Response to: ‘Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis’ by Wu et al

Mahler, E.; Minten, M.J.M.; Leseman-Hoogenboom, M.M.; Poortmans, Philip; Leer, J.W.H.; Boks, Simone S.; Hoogen, F.H.J. van den; Broeder, Alfons A den; Ende, C.H. van den

doi:10.1136/annrheumdis-2018-214795

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…The most important treatment of KOA is to relieve pain and restore function, and the fundamental purpose is to protect and repair articular cartilage and delay the pathological process. Western medicine treatment can be divided into two categories: medicine and operation [ 9 , 10 ]. Nonsteroidal anti-inflammatory drugs (NSAID) [ 11 ] are the most commonly used drugs in the treatment of KOA, such as Celebrex, Tylenin, and diclofenac sodium.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Safety of Chondroitin Combined with Glucosamine in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Wang

Yao

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This analysis was aimed at providing evidence-based medicine basis for systematic evaluation of chondroitin combined with glucosamine in the treatment of knee osteoarthritis. Methods. The randomized controlled trials (RCTs) of chondroitin combined with glucosamine in the treatment of knee osteoarthritis (KOA) were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) online database. The retrieval time ranges from the database creation to the present. Two investigators gathered the information individually. The risk of bias was assessed using the criteria of the Cochrane back review group. RevMan5.4 statistical software analyzed the selected data. Results. A total of 6 RCT articles were obtained. Overall, 764 samples were evaluated by meta-analysis. The clinical efficacy of chondroitin combined with glucosamine was significantly better than that of routine treatment by meta-analysis. The confidence interval of 95% was (4.86, 17.08) ( Z = 6.89 , P < 0.00001 ). The scores of joint pain, tenderness, swelling, and dysfunction in patients with knee osteoarthritis treated with chondroitin combined with glucosamine were significantly lower than those treated with routine treatment. There was no significant difference in the incidence of adverse reactions between chondroitin combined with glucosamine and single treatment of KOA. Due to the small number of documents included in the analysis, it is not suitable to make a funnel chart, but there may be some publication deviation in the analysis. Conclusion. Chondroitin combined with glucosamine is more effective than chondroitin or glucosamine alone in the treatment of KOA and deserves clinical promotion. However, this conclusion still needs to be supported by multicenter, high-quality, double-blind, large-sample randomized controlled clinical trials due to the limitations of the six trials included.

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Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Safety of Chondroitin Combined with Glucosamine in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Wang

Yao

et al. 2022

Computational and Mathematical Methods in Medicine

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“…In a randomised study by Mahler et al, there were no specific concomitant drug restrictions. 10 Patients were encouraged not to change analgesics and were discouraged from receiving other active treatments during the study; however, their use was allowed and monitored when needed. 10 As a result, unspecified analgesics were Open access used by approximately half of the patients (56% in the LDRT group and 43% in the sham group) for 3 months, and this uncontrolled part may have resulted in a study with bias.…”

Section: Discussionmentioning

confidence: 99%

“…10 Patients were encouraged not to change analgesics and were discouraged from receiving other active treatments during the study; however, their use was allowed and monitored when needed. 10 As a result, unspecified analgesics were Open access used by approximately half of the patients (56% in the LDRT group and 43% in the sham group) for 3 months, and this uncontrolled part may have resulted in a study with bias. In the recent ArthroRad trial, the use of analgesics during the trial was also not limited despite patients having undergone surgical interventions or injections to the involved joint after LDRT were excluded as soon as this therapy became known.…”

Section: Discussionmentioning

confidence: 99%

Low-dose RaDiation therapy for patients with KNee osteoArthritis (LoRD-KNeA): a protocol for a sham-controlled randomised trial

et al. 2023

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IntroductionLow-dose radiation therapy (LDRT) for osteoarthritis (OA) has been performed for several decades. However, supporting evidence from randomised studies using modern methodologies is lacking, and a recently published randomised study failed to show the significant benefit of LDRT. The presented trial aims to evaluate the efficacy and safety of LDRT for patients with knee OA.Methods and analysisThis prospective, multicentre, randomised trial will be conducted in the Republic of Korea. A total of 114 participants will be randomly assigned (1:1:1) to receive sham irradiation, 0.3 Gy/6 fractions of LDRT or 3 Gy/6 fractions of LDRT. Key inclusion criteria are primary knee OA with Kellgren-Lawrence grade 2–3 and visual analogue scale 50–90 when walking at the baseline. The primary endpoint is the rate of responders at 4 months after LDRT according to the OARSI-OMERACT criteria. Concomitant use of analgesics is prohibited until the primary efficacy evaluation is scheduled.Ethics and disseminationCurrently, approval from the Ministry of Food and Drug Safety of the Republic of Korea and the institutional review board of each participating hospital has been obtained. Patient enrolment began in October 2022 and is ongoing at three participating sites. The results will be disseminated to academic audiences and the public via publication in an international peer-reviewed journal and presentation at conferences. This trial will provide valuable information on the safety and efficacy of LDRT for patients with knee OA.Trial registration numberNCT05562271.

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Response to: ‘Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis’ by Wu et al

Cited by 2 publications

References 4 publications

Clinical Efficacy and Safety of Chondroitin Combined with Glucosamine in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Clinical Efficacy and Safety of Chondroitin Combined with Glucosamine in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Low-dose RaDiation therapy for patients with KNee osteoArthritis (LoRD-KNeA): a protocol for a sham-controlled randomised trial

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