背景:一些研究报道,硫酸葡糖胺(GS)可以改善膝骨关节炎(OA)症状。并行,还研究了非甾体类抗炎药(NSAIDs)对膝关节OA的疾病改善作用.然而,有限的文献报道了GS和NSAIDs的联合作用。本范围综述的目的是描述研究GS和NSAIDs联合治疗膝关节OA患者的潜在益处和协同作用的文献的范围和数量。
方法:检索PubMed和Embase从开始到2022年4月发表的研究,评估GS和NSAIDs联合治疗对OA患者的影响,与单独治疗相比。数据以叙述方式报告。
结果:本综述包括5项研究;4项为随机对照试验,1项为前瞻性观察性研究。联合治疗的持续时间为6至12周。在2项研究中将该组合与塞来昔布进行了比较,美洛昔康1,依托考昔1,常规NSAID1(布洛芬或吡罗昔康)。所有5项研究都报道了膝关节OA患者,GS加NSAID的组合比单药治疗产生了显著更大的益处,就包括疼痛减轻在内的结果而言,函数,接头刚度,以及炎症活动和软骨降解的标志物。
结论:本次范围综述中包含的5项研究均报告了GS加NSAID联合治疗与任何单独治疗相比具有显著更大的临床益处。证据支持减轻疼痛的功效,改善功能,并可能调节关节损伤。然而,需要进一步的更大样本量的随机试验来证实这些发现.
BACKGROUND: Several studies have reported that glucosamine sulfate (GS) can improve knee osteoarthritis (OA) symptomatology. In parallel, the disease-modifying effects of non-steroidal anti-inflammatory drugs (NSAIDs) in knee OA have also been investigated. However, limited literature has reported the combined effect of GS and NSAIDs. The aim of this scoping
review is to describe the scope and volume of the literature investigating the potential benefits and synergistic effect of a combination of GS and NSAIDs in patients with knee OA.
METHODS: PubMed and Embase were searched for studies published from inception through April 2022, evaluating the effects of the combination of GS and NSAIDs in OA patients, versus either treatment alone. Data are reported narratively.
RESULTS: Five studies were included in this
review; 4 were randomized control trials and one was a prospective observational study. The duration of combination treatment was 6 to 12 weeks. The combination was compared to celecoxib in 2 studies, meloxicam in 1, etoricoxib in 1, and a conventional NSAID in 1 (ibuprofen or piroxicam). All 5 studies reported that in patients with knee OA, the combination of GS plus NSAID yielded a significantly greater benefit than single-agent therapy, in terms of outcomes including pain reduction, function, joint stiffness, and markers of inflammatory activity and cartilage degradation.
CONCLUSIONS: The 5 studies included in this scoping
review all report a significantly greater clinical benefit with a combination of GS plus NSAID compared to either treatment alone. The evidence supports efficacy in reducing pain, improving function, and possibly regulating joint damage. However, further randomized trials with larger sample sizes are warranted to confirm these findings.