | | | - Philip Peng
- Department of Anesthesia and Pain Medicine, Toronto Western HospitalUniversity of TorontoTorontoOntarioCanada
| | - Michael Sommer
- Department of Anesthesiology and Pain MedicineMaastricht University Medical Center+MaastrichtThe Netherlands
- MHeNs, Mental Health and Neuroscience Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Bert Vanneste
- Department of Anesthesia and Pain MedicineAZ GroeningeKortrijkBelgium
| | - Steven P. Cohen
- Anesthesiology, Neurology, Physical Medicine & Rehabilitation, Psychiatry and Neurological SurgeryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Anesthesiology and Physical Medicine & Rehabilitation, Walter Reed National Military Medical CenterUniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Jan Van Zundert
- Department of Anesthesiology, Intensive Care MedicineEmergency Medicine and Multidisciplinary Pain CenterGenkBelgium
- Department of Anesthesiology and Pain MedicineMaastricht University Medical Center+MaastrichtThe Netherlands
- MHeNs, Mental Health and Neuroscience Research InstituteMaastricht UniversityMaastrichtThe Netherlands
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Yoo M, Jang CW. Presentation suitability and readability of ChatGPT's medical responses to patient questions about on knee osteoarthritis. Health Informatics J 2025; 31:14604582251315587. [PMID: 39828887 DOI: 10.1177/14604582251315587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2025]
Abstract
Objective: This study aimed to evaluate the presentation suitability and readability of ChatGPT's responses to common patient questions, as well as its potential to enhance readability. Methods: We initially analyzed 30 ChatGPT responses related to knee osteoarthritis (OA) on March 20, 2023, using readability and presentation suitability metrics. Subsequently, we assessed the impact of detailed and simplified instructions provided to ChatGPT for same responses, focusing on readability improvement. Results: The readability scores for responses related to knee OA significantly exceeded the recommended sixth-grade reading level (p < .001). While the presentation of information was rated as "adequate," the content lacked high-quality, reliable details. After the intervention, readability improved slightly for responses related to knee OA; however, there was no significant difference in readability between the groups receiving detailed versus simplified instructions. Conclusions: Although ChatGPT provides informative responses, they are often difficult to read and lack sufficient quality. Current capabilities do not effectively simplify medical information for the general public. Technological advancements are needed to improve user-friendliness and practical utility.
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Affiliation(s)
- Myungeun Yoo
- Department of Rehabilitation Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Chan Woong Jang
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
- Command Center, Doheon Institute for Digital Innovation in Medicine, Hallym University Medical Center, Anyang, Republic of Korea
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Dell'Isola A, Lohmander SL, Kiadaliri A. Response to the comment on 'The coexistence of diabetes, hypertension and obesity is associated with worse pain outcomes following exercise for osteoarthritis: A cohort study on 80 893 patients'. Osteoarthritis Cartilage 2025; 33:186-187. [PMID: 39547598 DOI: 10.1016/j.joca.2024.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 11/07/2024] [Indexed: 11/17/2024]
Affiliation(s)
- Andrea Dell'Isola
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Stefan L Lohmander
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ali Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden
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Hidayat R, Parlindungan F, Nisa JI, Mahendra AI, Indika MI, Efendi C. Efficacy of Curcuma longa in relieving pain symptoms of knee osteoarthritis patients: a systematic review and meta-analysis of clinical trials. JOURNAL OF RHEUMATIC DISEASES 2025; 32:17-29. [PMID: 39712249 PMCID: PMC11659657 DOI: 10.4078/jrd.2024.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 12/24/2024]
Abstract
Objective Osteoarthritis (OA), particularly knee OA, affects 24% of adults and is a significant cause of disability. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used but have many adverse effects. Antioxidant and anti-iflammatory properties of Curcuma longa might decrease pain thus improving joint function. Methods This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) on Curcuma longa efficacy for knee OA. We reported mean differences (MD) with 95% confidence interval (CI) for continuous outcomes and evaluated Visual Analog Scale (VAS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) total score over 4 to 6 weeks for treatment effects. Results Ten RCTs with 786 patients were included. Curcuma longa significantly improved VAS for pain than placebo (MD 18.25, 95% CI 7.79 to 28.72, p=0.0006). It was not inferior to NSAIDs in WOMAC total score improvement (MD -11.99, 95% CI -39.21 to 15.23, p=0.39). Both dosages (<1,000 and ≥1,000 mg/day) of Curcuma longa demonstrated similar improvement in VAS for pain compared to placebo (MD 27.02, 95% CI 1.45 to 52.60, p=0.04; MD 21.48, 95% CI 1.78 to 41.18, p=0.03). Conclusion Curcuma longa benefits knee OA pain and function, being more effective than placebo and comparable to NSAIDs. Despite positive results, limitation and heterogeneity of the studies necessitates further research to explore optimal dosages and administration methods of Curcuma longa as therapeutic option for knee OA.
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Affiliation(s)
- Rudy Hidayat
- Division of Rheumatology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Faisal Parlindungan
- Division of Rheumatology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Medical Staff Group of Internal Medicine, Universitas Indonesia Hospital, Depok City, Indonesia
| | | | | | - Muhammad Izza Indika
- Dr. Soeratno Gemolong Regional General Hospital, Sragen Regency, Central Java, Indonesia
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Kayaalp ME, Hakam HT, Klugarová J, Klugar M, Peričić TP, Bała MM, Becker R, Prill R. Intra-articular knee injections in patients with primary osteoarthritis in a tertiary clinical setting: a best practice implementation project. JBI Evid Implement 2025; 23:81-89. [PMID: 39463188 DOI: 10.1097/xeb.0000000000000474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2024]
Abstract
AIMS This project aimed to improve physicians' adherence to evidence-based practices regarding the selection and administration of intra-articular knee injections for patients with osteoarthritis. The project also aimed to empower patients by increasing their awareness of these evidence-based practices. INTRODUCTION In the management of knee osteoarthritis, intra-articular injections are commonly used when initial treatments prove inadequate. However, issues such as patients' demand for rapid relief and variability in physicians' familiarity with optimal practices often lead to suboptimal treatment decisions and potential adverse outcomes. METHODS This project followed the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit process. Initially, physicians were surveyed on the topic under consideration, and hospital records were reviewed. Subsequently, targeted interventions were implemented, including briefings and the distribution of informative flyers. RESULTS The baseline audit indicated low adherence with all audit criteria. Various parameters, such as adherence to best clinical practices, informed decision-making by patients, and the recommendation of alternative treatment modalities, were significantly lacking. Following the interventions, substantial improvements were observed, including higher rates of adherence to best clinical practices by physicians for multiple criteria, such as stepwise referral to conservative therapy options and the content of intra-articular injections. CONCLUSIONS Adherence to best clinical practices can be improved through educational briefings for physicians on the most current evidence-based treatment practices for injectable substances in knee osteoarthritis. The active engagement of patients, facilitated by informative flyers and physician assistance, contributed to better involvement in their treatment choices. However, the participation of health care institutions and providers as well as lifelong education practices may be necessary for more comprehensive and sustainable changes. SPANISH ABSTRACT http://links.lww.com/IJEBH/A277.
