Effect and usability of anti-inflammatory drug plasters for knee osteoarthritis: A crossover, double-blind, repeated measures, randomized controlled trial.


Journal

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
ISSN: 1436-2023
Titre abrégé: J Orthop Sci
Pays: Japan
ID NLM: 9604934

Informations de publication

Date de publication:
May 2021
Historique:
received: 29 11 2019
revised: 27 02 2020
accepted: 14 04 2020
pubmed: 11 8 2020
medline: 30 9 2021
entrez: 11 8 2020
Statut: ppublish

Résumé

The use of plasters is a well-accepted treatment with high adherence. However, the characteristics such as its cool feeling or extensibility favored by elderly have a possibility to contribute to clinical utility. The purpose is to examine the effect of anti-inflammatory drug plasters for knee osteoarthritis and the clinical preference of the patients for using plasters. We conducted a crossover, double-blind, randomized controlled trial (RCT) recruited 168 patients with knee osteoarthritis. We included a "run-in-period" to evaluate the patients' preference among A (first-generation; methyl salicylate), B (second-generation; indomethacin), and N (base substrate for B) before the crossover sequence of two treatment periods with A and B plasters; four arms (N-A-B, A-A-B, N-B-A, and B-B-A) were made to compare the assessment of A, B, and N plasters. We used two measures: The Japanese Knee Osteoarthritis Measure (JKOM), for clinical functions, and the usability questionnaire to evaluate the clinical value of plasters. At baseline, there were no significant differences in characteristics. The subjects in groups A and B showed improved overall JKOM scores at the end of each intervention. Comparison of the change of the mean difference showed that A and B were statistically significant improvement over N (-2.40, (95%CI = -3.58 to -1.21), -2.52, (-3.65 to -1.40)) but no significant difference between A and B - 0.13, (-1.14 to 0.89)). In network analysis for usability, twelve items were independent of JKOM's network structure and consisted of two domains. The analysis of usability showed that N and B were preferred over A significantly. Both the first- and second-generation plasters were statistically superior to the base only, but no significant difference between two generations. The patient is surely aware of the effect of the drug itself, but the two feelings are important in the preference.

Sections du résumé

BACKGROUND BACKGROUND
The use of plasters is a well-accepted treatment with high adherence. However, the characteristics such as its cool feeling or extensibility favored by elderly have a possibility to contribute to clinical utility. The purpose is to examine the effect of anti-inflammatory drug plasters for knee osteoarthritis and the clinical preference of the patients for using plasters. We conducted a crossover, double-blind, randomized controlled trial (RCT) recruited 168 patients with knee osteoarthritis.
METHODS METHODS
We included a "run-in-period" to evaluate the patients' preference among A (first-generation; methyl salicylate), B (second-generation; indomethacin), and N (base substrate for B) before the crossover sequence of two treatment periods with A and B plasters; four arms (N-A-B, A-A-B, N-B-A, and B-B-A) were made to compare the assessment of A, B, and N plasters. We used two measures: The Japanese Knee Osteoarthritis Measure (JKOM), for clinical functions, and the usability questionnaire to evaluate the clinical value of plasters.
RESULTS RESULTS
At baseline, there were no significant differences in characteristics. The subjects in groups A and B showed improved overall JKOM scores at the end of each intervention. Comparison of the change of the mean difference showed that A and B were statistically significant improvement over N (-2.40, (95%CI = -3.58 to -1.21), -2.52, (-3.65 to -1.40)) but no significant difference between A and B - 0.13, (-1.14 to 0.89)). In network analysis for usability, twelve items were independent of JKOM's network structure and consisted of two domains. The analysis of usability showed that N and B were preferred over A significantly.
CONCLUSION CONCLUSIONS
Both the first- and second-generation plasters were statistically superior to the base only, but no significant difference between two generations. The patient is surely aware of the effect of the drug itself, but the two feelings are important in the preference.

Identifiants

pubmed: 32773325
pii: S0949-2658(20)30134-2
doi: 10.1016/j.jos.2020.04.014
pii:
doi:

Substances chimiques

Anti-Inflammatory Agents 0
Anti-Inflammatory Agents, Non-Steroidal 0
Pharmaceutical Preparations 0

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

421-429

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest All authors declare that they have no competing interests. (Please see COI Disclosure Form).

Auteurs

Hideki Tanabe (H)

Tanabe Orthopaedic Clinic, 3-2-16 Narimasu, Itabashi-ku, Tokyo, 175-0094, Japan. Electronic address: narimasu@mint.ocn.ne.jp.

Tokuhide Doi (T)

Geriatric Care Facilities Narita Tomisato Tokushu-en, 1-1-1 Hiyoshi-dai, Tomisato-shi, Chiba, 286-0201, Japan. Electronic address: doi@mars.dti.ne.jp.

Masami Akai (M)

Graduate School, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan. Electronic address: akai-masami@iuhw.ac.jp.

Keiji Fujino (K)

Fujino Orthopaedic Clinic, 2-15-12 Johoku, Naka-ku, Hamamatsu-shi, Shizuoka, 432-8011, Japan. Electronic address: keifujino@lily.ocn.ne.jp.

Sadao Arai (S)

Arai Orthopaedic Clinic, 1-19-7 Asumigaoka Midori-ku, Chiba-shi, Chiba, 267-0066, Japan. Electronic address: ryokusei@fb3.so-net.ne.jp.

Kunihiko Hayashi (K)

Department of Statistical Epidemiology, School of Health Sciences, Gunma University, 3-39-22 Shouwa-machi, Maebashi-shi, Gunma, 371-8514, Japan. Electronic address: khayashi@health.gunma-u.ac.jp.

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