“…24 However, the patient in the clinical vignette has a normal skin exam. Table 1 4 , 5 , 6 , 8 , 9 , 15 , 25 , 26 , 27 summarizes findings in OA and RA. Fig.…”
“…24 However, the patient in the clinical vignette has a normal skin exam. Table 1 4 , 5 , 6 , 8 , 9 , 15 , 25 , 26 , 27 summarizes findings in OA and RA. Fig.…”
“…Osteoarthritis (OA) is a common and chronic degenerative joint disorder that mainly affects the knee joints with the hip, hand, and spine being other common sites. The global burden of OA increased further due to the aging population and the rising prevalence of obesity [1]. As per the Global Burden of Disease (GBD) Study 2019, OA is ranked 16th Ambrish Singh and Pablo Molina-Garcia contributed equally to this work.…”
Section: Introductionmentioning
confidence: 99%
“…Despite the high prevalence and global impact of OA, there are no disease-modifying drugs approved for the treatment of OA that can arrest, slow, or reverse the progression of structural damage of the joint. [1,3].…”
Objective
Colchicine, an approved treatment for gout, has been trialed in many diseases including osteoarthritis (OA) due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA. This systematic review and meta-analysis evaluated the efficacy and safety of colchicine for the treatment of OA.
Methods
PubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through September 2022. Two reviewers independently screened for randomized controlled trials (RCTs) comparing colchicine with placebo or other active comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments.
Result
Nine RCTs for the knee OA and one for the hand OA were identified, consisting of 847 patients (429 in colchicine arms, 409 in control arms). The studies were conducted between 2002 and 2021 with follow-up periods ranging from 2 to 12 months, in India, Iran, Turkey, Australia, Singapore, and Iraq. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to control (standardized mean difference [SMD], 0.17; 95% confidence interval [CI], − 0.55, 0.22). Moderate-quality evidence showed no improvement in function with colchicine compared to control in knee OA patients (SMD, − 0.37; 95% CI, − 0.87, 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to control.
Conclusion
Current evidence does not suggest a benefit of colchicine in reducing pain and improving physical function in the overall cohort of hand/knee OA patients. Future trials should focus on the subgroups of OA patients with local or systemic inflammation and/or mineralization who might benefit from colchicine.
Graphical abstract
Key Points•Colchicine is an approved treatment for gout that has been trialed in many diseases including osteoarthritis (OA) due to its anti-inflammatory effects. However, the benefit and harms of colchicine in OA remain unclear.• Current evidence from randomized control trials does not suggest a benefit of colchicine in reducing pain and improving physical function for the treatment of OA patients.• Future trials of colchicine in OA should focus on the subgroups of OA patients with local or systemic inflammation and/or mineralization who might benefit from colchicine.
“…Commonly, OA affects people over the age of 40, and the risk of disease increases with age, reaching 40% of people over the age of 70 suffering from OA [ 6 , 11 ]. In 2017, 303 million people were globally affected by OA [ 12 ] and, according to the most recent report from 2019, the number of people suffering from this condition exceeded 500 million (prevalence of 6.5%) [ 13 ]. WHO estimates that the number of people affected by OA in the U.S. will increase from 30 million (9% prevalence) to 67 million by the year 2030 [ 8 ] and it will reach 130 million by the year 2050 [ 14 ].…”
Osteochondral structure reconstruction by tissue engineering, a challenge in regenerative medicine, requires a scaffold that ensures both articular cartilage and subchondral bone remodeling. Functional hydrogels and scaffolds present a strategy for the controlled delivery of signaling molecules (growth factors and therapeutic drugs) and are considered a promising therapeutic approach. Icariin is a pharmacologically-active small molecule of prenylated flavonol glycoside and the main bioactive flavonoid isolated from Epimedium spp. The in vitro and in vivo testing of icariin showed chondrogenic and ostseoinductive effects, comparable to bone morphogenetic proteins, and suggested its use as an alternative to growth factors, representing a low-cost, promising approach for osteochondral regeneration. This paper reviews the complex structure of the osteochondral tissue, underlining the main aspects of osteochondral defects and those specifically occurring in osteoarthritis. The significance of icariin’s structure and the extraction methods were emphasized. Studies revealing the valuable chondrogenic and osteogenic effects of icariin for osteochondral restoration were also reviewed. The review highlighted th recent state-of-the-art related to hydrogels and scaffolds enriched with icariin developed as biocompatible materials for osteochondral regeneration strategies.
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