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Affiliation(s)
- Mahmut Enes Kayaalp
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- University of Pittsburgh, Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- Istanbul Kartal Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Centre of Evidence Based Practice in Brandenburg: A JBI Affiliated Group, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Jitka Klugarová
- The Czech Republic Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute for Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Institute of Health Informatics and Statistics of the Czech Republic, Prague, Czech Republic
| | - Miloslav Klugar
- The Czech Republic Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Institute for Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Institute of Health Informatics and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tina Poklepović Peričić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Małgorzata M Bała
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Centre of Evidence Based Practice in Brandenburg: A JBI Affiliated Group, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
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Jacobs MV, Jochimsen KN, Clasey JL, Samaan MA. Exploratory analysis of gait mechanics in farmers. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2025; 22:1-7. [PMID: 39752577 PMCID: PMC11790371 DOI: 10.1080/15459624.2024.2421004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
Abstract
Farmers may be at a higher risk of developing hip osteoarthritis (OA) due to the high demands of their occupation. To the authors' knowledge, the gait patterns of farmers that may be associated with hip joint degeneration have yet to be analyzed. Therefore, this study compares gait mechanics between farmers and non-farmers (controls). It is hypothesized that farmers would exhibit altered lower extremity joint mechanics during walking when compared to matched controls. This exploratory study included five farmers and five sex-, age-, and body mass index (BMI)-matched controls. A 3D gait analysis was performed while study participants walked at a self-selected speed on an instrumented treadmill. Sagittal plane hip, knee, and ankle kinetics and kinematics were assessed. Effect sizes and between-group differences in demographics and gait mechanics were assessed. There were no group differences in walking speed, total stance time as well as hip and knee joint kinematics (p > 0.05). Farmers exhibited statistical trends (p = 0.07-0.08) of lower peak ankle plantarflexion angles, higher plantarflexor moments, higher knee flexion moment impulse, and higher peak vertical ground reaction force during the first and second halves of stance. Additionally, farmers ambulated with a significantly higher knee extensor moment (p = 0.04) and moment impulse (p = 0.05) during the first half of stance and a higher ankle plantarflexion moment impulse (p = 0.04). The results demonstrate a multi-joint gait alteration in farmers compared to non-farmers and may suggest a compensatory gait pattern to optimize hip joint mechanics and mitigate hip joint degeneration. These results provide a preliminary understanding of the impact that agricultural occupations have on joint mechanics that may be associated with the increased prevalence of hip OA in the farming population.
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Affiliation(s)
- Mariana V. Jacobs
- Department of Kinesiology & Health Promotion, University of Kentucky, Lexington, KY, USA]
| | - Kate N. Jochimsen
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jody L. Clasey
- Department of Kinesiology & Health Promotion, University of Kentucky, Lexington, KY, USA]
| | - Michael A. Samaan
- Department of Kinesiology & Health Promotion, University of Kentucky, Lexington, KY, USA]
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Kurniari PK, Hidayat R, Parlindungan F, Pratama MZ, Wibowo SAK, Sarmidi S, Wahono CS, Suryana BPP, Rahman AP, Partan RU, Reagan M, Darma S, Marpaung B, Ginting AR, Siregar RA, Kambayana G, Tejawati DAK, Sindhughosa DA, Hamijoyo L, Rahmadi AR, Wirawan C, Sofiatin Y, Kertia N, Sari LK, Hellmi RY, Warlisti IV, Adita F, Werdiningsih Y, Nurudhin A, Sunarso I, Sylvawani M, Zuaidi R, Jazmi D, Najirman N, Rikarni R, Yudha MAP, Suarjana N, Ariadie D, Djallalluddin D, Nugroho CW, Rahmawati LD, Syahriani F, Harman PP, Elwindy S, Ongkowijaya JA, Januraga PP, Wardhani BDK, Pradnyani PE. Prevalence, Risk Factors, and Quality of Life of Knee Osteoarthritis in Urban Community in Indonesia: A COPCORD Study. Int J Rheum Dis 2025; 28:e70014. [PMID: 39791539 DOI: 10.1111/1756-185x.70014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 12/01/2024] [Accepted: 12/04/2024] [Indexed: 01/12/2025]
Abstract
AIM This study evaluates the prevalence, risk factors, and quality of life of patients with knee osteoarthritis (OA) in the Indonesian population. METHOD A cross-sectional study of 3597 adults (≥ 18 years old) was conducted in 2023 involving 15 different cities in Indonesia. Knee OA was classified according to the clinical ACR criteria. The COPCORD questionnaire was used for all subjects. The quality of life (QoL) was assessed using the WOMAC score. RESULTS The prevalence of knee OA was 15.0%. Banda Aceh has the highest prevalence of knee OA at 70.79%, whereas Bandung has the lowest (4.18%)-the odds of having knee OA increased with age. The adjusted odds ratio (aOR) were 5.01 (95% CI 2.47-10.15, p < 0.001) for participants aged 40-49 years and 72.19 (95% CI 36.32-143.51, p < 0.001) for participants aged 70 years or over, compared to participants under 40 years. Knee OA was higher among female participants (aOR = 1.91; 95% CI 1.53-2.39, p < 0.001). Married and divorced participants had higher odds of having knee OA compared to those who never married (aORs 2.56 (95% CI 1.37-4.77, p = 0.003) and 2.40 (95% CI 1.23-4.68, p < 0.010), respectively). Knee OA is less likely found among participants with elementary school education background (aOR 0.37; 95% CI 0.22-0.64, p < 0.001) and those with senior high school (aOR 0.49; 95% CI 0.29-0.83, p = 0.007). The total WOMAC score was 25.9 ± 18.7 from all participants, indicating moderate impairment in QoL. CONCLUSION The prevalence of knee OA in several urban districts in Indonesia was 15.0%, with most patients having moderate impairment in QoL. Several sociodemographic factors were associated with the odds of having knee OA.
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Affiliation(s)
- Pande Ketut Kurniari
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Udayana, Ngoerah General Hospital Denpasar, Bali, Indonesia
| | - Rudy Hidayat
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Faisal Parlindungan
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Mirza Zaka Pratama
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia
| | - Suryo Anggoro Kusumo Wibowo
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Sumariyono Sarmidi
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Cesarius Singgih Wahono
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia
| | - Bagus Putu Putra Suryana
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia
| | - Aditya Perdana Rahman
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia
| | - Radiyati Umi Partan
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Sriwijaya, Mohammad Hoesin General Hospital, Palembang, Indonesia
| | - Muhammad Reagan
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Sriwijaya, Mohammad Hoesin General Hospital, Palembang, Indonesia
| | - Surya Darma
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Sriwijaya, Mohammad Hoesin General Hospital, Palembang, Indonesia
| | - Blondina Marpaung
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia
| | - Andi Raga Ginting
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia
| | - Rizqi Arini Siregar
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia
| | - Gede Kambayana
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Udayana, Ngoerah General Hospital Denpasar, Bali, Indonesia
| | - Dewa Ayu Kartika Tejawati
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Udayana, Ngoerah General Hospital Denpasar, Bali, Indonesia
| | - Dwijo Anargha Sindhughosa
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Udayana, Ngoerah General Hospital Denpasar, Bali, Indonesia
| | - Laniyati Hamijoyo
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Andri Reza Rahmadi
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Chevie Wirawan
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Yulia Sofiatin
- Department of Public Health Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Nyoman Kertia
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lisa Kurnia Sari
- Department of Internal Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
| | - Rakhma Yanti Hellmi
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Dr Kariadi General Hospital, Semarang, Indonesia
| | - Ika Vemilia Warlisti
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Dr Kariadi General Hospital, Semarang, Indonesia
| | - Fenda Adita
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Dr Kariadi General Hospital, Semarang, Indonesia
| | - Yulyani Werdiningsih
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Dr Moewardi General Hospital, Solo, Indonesia
| | - Arief Nurudhin
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Dr Moewardi General Hospital, Solo, Indonesia
| | - Indrayana Sunarso
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Dr Moewardi General Hospital, Solo, Indonesia
| | - Mahriani Sylvawani
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Syah Kuala, Banda Aceh, Indonesia
| | - Rahmat Zuaidi
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Syah Kuala, Banda Aceh, Indonesia
| | - Dolly Jazmi
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Syah Kuala, Banda Aceh, Indonesia
| | - Najirman Najirman
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | - Rikarni Rikarni
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | - M Agung Pratama Yudha
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | - Nyoman Suarjana
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin, Indonesia
| | - Dimas Ariadie
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin, Indonesia
| | - Djallalluddin Djallalluddin
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin, Indonesia
| | - Cahyo Wibisono Nugroho
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr Soetomo General Hospital, Surabaya, Indonesia
| | - Lita Diah Rahmawati
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr Soetomo General Hospital, Surabaya, Indonesia
| | - Femi Syahriani
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Hasanudin, Makassar, Indonesia
| | - Paramitha Puspasari Harman
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Hasanudin, Makassar, Indonesia
| | - Sarafina Elwindy
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Hasanudin, Makassar, Indonesia
| | - Jeffrey Arthur Ongkowijaya
- Rheumatology Division Department of Internal Medicine, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia
| | - Pande Putu Januraga
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia
- Center for Public Health Innovation (CPHI), Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia
| | | | - Putu Erma Pradnyani
- Center for Public Health Innovation (CPHI), Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia
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Carabot F, Donat-Vargas C, Lara-Abelenda FJ, Martínez OF, Santoma J, Garcia-Montero C, Valadés T, Gutierrez-Rojas L, Martinez-González MA, Ortega MA, Alvarez-Mon M, Alvarez-Mon MA. Analysis of User-Generated Posts on Social Media of Adjuvant Analgesics: A Machine Learning Study. Int J Med Sci 2025; 22:170-178. [PMID: 39744167 PMCID: PMC11659822 DOI: 10.7150/ijms.96981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 10/21/2024] [Indexed: 02/01/2025] Open
Abstract
Background: Antiepileptics and antidepressants are frequently prescribed for chronic pain, but their efficacy and potential adverse effects raise concerns, including dependency issues. Increased prescriptions, sometimes fraudulent, prompted reclassification of antiepileptics in some countries. Our aim is to comprehend opinions, perceptions, beliefs, and attitudes towards co-analgesics from online discussions on X (formerly known as Twitter), offering insights closer to reality than conventional surveys. Methods: In this cross-sectional study, we collected 77,183 public posts about co-analgesics in English or Spanish from January 1st 2019 to December 31st, 2020. A total of 51,167 post were included, and 2,000 were manually analyzed using a researcher-created codebook. Machine learning classifiers were then applied to the remaining datasets to determine the number of publications for each user type and identify categories through content analysis. Results: Of the 51,167 posts analyzed, 78% discussed anticonvulsants and 24% discussed analgesic antidepressants (Percentages add up to more than 100% because there were 1,300 posts containing references to both types of medications). Only 13% were authored by healthcare professionals, while 67% were from patients. Medical content predominated, with 70% noting low medication efficacy and almost 50% referencing side effects. Non-medical content included challenges in dispensing (25%), complaints about high costs (15%), and trivialization of medication use (10%). Conclusions: This study offers valuable insights into public perceptions of co-analgesics. Findings aid in designing public health communications to raise awareness of associated risks, urging both healthcare providers and the public to optimize drug use.
