Effect of disease-modifying anti-rheumatic drugs in osteoarthritis: A meta-analysis.


Journal

Joint bone spine
ISSN: 1778-7254
Titre abrégé: Joint Bone Spine
Pays: France
ID NLM: 100938016

Informations de publication

Date de publication:
11 2022
Historique:
received: 17 05 2022
revised: 28 06 2022
accepted: 11 07 2022
pubmed: 1 8 2022
medline: 24 11 2022
entrez: 31 7 2022
Statut: ppublish

Résumé

Osteoarthritis (OA) displays features of systemic and local inflammation, suggesting that DMARDs used in rheumatoid arthritis could potentially also be effective in OA. However, studies of the effects of DMARDs in OA have yielded conflicting data, and have been insufficiently large to draw conclusions. In this meta-analysis, we aimed to estimate the effect of DMARDs - such as methotrexate, hydroxychloroquine, TNF, and IL-1 inhibitors - on OA. We searched for relevant articles of randomized controlled trials published up to March 2022, using Pubmed, EMBASE, and the Cochrane Library. Studies were reviewed in accordance with PRISMA 2020 guidelines. The effects of DMARDs on OA outcomes (symptoms, quality of life, ESR) were expressed as the standardized mean difference. We retrieved 29 references. Among these, 23 randomized controlled trials compared the effects of DMARDs versus placebo or other treatments on disease activity, including 1143 DMARD-treated OA patients and 1155 OA patients in the control group. We found statistically significant improvement of pain and stiffness with methotrexate, especially in knee OA. TNF inhibitors improved the swollen joint count in hand OA, and inflammation parameters, without change in pain, stiffness, or function. Hydroxychloroquine and IL-1 inhibitors were not effective. Overall, the presently available data regarding the effects of DMARDs on OA symptoms intensity are disappointing. Only methotrexate might have an analgesic effect, especially in knee OA, which warrants further investigation.

Identifiants

pubmed: 35908643
pii: S1297-319X(22)00104-X
doi: 10.1016/j.jbspin.2022.105444
pii:
doi:

Substances chimiques

Methotrexate YL5FZ2Y5U1
Hydroxychloroquine 4QWG6N8QKH
Antirheumatic Agents 0
Interleukin-1 0

Types de publication

Meta-Analysis Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105444

Informations de copyright

Copyright © 2022 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.

Auteurs

Sylvain Mathieu (S)

Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France. Electronic address: smathieu@chu-clermontferrand.fr.

Anne Tournadre (A)

Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France.

Martin Soubrier (M)

Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France.

Jérémie Sellam (J)

Sorbonne Université, Service de rhumatologie, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP) Inserm UMRS_938, Centre de Recherche Saint-Antoine, 75012 Paris, France.

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Classifications MeSH