The University of Southampton
University of Southampton Institutional Repository

The OA Trial Bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids

The OA Trial Bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids
The OA Trial Bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids
Objective: to evaluate the efficacy of intra-articular (IA) glucocorticoids for knee or hip osteoarthritis (OA) in specific subgroups of patients with severe pain and inflammatory signs using individual patient data (IPD) from existing trials.

Design: randomized trials evaluating one or more IA glucocorticoid preparation in patients with knee or hip OA, published from 1995 up to June 2012 were selected from the literature. IPD obtained from original trials included patient and disease characteristics and outcomes measured. The primary outcome was pain severity at short-term follow-up (up to 4 weeks). The subgroup factors assessed included severe pain (?70 points, 0–100 scale) and signs of inflammation (dichotomized in present or not) at baseline. Multilevel regression analyses were applied to estimate the magnitude of the effects in the subgroups with the individuals nested within each study.

Results: seven out of 43 published randomized clinical trials (n = 620) were included. Patients with severe baseline pain had a significantly larger reduction in short-term pain, but not in mid- and long-term pain, compared to those with less severe pain at baseline (Mean Difference 13.91; 95% Confidence Interval 1.50–26.31) when receiving IA glucocorticoid injection compared to placebo. No statistical significant interaction effects were found between inflammatory signs and IA glucocorticoid injections compared to placebo and to tidal irrigation at all follow-up points.

Conclusions: this IPD meta-analysis demonstrates that patients with severe knee pain at baseline derive more benefit from IA glucocorticoid injection at short-term follow-up than those with less severe pain at baseline
1063-4584
1143-1152
van Middelkoop, M.
f9bdcea9-dd94-48f0-b76c-7792b17f7e8e
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Atchia, I.
a64a1454-e6a7-46b3-a1a2-354223284e92
Birrell, F.
a37bb72c-a86a-4cc0-a3b2-8a26508b1cce
Chao, J.
7f41aa0a-d0e8-48b6-a5c9-675a117ed435
Rezende, M.U.
68dd05b6-bebc-4c8c-88a2-ff227d3f3fc5
Lambert, R.G.
defd6672-576f-4037-96b8-a9dedb674551
Ravaud, P.
699240fd-cd15-49ec-a360-8723211b6428
Bijlsma, J.W.
7cb4fea9-4b22-4ba9-8bfc-01eef45503ef
Doherty, M.
3ccd8b47-e119-4f38-b813-08e9036a9ff3
Dziedzic, K.S.
2a6f8dfd-b08a-40f6-9950-60c7f4481642
Lohmander, L.S.
49c49f6f-5140-43fc-a33c-d7f8120b6640
McAlindon, T.E.
a2dae1c5-39e5-4e8c-bf72-8b8c446969b4
Zhang, W.
1c80d4f2-4ba8-41f6-85a6-a76a4d65dc9b
Bierma-Zeinstra, S.M.
c682a0d4-16c9-4d34-aec6-d53342074b5b
van Middelkoop, M.
f9bdcea9-dd94-48f0-b76c-7792b17f7e8e
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Atchia, I.
a64a1454-e6a7-46b3-a1a2-354223284e92
Birrell, F.
a37bb72c-a86a-4cc0-a3b2-8a26508b1cce
Chao, J.
7f41aa0a-d0e8-48b6-a5c9-675a117ed435
Rezende, M.U.
68dd05b6-bebc-4c8c-88a2-ff227d3f3fc5
Lambert, R.G.
defd6672-576f-4037-96b8-a9dedb674551
Ravaud, P.
699240fd-cd15-49ec-a360-8723211b6428
Bijlsma, J.W.
7cb4fea9-4b22-4ba9-8bfc-01eef45503ef
Doherty, M.
3ccd8b47-e119-4f38-b813-08e9036a9ff3
Dziedzic, K.S.
2a6f8dfd-b08a-40f6-9950-60c7f4481642
Lohmander, L.S.
49c49f6f-5140-43fc-a33c-d7f8120b6640
McAlindon, T.E.
a2dae1c5-39e5-4e8c-bf72-8b8c446969b4
Zhang, W.
1c80d4f2-4ba8-41f6-85a6-a76a4d65dc9b
Bierma-Zeinstra, S.M.
c682a0d4-16c9-4d34-aec6-d53342074b5b

van Middelkoop, M., Arden, Nigel, Atchia, I., Birrell, F., Chao, J., Rezende, M.U., Lambert, R.G., Ravaud, P., Bijlsma, J.W., Doherty, M., Dziedzic, K.S., Lohmander, L.S., McAlindon, T.E., Zhang, W. and Bierma-Zeinstra, S.M. (2016) The OA Trial Bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids. Osteoarthritis and Cartilage, 24 (7), 1143-1152. (doi:10.1016/j.joca.2016.01.983.). (PMID:26836288)

Record type: Article

Abstract

Objective: to evaluate the efficacy of intra-articular (IA) glucocorticoids for knee or hip osteoarthritis (OA) in specific subgroups of patients with severe pain and inflammatory signs using individual patient data (IPD) from existing trials.

Design: randomized trials evaluating one or more IA glucocorticoid preparation in patients with knee or hip OA, published from 1995 up to June 2012 were selected from the literature. IPD obtained from original trials included patient and disease characteristics and outcomes measured. The primary outcome was pain severity at short-term follow-up (up to 4 weeks). The subgroup factors assessed included severe pain (?70 points, 0–100 scale) and signs of inflammation (dichotomized in present or not) at baseline. Multilevel regression analyses were applied to estimate the magnitude of the effects in the subgroups with the individuals nested within each study.

Results: seven out of 43 published randomized clinical trials (n = 620) were included. Patients with severe baseline pain had a significantly larger reduction in short-term pain, but not in mid- and long-term pain, compared to those with less severe pain at baseline (Mean Difference 13.91; 95% Confidence Interval 1.50–26.31) when receiving IA glucocorticoid injection compared to placebo. No statistical significant interaction effects were found between inflammatory signs and IA glucocorticoid injections compared to placebo and to tidal irrigation at all follow-up points.

Conclusions: this IPD meta-analysis demonstrates that patients with severe knee pain at baseline derive more benefit from IA glucocorticoid injection at short-term follow-up than those with less severe pain at baseline

Full text not available from this repository.

More information

Accepted/In Press date: 22 January 2016
e-pub ahead of print date: 2 February 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 397267
URI: http://eprints.soton.ac.uk/id/eprint/397267
ISSN: 1063-4584
PURE UUID: 10ddcbd0-3809-4c33-a8ba-f19d09108c6e

Catalogue record

Date deposited: 30 Jun 2016 08:47
Last modified: 15 Jul 2019 20:20

Export record

Altmetrics

Contributors

Author: M. van Middelkoop
Author: Nigel Arden
Author: I. Atchia
Author: F. Birrell
Author: J. Chao
Author: M.U. Rezende
Author: R.G. Lambert
Author: P. Ravaud
Author: J.W. Bijlsma
Author: M. Doherty
Author: K.S. Dziedzic
Author: L.S. Lohmander
Author: T.E. McAlindon
Author: W. Zhang
Author: S.M. Bierma-Zeinstra

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×