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Affiliation(s)
- Federico Carabot
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Carolina Donat-Vargas
- ISGlobal, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cardiovascular and Nutritional Epidemiology, Unit of Institute of Environmental Medicine, Karolinska In-stitute, Stockholm, Sweden
| | - Francisco J. Lara-Abelenda
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Departamento Teoria de la Señal y Comunicaciones y Sistemas Telemáticos y Computación, Escuela Tecnica Superior de Ingenieria de Telecomunicación, Universidad Rey Juan Carlos, 28942 Fuenlabrada, Spain
| | - Oscar Fraile- Martínez
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Javier Santoma
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
| | - Cielo Garcia-Montero
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Teresa Valadés
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
| | - Luis Gutierrez-Rojas
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain
- Department of Psychiatry, San Cecilio University Hospital, Granada, Spain
| | - MA Martinez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Insti-tute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Miguel Angel Ortega
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities. University of Alcala, Alcala de Henares, 28801 Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Mental Health. Hospital Universitario Infanta Leonor, Madrid, Spain
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
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Kamata T, Nakano J, Fujii R, Murakami S, Ikaga T, Kawakubo S. Survival time analysis of the relationship between the residential environment and residents’ health status. BUILDING AND ENVIRONMENT 2025; 267:112305. [DOI: 10.1016/j.buildenv.2024.112305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Hao G, Han S, Xiao Z, Shen J, Zhao Y, Hao Q. Synovial mast cells and osteoarthritis: Current understandings and future perspectives. Heliyon 2024; 10:e41003. [PMID: 39720069 PMCID: PMC11665477 DOI: 10.1016/j.heliyon.2024.e41003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 10/29/2024] [Accepted: 12/04/2024] [Indexed: 12/26/2024] Open
Abstract
Osteoarthritis (OA) is a prevalent joint disease worldwide that significantly impacts the quality of life of individuals, particularly those in middle-aged and elderly populations. OA was initially considered as non-inflammatory arthritis, but recent studies have identified a substantial number of immune responses in OA, leading to the recognition of inflammation as a key factor in its pathogenesis. An increasing number of studies have found that mast cell (MC) and MC-secreted inflammatory mediators and cytokines are notably increased in the synovial fluid of OA patients, indicating a potential association between MCs and the onset and progression of synovial inflammation. The present review aims to summarize the significance and mechanism of MCs in the pathogenesis of OA. Meanwhile, we also discuss the clinical potential of using MCs as therapeutic target for OA therapy. Modulating the activities of MCs or the mediators of MCs in the synovial fluid inflammatory microenvironment will be promising new options for the treatment of OA.
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Affiliation(s)
- Guanghui Hao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Southwest Medical University, Luzhou, Sichuan, China
- South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, China
| | - Shanqian Han
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Southwest Medical University, Luzhou, Sichuan, China
- South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, China
| | - Zhangang Xiao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Southwest Medical University, Luzhou, Sichuan, China
- South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, China
| | - Jing Shen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Southwest Medical University, Luzhou, Sichuan, China
- South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, China
| | - Yueshui Zhao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
- Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Southwest Medical University, Luzhou, Sichuan, China
- South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, China
| | - Qi Hao
- Department of Joint Surgery, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China
- The Third People's Hospital of Longmatan District, Luzhou, Sichuan, China
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Zhang Z, Ma J, Yi Y, Wang S, He Y, Liu Y, Meng K, Wang Y, Ma W. Isoliensinine suppresses chondrocytes pyroptosis against osteoarthritis via the MAPK/NF-κB signaling pathway. Int Immunopharmacol 2024; 143:113589. [PMID: 39547017 DOI: 10.1016/j.intimp.2024.113589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 10/19/2024] [Accepted: 11/05/2024] [Indexed: 11/17/2024]
Abstract
BACKGROUND Isoliensinine is an active compound derived from Nelumbo nucifera which has long been used for its anti-inflammatory properties. However, the mechanism of Isoliensinine in the treatment of osteoarthritis is poorly known. PURPOSE The present study aims to investigate whether Isoliensinine could alleviate osteoarthritis by regulating MAPK/NF-κB signaling pathway-mediated pyroptosis. METHODS Network pharmacology and KEGG enrichment analysis were used to identify the therapeutic targets of Isoliensinine for OA. Molecular docking was used to confirm the binding ability of Isoliensinine and related proteins. In vitro, chondrocytes were stimulated with IL-1β to construct an inflammatory model and treated with Isoliensinine. The viability of the cells was assessed using the CCK-8 kit. The apoptosis rate of cells was measured using Annexin V-FITC/PI assay. And assessed the levels of ROS, lipid-ROS, and mitochondrial membrane potential. Corresponding assay kits were utilized to measure the levels of MDA and SOD. Subsequently, the anabolic and catabolic markers in chondrocytes, alongside inflammatory targets were measured by RT-PCR and Western blot. The expression level of pyroptosis and MAPK/NF-κB signaling pathway-related targets was examined. Furthermore, we constructed a rat osteoarthritis model using ACLT surgery. We then assessed the progression of osteoarthritis by Micro-CT, H&E staining, S&F staining and immunohistochemistry. RESULTS Enrichment analysis showed that Isoliensinine treatment of osteoarthritis may be through the MAPK/NF-κB pathway, and molecular docking showed that Isoliensinine and MAPK/NF-κB pathway proteins had a good binding ability. Data showed that Isoliensinine could reduce ECM degradation and inflammation, and inhibit IL-1β-induced apoptosis. It also mitigated ROS and LPO activation, regulated mitochondrial dysfunction, and reduced intracellular oxidative stress levels. Furthermore, Western blot showed that Isoliensinine also inhibited the activation of the MAPK/NF-κB pathway, thereby inhibiting the pyroptosis of chondrocytes. In vivo, Micro-CT, H&E staining and S&F staining results showed that Isoliensinine could effectively improve joint damage caused by osteoarthritis. And IHC analyses indicated NLRP3, MMP3 protein expression were significantly diminished and Collagen II expression was increased in the Isoliensinine treatment groups. CONCLUSION In conclusion, our study suggested that Isoliensinine mitigates ECM degradation, oxidative stress, chondrocytes apoptosis, and pyroptosis through the inhibition of the MAPK and NF-κB pathways, thereby delaying the progression of osteoarthritis.
