背景:在用于治疗膝骨关节炎(OA)的药物中,口服专利结晶硫酸葡糖胺(pCGS)和富血小板血浆(PRP)已成为止痛药或非甾体抗炎药(NSAIDs)的流行替代品.尽管研究表明pCGS和PRP改善了临床结果,没有研究比较这些可选治疗的结局.我们比较了膝关节OA患者口服pCGS和PRP从基线到1年随访(FU)的功能表现结果。
方法:招募了三百八十二名接受口服PCGS的患者和122名接受PRP注射的患者,以评估功能表现结果,包括五次静坐测试(5xSST),时间上行测试(TUGT),和3分钟步行距离测试(3MWDT)。患者随访1年。pCGS组每天接受1500毫克,而PRP组在第0周和第6周接受2个周期的关节内注射。使用基于年龄的倾向得分匹配,性别,高度,体重,BMI,和凯尔格伦和劳伦斯(KL)分类,所有三个功能表现结果在基线(预处理)之间进行比较,6周,12周,24周,和1年FU。
结果:比例为2:1(pCGS:PRP),pCGS组的204例患者与PRP组的102例患者相匹配。与基线水平相比,PRP组从6周开始,5xSST和TUGT结局显着改善,从12周开始,3MWDT结局显着改善,而pCGS组在6周时TUGT结局显著改善,在12周时5xSST和3MWDT结局显著改善.在24周和1年的FU,两组在3项功能性能测试中均显示显著改善,无不良事件.
结论:尽管PRP组在6周时5xSST结局改善更快,从12周到1年的FU,PCGS和PRP组在5xSST中均显示出显着改善,TUGT,和3MWDT结果。由于PRP的使用比口服pCGS的使用更复杂和侵入性,应研究在膝OA治疗中选择PRP而非PCGS的利弊.
BACKGROUND: Among the medications used to treat knee osteoarthritis (OA), oral patented crystalline glucosamine sulfate (pCGS) and platelet-rich plasma (PRP) have become popular alternatives to painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs). Although studies have shown that pCGS and PRP improve clinical outcomes, no study has compared outcomes between these optional treatments. We compared functional performance outcomes from baseline to the 1-year follow-up (FU) between oral pCGS and PRP in patients with knee OA.
METHODS: Three hundred eighty-two patients receiving oral pCGS and 122 patients receiving PRP injections were enrolled for a review of functional performance outcomes, including a five-time sit-to-stand test (5xSST), time up-and-go test (TUGT), and 3-minute walk distance test (3MWDT). The patients were followed up for one year. The pCGS group received 1500 mg daily, whereas the PRP group received 2 cycles of intra-articular injections at week 0 and week 6. Using propensity score matching based on age, sex, height, weight, BMI, and Kellgren and Lawrence (KL) classification, all three functional performance outcomes were compared between the baseline (pretreatment), 6-week, 12-week, 24-week, and 1-year FUs.
RESULTS: With a ratio of 2:1 (pCGS: PRP), 204 patients in the pCGS group were matched with 102 patients in the PRP group. Compared with the baseline levels, the PRP group showed significant improvements in 5xSST and TUGT outcomes from 6 weeks and significant improvements in 3MWDT outcomes from 12 weeks, whereas the pCGS group showed significant improvements in TUGT outcomes from 6 weeks and significant improvements in 5xSST and 3MWDT outcomes from 12 weeks. At the 24-week and 1-year FU, both groups showed significant improvements in all three functional performance tests without adverse events.
CONCLUSIONS: Although the PRP group showed faster improvements in 5xSST outcomes at six weeks, from the 12-week to 1-year FU, both the pCGS and PRP groups showed significant improvements in 5xSST, TUGT, and 3MWDT outcomes. As the use of PRP is more complicated and invasive than the use of oral pCGS, the benefits and drawbacks of selecting PRP over pCGS in knee OA treatment should be examined.