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Affiliation(s)
- Zhengze Zhang
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China
| | - Jizhi Ma
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China
| | - Yanzi Yi
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China
| | - Shuai Wang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China
| | - Yuewen He
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China
| | - Yurui Liu
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China
| | - Kai Meng
- Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, PR China.
| | - Yong Wang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China; State Key Laboratory of Traditional Chinese Medicine Syndrome, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China.
| | - Wuhua Ma
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, PR China.
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Lu S, Fang C. Isosakuranetin inhibits subchondral osteoclastogenesis for attenuating osteoarthritis via suppressing NF-κB/CXCL2 axis. Int Immunopharmacol 2024; 143:113321. [PMID: 39388890 DOI: 10.1016/j.intimp.2024.113321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 09/24/2024] [Accepted: 10/01/2024] [Indexed: 10/12/2024]
Abstract
As the most predominant form of arthritis, osteoarthritis (OA) is featured with irreversible progress and involvement of the whole joint. Since OA onset, abnormal mechanical load initiates excessive osteoclastogenesis, evolving a rapid turnover of subchondral bone, cyst creation, synovitis, cartilage degradation, and ultimately resulting in joint failure. Additionally, aberrant vascularization and nociceptive pain are invoked by osteoclast-induced angiogenesis and sensory innervation in the subchondral bone. Rhizoma anemarrhenae (Zhimu) has been extensively demonstrated to show multiple pharmacological effects including anti-inflammation, anti-aging, and immunomodulation. Herein, Broussonin a (BRA), Markogein (MAN), and Isosakuranetin (ISN) derived from Rhizoma anemarrhenae, were initially discovered for their affinity with Bone marrow mononuclear cell (BMMC) membranes using the Cell membrane chromatography/Time of flight mass spectrometry (CMC/TOFMS) method, while only ISN exerted a significant inhibitory effect on RANKL-induced osteoclastogenesis in BMMC in vitro. Intriguingly, we disclosed that ISN blunted the overactivation of Tartrate-resistant acid phosphatase positive (TRAP+) osteoclasts in subchondral bone in OA mice, as indicated by enhanced bone volume/total volume (BV/TV), trabecular number (Tb.N), and trabeculae thickness (Tb.Th), as well as diminished trabecular pattern factor (Tb.pf). Treatment with ISN also impaired aberrant angiogenesis and nociceptive reaction in the subchondral bone marrow. Moreover, ISN hindered the loss of articular cartilage proteoglycan and lowered the Osteoarthritis Research Society International (OARSI) grade, boosting the expression amount of Aggrecan (ACAN) and Collagen II (COL II) positive cells while reducing Matrix metalloproteinase 13 (MMP-13) positive cells. For mechanisms, We verified that ISN hampered subchondral osteoclastogenesis by blocking nuclear factor kappa light chain enhancer of activated B cells (NF-κB) signaling and C-X-C Motif Chemokine Ligand 2 (CXCL2) stimulation. Taken together, we reveal that ISN impedes the progression of OA by preventing hyperactivated subchondral osteoclastogenesis via suppressing the NF-κB/CXCL2 axis.
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Affiliation(s)
- Shuai Lu
- Department of Orthopedics, Shanghai Fengxian District Central Hospital, Shanghai, 201499, China
| | - Chao Fang
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
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Mirt PK, Erjavec K, Krsnik S, Kotnik P, Hussein M. A mixed-methods study of patient and healthcare professional perceptions of care pathways for knee osteoarthritis. BMC PRIMARY CARE 2024; 25:435. [PMID: 39709355 DOI: 10.1186/s12875-024-02690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 12/11/2024] [Indexed: 12/23/2024]
Abstract
BACKGROUND This study aimed to address research gap concerning the perception of the care pathway for knee osteoarthritis (KOA) patients, focusing on both the patient and health professional perspectives in countries with inefficient health systems, such as Slovenia, by examining patient satisfaction with conservative treatment, assessing the perceptions of both patients and health professionals regarding the latter's involvement, and justifying the chosen KOA treatment approaches. METHODS A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews with KOA patients (n = 82) and healthcare professionals (n = 68). RESULTS The care pathway for conservative KOA treatment in Slovenia begins with general practitioners (GPs), who conduct initial examinations, prescribe analgesics, and refer patients to radiologists and orthopaedic surgeons. GPs received high satisfaction ratings (μ = 4.32). Orthopaedic surgeons, who confirm diagnoses and create treatment plans involving physiotherapy, medication, or joint injections, also received high satisfaction scores (μ = 4.47), despite long waiting times. Consultations with radiologists, mentioned less frequently, again received high satisfaction scores (μ = 4.67). Physiotherapists, consulted later, received high satisfaction scores (μ = 4.16) but long waiting times resurfaced. Referrals to rheumatologists occur for systemic diseases or ineffective conservative treatments. Psychologists, occupational therapists, and dieticians are rarely consulted, indicating limited integration into the treatment pathway. A comparison of health professionals' involvement showed that health professionals consider GP involvement less necessary (μ = 2.47) than patients do (μ = 2.82, p = 0.015). The same applies to radiologists (μ = 2.47 vs. μ = 2.87, p = 0.004), reflecting different views on diagnostic imaging. Our qualitative investigation revealed that, due to long waiting times, an alternative care pathway is developing with orthopaedic surgeons as the initial point of contact, bypassing GPs, and highlighted that patients and healthcare professionals differently perceive the latter's treatment roles. CONCLUSIONS The current conservative KOA care pathway lacks initial lifestyle change advice from the GP, referrals for conservative treatments, and a multidisciplinary team engaged in regular treatment monitoring and adjustment. Our mixed-methods research approach highlighted significant differences in perceptions of the treatment process and the roles of health professionals; the knowledge supplied of those differences should support experts and policymakers to optimise care pathways in Slovenia.
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Affiliation(s)
- Pika Krištof Mirt
- General Hospital Novo mesto, Šmihelska cesta 1, Novo mesto, 8000, Slovenia
| | - Karmen Erjavec
- University of Novo mesto, Na Loko 2, Novo mesto, 8000, Slovenia
| | - Sabina Krsnik
- University of Novo mesto, Na Loko 2, Novo mesto, 8000, Slovenia.
| | - Petra Kotnik
- University of Novo mesto, Na Loko 2, Novo mesto, 8000, Slovenia
| | - Mohsen Hussein
- Artros d.o.o, Tehnološki park 19, Ljubljana, 1000, Slovenia
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Zhu B, Tang C, Zhou X, Janice Hiew YY, Fang S, Fu Y, Zhu Q, Fang M. Effects of traditional Chinese medicine massage therapy on pain, functional activity, muscle activation patterns and proprioception in knee osteoarthritis: a randomised controlled trial protocol. BMJ Open 2024; 14:e081771. [PMID: 39806726 PMCID: PMC11667377 DOI: 10.1136/bmjopen-2023-081771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/26/2024] [Indexed: 01/16/2025] Open
Abstract
INTRODUCTION Health education, weight control and exercise therapy are recognised treatment options for the non-surgical management of knee osteoarthritis (KOA); however, the pain and muscle fatigue associated with exercise make it difficult for patients to initially adhere. Traditional Chinese medicine (TCM) massage is an important complementary and alternative therapy that can effectively address these deficiencies. According to TCM theory and preliminary clinical practice, loosening of the muscles while pointing to acupoints can promote the recovery of KOA. Therefore, we hypothesised that exercise therapy in conjunction with TCM massage may lead to more satisfactory results in terms of pain management, active functional muscle activation patterns and proprioception in patients with KOA. METHODS AND ANALYSIS A parallel, single-centre, randomised controlled trial involving 106 patients will be conducted at Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. Eligible patients with KOA who agree to participate will be randomised via a 1:1 randomisation system into the experimental group (receiving TCM massage and exercise treatment) and the control group (receiving exercise treatment). The primary endpoint is the change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain from baseline to 24 weeks. Secondary outcomes include knee function (measured using the WOMAC stiffness and WOMAC functional subscale questionnaire and the timed 'Up and Go' test), muscle activation states (evaluated with electromyography techniques), knee proprioception and treatment satisfaction, adherence, safety evaluation and other relevant factors. Outcome assessors and data analysts will be blinded to the allocations, and the participants will not disclose their specific allocations. Outcome analyses will be conducted on both intention-to-treat and per-protocol populations. A preliminary analysis will test whether TCM massage, in addition to exercise, has statistically better outcomes. ETHICS AND DISSEMINATION The study protocol has received approval from the Ethics Committee of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine (2023-1357-124-01).All study participants will be required to give written informed consent. The findings of the study will be submitted to a peer-reviewed journal for publication and presented at scientific conferences. Additionally, the participants will receive copies of the results. TRIAL REGISTRATION NUMBER ChiCTR2300077308.
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Affiliation(s)
- Bowen Zhu
- Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM, Shanghai, Shanghai, China
| | - Cheng Tang
- Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM, Shanghai, Shanghai, China
| | - Xin Zhou
- Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM, Shanghai, Shanghai, China
| | | | - Sitong Fang
- Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM, Shanghai, Shanghai, China
| | - Yangyang Fu
- Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, Shanghai, China
| | - Qingguang Zhu
- Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai, Shanghai, China
| | - Min Fang
- Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM, Shanghai, Shanghai, China
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Su YC, Shen YP, Chang CY, Pan KT, Huang SM, Chen LC. The Effect of Intravascular Laser Irradiation of Blood on Serum Biomarkers and Clinical Outcome in Knee Osteoarthritis Patients: A Double-Blind Randomized Control Trial. Int J Mol Sci 2024; 25:13608. [PMID: 39769371 PMCID: PMC11677140 DOI: 10.3390/ijms252413608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 12/14/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
Knee osteoarthritis (OA) is a prevalent degenerative joint disease globally, causing pain, stiffness, and disability. Intravascular laser irradiation of blood (ILIB) has been used for chronic pain and musculoskeletal disease. However, evidence on the clinical benefits and serum biomarkers post-ILIB therapy in knee OA is insufficient. We designed a double-blind randomized controlled trial to evaluate the clinical and biological outcomes of ILIB therapy for knee OA. Seventeen patients with knee OA were randomly assigned to the ILIB and control groups. The outcomes included the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Scale, visual analog scale, and biomarker analysis of interleukin (IL)-6, IL-13, IL-1β, epidermal growth factor, macrophage inflammatory protein-1β, and eotaxin. The measurements were performed at baseline and three days, one month, and three months post-intervention. The ILIB group showed a significant improvement in the WOMAC-pain score at one month of follow-up than the control group. IL-1β levels reduced significantly on day three, one month, and three months, and IL-13 levels reduced on day three and three months during follow-up in the ILIB group. ILIB therapy reduced knee OA pain for one month and significantly reduced serum IL-1β and IL-13 levels, suggesting potential for pain management.
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Affiliation(s)
- Yu-Chi Su
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.S.); (Y.-P.S.); (C.-Y.C.)
| | - Yu-Ping Shen
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.S.); (Y.-P.S.); (C.-Y.C.)
| | - Chih-Ya Chang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.S.); (Y.-P.S.); (C.-Y.C.)
| | - Ke-Ting Pan
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Centre, Taipei 114, Taiwan;
| | - Shih-Ming Huang
- Biochemistry Department, National Defense Medical Center, Taipei 114, Taiwan;
| | - Liang-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan; (Y.-C.S.); (Y.-P.S.); (C.-Y.C.)
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Fallon EA, Foster AL, Boring MA, Brown DR, Odom EL. Arthritis Management: Patient-Reported Health Care Provider Screening, Counseling, and Recommendations for Physical Activity. Prev Chronic Dis 2024; 21:E101. [PMID: 39700073 DOI: 10.5888/pcd21.240074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2024] Open
Abstract
Introduction Little is known about the recency, correlates, and content of health care provider (HCP) counseling about physical activity (PA) among adults with arthritis. Methods We analyzed data from the Porter Novelli FallStyles cross-sectional survey of noninstitutionalized US adults. Among adults with arthritis, we assessed the recency of HCP counseling about PA; counseling content, including PA assessment/screening and advice/counseling; and recommendations. Data were weighted by sex, age, household income, race and ethnicity, household size, education, census region, and metropolitan status. Results Among adults with arthritis (n = 1,113), 16.8% received HCP counseling within the past 6 months, 9.6% received counseling between 6 months and a year ago; 27.7% received HCP counseling more than a year ago; 30.4% never received HCP counseling; and 15.5% did not recall. Prevalence of HCP counseling about PA was higher for those reporting obesity (prevalence ratio [PR] = 1.3) and chronic pain (PR = 1.2), compared with those without these conditions. The most and least common content of HCP counseling were assessment of PA level (74.7%) and receiving a physical activity prescription (6.1%), respectively. The most frequent recommendations for PA type were flexibility exercises (40.1%), aerobic activities (39.8%), specific modalities of PA (eg, swimming, walking, dancing; 38.1%), and muscle-strengthening exercises (36.6%). Only 4.4% received a recommendation for arthritis-appropriate PA programs. Conclusion HCP counseling about PA among adults with arthritis for arthritis symptom management is lacking in frequency, actionable content, and recommendations to engage in evidence-based PA interventions. Dissemination and implementation of policies and programs facilitating frequent high-quality HCP counseling and recommendation to PA programs for arthritis remains a public health priority.
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Affiliation(s)
- Elizabeth A Fallon
- Centers for Disease Control and Prevention, Division of Population Health, Atlanta, Georgia
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Healthy Aging Branch, 4770 Buford Hwy NE, Mailstop S-107-6, Atlanta, GA 30341
| | - Anika L Foster
- Centers for Disease Control and Prevention, Division of Population Health, Atlanta, Georgia
| | | | - David R Brown
- Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, Atlanta, Georgia
| | - Erica L Odom
- Centers for Disease Control and Prevention, Division of Population Health, Atlanta, Georgia
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Han S, Li T, Cao Y, Li Z, Mai Y, Fan T, Zeng M, Wen X, Han W, Lin L, Zhu L, Fu SN, Bennell KL, Hunter DJ, Ding C, Li L, Zhu Z. Quantitative analysis of effectiveness and associated factors of exercise on symptoms in osteoarthritis: a pharmacodynamic model-based meta-analysis. Br J Sports Med 2024; 58:1539-1550. [PMID: 39393837 DOI: 10.1136/bjsports-2023-107625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2024] [Indexed: 10/13/2024]
Abstract
OBJECTIVE This study aims to evaluate the time point and magnitude of peak effectiveness of exercise and the effects of various exercise modalities for osteoarthritis (OA) symptoms and to identify factors that significantly affect the effectiveness of exercise. DESIGN Pharmacodynamic model-based meta-analysis (MBMA). DATA SOURCES Embase, PubMed, Cochrane Library, Web of Science and Scopus were searched for randomised controlled trials (RCTs) examining the effect of exercise for OA from inception to 20 November 2023. ELIGIBILITY CRITERIA RCTs of exercise interventions in patients with knee, hip or hand OA, using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscales or Visual Analogue Scale (VAS) pain scores as outcome measures, were included. The minimum clinically important difference (MCID) for WOMAC total, pain, stiffness, function and VAS pain was 9.0, 1.6, 0.8, 5.4 and 0.9, respectively. RESULTS A total of 186 studies comprising 12 735 participants with symptomatic or radiographic knee, hip or hand OA were included. The effectiveness of exercise treatments peaked at 1.6-7.2 weeks after initiation of exercise interventions. Exercise was more effective than the control, but the differences in the effects of exercise compared with control on all outcomes were only marginally different with the MCID (7.5, 1.7, 1.0, 5.4 and 1.2 units for WOMAC total, pain, stiffness, function and VAS pain, respectively). During a 12-month treatment period, local exercise (strengthening muscles and improving mobilisations of certain joints) had the best effectiveness (WOMAC pain decreasing by 42.5% at 12 weeks compared with baseline), followed by whole-body plus local exercise. Adding local water-based exercise (eg, muscle strengthening in warm water) to muscle strengthening exercise and flexibility training resulted in 7.9, 0.5, 0.7 and 8.2 greater improvements in the WOMAC total score, pain, stiffness and function, respectively. The MBMA models revealed that treatment responses were better in participants with more severe baseline symptom scores for all scales, younger participants for the WOMAC total and pain scales, and participants with obesity for the WOMAC function. Subgroup analyses revealed participants with certain characteristics, such as female sex, younger age, knee OA or more severe baseline symptoms on the WOMAC pain scale, benefited more from exercise treatment. CONCLUSION Exercise reaches peak effectiveness within 8 weeks and local exercise has the best effectiveness, especially if local water-based exercise is involved. Patients of female sex, younger age, obesity, knee OA or more severe baseline symptoms appear to benefit more from exercise treatment than their counterparts.
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Affiliation(s)
- Shun Han
- Clinical Research Centre, Zhujiang Hospital,Southern Medical University, Guangzhou, Guangdong, China
| | - Ting Li
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai, China
| | - Ying Cao
- Department of Etiology and Carcinogenesis, National Clinical Research Center for Cancer, Beijing, China
| | - Zewei Li
- Southern Medical University, Guangzhou, Guangdong, China
| | - Yiying Mai
- Department of Neurosurgery, Beijing Tiantan Hospital, Beijing, China
| | - Tianxiang Fan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Muhui Zeng
- Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Wen
- Clinical Research Centre, Zhujiang Hospital,Southern Medical University, Guangzhou, Guangdong, China
| | - Weiyu Han
- Department of Joint and Orthopedics, Southern Medical University, Guangzhou, Guangdong, China
| | - Lijun Lin
- Department of Joint and Orthopedics, Southern Medical University, Guangzhou, Guangdong, China
| | - Lixin Zhu
- Orthopedic Medical Center, Zhujiang Hospital, Guangzhou, Guangdong, China
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Kim L Bennell
- Department of Physiotherapy, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - David J Hunter
- Clinical Research Centre, Zhujiang Hospital,Southern Medical University, Guangzhou, Guangdong, China
- Department of Rheumatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital,Southern Medical University, Guangzhou, Guangdong, China
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Lujin Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital,Southern Medical University, Guangzhou, Guangdong, China
- Orthopedic Medical Center, Zhujiang Hospital, Guangzhou, Guangdong, China
- Department of Rheumatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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Dasa V, Mihalko W, Rivadeneyra A, Urban J, Wickline A, Rogenmoser D, Concoff A, Spitzer A, Mont MA. Innovations in Genicular Outcomes Registry (IGOR): protocol for a real-world registry study of treatments for knee osteoarthritis. Ther Adv Musculoskelet Dis 2024; 16:1759720X241304193. [PMID: 39691173 PMCID: PMC11650579 DOI: 10.1177/1759720x241304193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 11/15/2024] [Indexed: 12/19/2024] Open
Abstract
Background Osteoarthritis (OA) is the leading cause of disability among US adults and most commonly affects the knee. Guidelines for knee OA treatment include behavioral, nonpharmacological, pharmacological, and surgical interventions. While emerging knee OA treatments show promise for pain control, data gaps remain regarding the efficacy, safety, comparative effectiveness, and real-world value of treatments. Objectives The Innovations in Genicular Outcomes Registry (IGOR) is prospectively collecting real-world data to assess clinical effectiveness, safety, health-related quality of life, and healthcare resource utilization of knee OA treatments. Design The IGOR is a prospective, observational, longitudinal, multicenter registry (NCT05495334) examining knee OA pain treatment outcomes at intervals up to 18 months after treatment. Methods and analysis All clinical management decisions are made via shared decision-making involving both the physician and the patient. Index joint-directed treatments may include various intra-articular injections, oral opioid and nonopioid medications (including nonsteroidal anti-inflammatory drugs), cryo nerve blocks, radiofrequency ablations, novel treatment modalities, other physical therapy modalities (including muscle strengthening), and total knee arthroplasties. Patient-reported assessments along with physician-provided medical record data are recorded. Regular data quality assessments are conducted for each site, and an outside monitor ensures data quality and integrity. A steering committee ensures transparency and oversees administrative, legal, ethical, and scientific decisions. Treatment outcomes within and between therapies are compared. Ethics Ethical approval was granted by Advarra, Inc. (protocol number, Pro00050981). Discussion Data from the IGOR registry study will further elucidate the effectiveness, safety, and real-world value of knee OA treatments individually or in combination. Characterization of real-world treatment patterns will help better understand the impact of specific treatments. Trial registration Clinicaltrials.gov, NCT05495334.
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Affiliation(s)
- Vinod Dasa
- Louisiana State University Health Services Center, 2021 Perdido Avenue, New Orleans, LA, USA
| | - William Mihalko
- University of Tennessee Health Science Center, Campbell Clinic Orthopaedics, Memphis, TN, USA
| | | | | | - Andrew Wickline
- Genesee Orthopedics and Plastic Surgery Associates, PC, New Hartford, NY, USA
| | - David Rogenmoser
- Mid State Orthopaedic and Sports Medicine Center, Alexandria, LA, USA
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Al-Sherief S, El-Hadidy A, Hamed S, El-Hawwary A, Mazroa S. Bone marrow mesenchymal stem cells (BM-MSCs) modulate MMP9 expression and promote articular cartilage regeneration in knee joint of a model of arthritis induced in adult rat: histological and immunohistochemical study. J Mol Histol 2024; 56:38. [PMID: 39661261 DOI: 10.1007/s10735-024-10284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 10/31/2024] [Indexed: 12/12/2024]
Abstract
Arthritis is characterized by the progressive degeneration of articular cartilage, and the avascular nature of cartilage limits its capacity for self-repair. Stem cells are considered a promising treatment option due to their multipotent differentiation potential. The aim of this work was to investigate the structural changes in the hyaline articular cartilage of the knee joint in a model of arthritis induced by complete Freund's adjuvant, and to assess intra-articular injection of bone marrow mesenchymal stem cells (BM-MSCs) through both histological and immunohistochemical study. Adult male albino rats were divided into four groups: group 0 (donor group), group I (control group), group II (arthritis group) and group III (BM-MSCs treated arthritis group). Samples were collected 2, 6 and 10 weeks after the onset of the experiment. Sections were stained with; hematoxylin and eosin, Safranin O fast green stain, Masson's trichrome stain and anti-MMP9 antibody. In Group II (arthritis group), the articular cartilage showed signs of degeneration, including chondrocyte extensive proliferation, fibrillations, fissuring, and denudation, with fibrous tissue covering the exposed surface. There was a significant decrease in cartilage thickness, collagen content, and proteoglycan levels. The integrated density of MMP9 in the cartilage was significantly increased compared to Group I (control group). In contrast, Group III (BM-MSCs-treated arthritis group) exhibited a continuous cartilage surface with no cracks or fissures. There was a significant increase in cartilage thickness, collagen content, and proteoglycan levels, while the integrated density of MMP9 was significantly decreased compared to Group II (arthritis group).
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Affiliation(s)
- Sara Al-Sherief
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Azza El-Hadidy
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Shereen Hamed
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Amany El-Hawwary
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Shireen Mazroa
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Franceschi G, Scotto I, Maselli F, Mourad F, Gallotti M. Hands-On Versus Hands-Off Treatment of Hip-Related Nonspecific Musculoskeletal Diseases: A Systematic Review. J Funct Morphol Kinesiol 2024; 9:262. [PMID: 39728246 DOI: 10.3390/jfmk9040262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Revised: 12/04/2024] [Accepted: 12/05/2024] [Indexed: 12/28/2024] Open
Abstract
Background/Objectives: A manual approach combined with therapeutic exercise versus therapeutic exercise alone is a debated issue in the literature. The American College of Rheumatology guidelines "conditionally recommended against" manual therapy for the management of hip osteoarthritis. Manual therapy followed by exercise, instead, appears to lead to a faster return to sport than exercise alone for adductor groin pain. There is a need to understand which is the most effective treatment in the management of hip nonspecific musculoskeletal diseases. The aim of this systematic review is to determine which is the most effective treatment between manual therapy combined with therapeutic exercise and therapeutic exercise alone in subjects with hip nonspecific musculoskeletal diseases. Methods: This systematic review complies with the guidelines of the 2020 Prisma Statement. The databases consulted were Pubmed, Cinahl, and Web Of Science. The search was conducted from October 2004 to November 2023. The search string was developed following the PICO model. Free terms or synonyms (e.g., manual therapy, exercise therapy, hip disease, effectiveness) and Medical Subject Headings terms were combined with Boolean operators (AND, OR, NOT). The risk-of-bias assessment was conducted using Version 2 of the Cochrane risk-of-bias tool for randomized controlled trials and the Newcastle Ottawa Scale for observational studies. A qualitative analysis of the results was conducted through narrative synthesis of key concepts. When possible, quantitative analysis was conducted through statistical parameters. Results: Ten articles were analyzed. Results show no differences between the interventions analyzed. Preliminary evidence seems to favor the combined intervention for the outcomes of pain, ROM, and patient satisfaction, with other studies claiming an absence of differences. Only one study claims that therapeutic exercise alone is more effective for quality of life. Preliminary evidence seems to show that manual therapy does not seem to bring any benefit in addition to therapeutic exercise in mid- and long-term functionality, especially for hip osteoarthritis. Conclusions: There seems to be no difference in effectiveness between manual therapy combined with therapeutic exercise and therapeutic exercise alone in individuals with hip nonspecific musculoskeletal diseases.
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Affiliation(s)
- Giulia Franceschi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Irene Scotto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Luxembourg, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, 4671 Luxembourg, Luxembourg
| | - Marco Gallotti
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
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Sumsuzzman DM, Khan ZA, Jung JH, Hong Y, Yang WJ, Park K, Choi HJ, Jeong OC, Kim SJ, Hong Y. Comparative Efficacy of Glucosamine-Based Combination Therapies in Alleviating Knee Osteoarthritis Pain: A Systematic Review and Network Meta-Analysis. J Clin Med 2024; 13:7444. [PMID: 39685902 DOI: 10.3390/jcm13237444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Revised: 11/23/2024] [Accepted: 12/02/2024] [Indexed: 12/18/2024] Open
Abstract
Background: The lack of definitive scientific evidence sustains uncertainty about the efficacy of glucosamine and its combination therapies for knee osteoarthritis (KOA), contributing to an ongoing debate among clinical practice guidelines and healthcare practitioners. This systematic review and network meta-analysis (NMA) aimed to identify the most effective glucosamine combination therapy for KOA patients. Methods: Frequentist random-effects models were employed for this NMA, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) calculated for primary outcomes. We incorporated an SMD value of 0.40 as a minimum clinically important difference (MCID) to interpret the pain outcome. Confidence in evidence was evaluated using CINeMA. Results: Thirty randomized controlled trials (RCTs) covering 5265 patients were included. Glucosamine with omega-3 (G + omega-3, SMD -2.59 [95% CI -4.42 to -0.75], moderate quality) and glucosamine with ibuprofen (G + ibuprofen, SMD -2.27 [95% CI -3.73 to -0.82], moderate quality) significantly reduced overall pain compared to placebo. Similarly, glucosamine + chondroitin sulfate + methylsulfonylmethane showed effectiveness in pain reduction (SMD -2.25 [95% CI -3.84 to -0.67], low-quality). None of the other interventions met the MCID threshold for overall pain reduction. Moreover, clustered ranking results showed that glucosamine with omega-3 interventions was more effective than others in reducing overall pain and adverse events. Conclusions: For KOA, combining glucosamine with omega-3 and ibuprofen effectively reduces pain and may lower NSAID side effects, improving treatment guidelines and decision-making for better patient care.
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Affiliation(s)
- Dewan Md Sumsuzzman
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Republic of Korea
- Research Center for Aged-life Redesign (RCAR), Inje University, Gimhae 50834, Republic of Korea
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Republic of Korea
- Department of Rehabilitation Science, Graduate School of Inje University, Gimhae 50834, Republic of Korea
| | - Zeeshan Ahmad Khan
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Republic of Korea
- Research Center for Aged-life Redesign (RCAR), Inje University, Gimhae 50834, Republic of Korea
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Republic of Korea
| | - Jin Ho Jung
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea
- Dementia and Neurodegenerative Disease Research Center, Inje University, Busan 47392, Republic of Korea
| | - Yunkyung Hong
- Medical Device Commercialization Support Team, Gimhae Biomedical Industry Promotion Agency (GBIA), Gimhae 50969, Republic of Korea
| | - Won Jong Yang
- Department of Rehabilitation Medicine, Medical Corporation Daegu Medical Foundation The K Hospital, Daegu 47392, Republic of Korea
| | - Kanghui Park
- Department of Physical Therapy, Busan Health University, Busan 49318, Republic of Korea
| | - Hong Jin Choi
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
| | - Ok Chan Jeong
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
- Department of Biomedical Engineering, College of Healthcare Medical Science & Engineering, Gimhae 50834, Republic of Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Republic of Korea
- Dementia and Neurodegenerative Disease Research Center, Inje University, Busan 47392, Republic of Korea
| | - Yonggeun Hong
- Department of Physical Therapy, College of Healthcare Medical Science & Engineering, Gimhae 50834, Republic of Korea
- Research Center for Aged-life Redesign (RCAR), Inje University, Gimhae 50834, Republic of Korea
- Biohealth Products Research Center (BPRC), Inje University, Gimhae 50834, Republic of Korea
- Department of Rehabilitation Science, Graduate School of Inje University, Gimhae 50834, Republic of Korea
- Department of Digital Anti-Aging Healthcare, Inje University, Gimhae 50834, Republic of Korea
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El-Haddad ME, El-Refaie WM, Hammad GO, El-Massik MA. Targeted non-invasive Metformin-Curcumin co-loaded nanohyaluosomes halt osteoarthritis progression and improve articular cartilage structure: A preclinical study. Int J Pharm 2024; 666:124845. [PMID: 39427700 DOI: 10.1016/j.ijpharm.2024.124845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 10/08/2024] [Accepted: 10/15/2024] [Indexed: 10/22/2024]
Abstract
Osteoarthritis (OA) is a degenerative disease that affects the quality of life in elderly and young populations. Current therapies using corticosteroids and non-steroidal anti-inflammatory drugs via parenteral or oral routes show limited ability to retard progression of the disease and achieve long term effectiveness and safety. Herein, the potential of MT-Cur combinatorial nano-formulations in OA management was explored for the first time. MT-Cur loaded nanohyaluosomes (MT-Cur-HL1) were designed for topical administration of the combined therapy in OA. The optimized MT-Cur-HL1 showed particle size 247.7 ± 3.7 nm, zeta potential -37.3 ± 0.4 mV; and entrapment efficiency (%EE) 70.22 %±0.303 and 76.7 %±0.077 for MT and Cur, respectively. MT-Cur-HL1 exhibited sustained drug release over 24 h and were stable over 3 months at 4 °C in terms of P.S., ZP and %EE. A detailed preclinical study, using MIA-induced osteoarthritis rat model, revealed the most significant anti-arthritic effect and halted OA progression of MT-Cur-HL1. This was proved to be mainly through the potentiation of p-AMPK signaling that ultimately led to suppression of its downstream TLR4/ NF-κB signaling pathway with subsequent reduction in MMP13 and ADAMTS5 induced chondrocytes degeneration. This study proved that this trajectory effectively promotes a significant improvement in the articular cartilage structure and reinforcement of joint mobility with an efficient antinociceptive effect. In conclusion, the novel MT-Cur coloaded nanohyaluosomes offer a promising non-invasive approach for the local management of OA.
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Affiliation(s)
- Mennatallah E El-Haddad
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Pharos University in Alexandria, Egypt.
| | - Wessam M El-Refaie
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Pharos University in Alexandria, Egypt.
| | - Ghada O Hammad
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Egypt.
| | - Magda A El-Massik
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Egypt.
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Lawford BJ, Hall M, Hinman RS, Van der Esch M, Harmer AR, Spiers L, Kimp A, Dell'Isola A, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 2024; 12:CD004376. [PMID: 39625083 PMCID: PMC11613324 DOI: 10.1002/14651858.cd004376.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2024]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a major public health issue causing chronic pain, impaired physical function, and reduced quality of life. As there is no cure, self-management of symptoms via exercise is recommended by all current international clinical guidelines. This review updates one published in 2015. OBJECTIVES We aimed to assess the effects of land-based exercise for people with knee osteoarthritis (OA) by comparing: 1) exercise versus attention control or placebo; 2) exercise versus no treatment, usual care, or limited education; 3) exercise added to another co-intervention versus the co-intervention alone. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (ClinicalTrials.gov and World Health Organisation International Clinical Trials Registry Platform), together with reference lists, from the date of the last search (1st May 2013) until 4 January 2024, unrestricted by language. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated exercise for knee OA versus a comparator listed above. Our outcomes of interest were pain severity, physical function, quality of life, participant-reported treatment success, adverse events, and study withdrawals. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane for systematic reviews of interventions. MAIN RESULTS We included 139 trials (12,468 participants): 30 (3065 participants) compared exercise to attention control or placebo; 60 (4834 participants) compared exercise with usual care, no intervention or limited education; and 49 (4569 participants) evaluated exercise added to another intervention (e.g. weight loss diet, physical therapy, detailed education) versus that intervention alone. Interventions varied substantially in duration, ranging from 2 to 104 weeks. Most of the trials were at unclear or high risk of bias, in particular, performance bias (94% of trials), detection bias (94%), selective reporting bias (68%), selection bias (57%), and attrition bias (48%). Exercise versus attention control/placebo Compared with attention control/placebo, low-certainty evidence indicates exercise may result in a slight improvement in pain immediately post-intervention (mean 8.70 points better (on a scale of 0 to 100), 95% confidence interval (CI) 5.70 to 11.70; 28 studies, 2873 participants). Moderate-certainty evidence indicates exercise likely results in an improvement in physical function (mean 11.27 points better (on a scale of 0 to 100), 95% CI 7.64 to 15.09; 24 studies, 2536 participants), but little to no improvement in quality of life (mean 6.06 points better (on a scale of 0 to 100), 95% CI -0.13 to 12.26; 6 studies, 454 participants). There was moderate-certainty evidence that exercise likely increases participant-reported treatment success (risk ratio (RR) 1.46, 95% CI 1.11 to 1.92; 2 studies 364 participants), and likely does not increase study withdrawals (RR 1.08, 95% CI 0.92 to 1.26; 29 studies, 2907 participants). There was low-certainty evidence that exercise may not increase adverse events (RR 2.02, 95% CI 0.62 to 6.58; 11 studies, 1684 participants). Exercise versus no treatment/usual care/limited education Compared with no treatment/usual care/limited education, low-certainty evidence indicates exercise may result in an improvement in pain immediately post-intervention (mean 13.14 points better (on a scale of 0 to 100), 95% CI 10.36 to 15.91; 56 studies, 4184 participants). Moderate-certainty evidence indicates exercise likely results in an improvement in physical function (mean 12.53 points better (on a scale of 0 to 100), 95% CI 9.74 to 15.31; 54 studies, 4352 participants) and a slight improvement in quality of life (mean 5.37 points better (on a scale of to 100), 95% CI 3.19 to 7.54; 28 studies, 2328 participants). There was low-certainty evidence that exercise may result in no difference in participant-reported treatment success (RR 1.33, 95% CI 0.71 to 2.49; 3 studies, 405 participants). There was moderate-certainty evidence that exercise likely results in no difference in study withdrawals (RR 1.03, 95% CI 0.88 to 1.20; 53 studies, 4408 participants). There was low-certainty evidence that exercise may increase adverse events (RR 3.17, 95% CI 1.17 to 8.57; 18 studies, 1557 participants). Exercise added to another co-intervention versus the co-intervention alone Moderate-certainty evidence indicates that exercise when added to a co-intervention likely results in improvements in pain immediately post-intervention compared to the co-intervention alone (mean 10.43 points better (on a scale of 0 to 100), 95% CI 8.06 to 12.79; 47 studies, 4441 participants). It also likely results in a slight improvement in physical function (mean 9.66 points better, 95% CI 7.48 to 11.97 (on a 0 to 100 scale); 44 studies, 4381 participants) and quality of life (mean 4.22 points better (on a 0 to 100 scale), 95% CI 1.36 to 7.07; 12 studies, 1660 participants) immediately post-intervention. There was moderate-certainty evidence that exercise likely increases participant-reported treatment success (RR 1.63, 95% CI 1.18 to 2.24; 6 studies, 1139 participants), slightly reduces study withdrawals (RR 0.82, 95% CI 0.70 to 0.97; 41 studies, 3502 participants), and slightly increases adverse events (RR 1.72, 95% CI 1.07 to 2.76; 19 studies, 2187 participants). Subgroup analysis and meta-regression We did not find any differences in effects between different types of exercise, and we found no relationship between changes in pain or physical function and the total number of exercise sessions prescribed or the ratio (between exercise group and comparator) of real-time consultations with a healthcare provider. Clinical significance of the findings To determine whether the results found would make a clinically meaningful difference to someone with knee OA, we compared our results to established 'minimal important difference' (MID) scores for pain (12 points on a 0 to 100 scale), physical function (13 points), and quality of life (15 points). We found that the confidence intervals of mean differences either did not reach these thresholds or included both a clinically important and clinically unimportant improvement. AUTHORS' CONCLUSIONS We found low- to moderate-certainty evidence that exercise probably results in an improvement in pain, physical function, and quality of life in the short-term. However, based on the thresholds for minimal important differences that we used, these benefits were of uncertain clinical importance. Participants in most trials were not blinded and were therefore aware of their treatment, and this may have contributed to reported improvements.
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Affiliation(s)
- Belinda J Lawford
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Michelle Hall
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, New South Wales, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Martin Van der Esch
- Reade Centre for Rehabilitation and Rheumatology, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Alison R Harmer
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Libby Spiers
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Alex Kimp
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Andrea Dell'Isola
- Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
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Bazancir-Apaydin Z. Orthosis Management in Knee Osteoarthritis: Evaluating Existing Recommendations and Achieving Consensus on Implementation Through the Delphi Method. Musculoskeletal Care 2024; 22:e70018. [PMID: 39608843 DOI: 10.1002/msc.70018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 11/01/2024] [Accepted: 11/13/2024] [Indexed: 11/30/2024]
Abstract
OBJECTIVE The available evidence on orthosis management in the knee osteoarthritis (KOA) remains questionable. This study aims to evaluate existing recommendations and achieve consensus on their implementation through the modified Delphi method. METHODS Experienced experts in orthosis management for KOA patients participated in three Delphi rounds. Each round involved addressing various questions related to recommended orthosis type such as insole, knee brace, footwear, indications and contraindications, dosage of orthosis usage, follow-up period, long-term side effects, fitting, and weaning procedure. Consensus was defined as ≥ 70% agreement with a question. RESULTS Consensus was achieved for all questions. Experts frequently recommended custom-made insoles, neoprene knee braces, and appropriate footwear. The recommended duration of insole and knee brace usage averaged 3-6 months. Insole usage was advised during all weight-bearing activities, while knee braces were suggested for 4-6 h per day. Experts recommended orthosis follow-up for an average of 4-6 months. Reduced compliance with orthoses was highlighted by experts as the most significant long-term side effect. The fitting of orthoses is typically evaluated through gait analyses, assessment of symptoms and comfort, and observation of the corrective effects on impaired biomechanics in the clinical setting. Besides, experts commonly recommend a gradual weaning process from orthoses. CONCLUSIONS This study addresses the existing lack of consensus on orthosis management in KOA and provides essential clinical practice recommendations from multidisciplinary experts.
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Affiliation(s)
- Zilan Bazancir-Apaydin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Ankara Medipol University, Ankara, Türkiye
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