Biologic drugs as analgesics for the management of osteoarthritis

被引:16
作者
Dimitroulas, Theodoros [1 ,2 ]
Lambe, Tosin [3 ]
Klocke, Rainer [1 ]
Kitas, George D. [1 ,4 ]
Duarte, Rui V. [3 ,5 ]
机构
[1] Dudley Grp NHS Fdn Trust, Dept Rheumatol, Dudley, England
[2] Aristotle Univ Thessaloniki, Sch Med, Hippokrat Hosp, Dept Internal Med 4, Thessaloniki, Greece
[3] Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England
[4] Univ Manchester, Arthrit Res UK Ctr Epidemiol, Ctr Musculoskeletal Res, Manchester, Lancs, England
[5] Univ Birmingham, Inst Appl Hlth Res, Murray Learning Ctr, Room 124, Birmingham B15 2TT, W Midlands, England
关键词
Anti-nerve growth factor; Anti-tumor necrosis factor alpha; Biologic drugs; Osteoarthritis; NERVE GROWTH-FACTOR; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; DOUBLE-BLIND; HAND OSTEOARTHRITIS; HIP OSTEOARTHRITIS; NEUROPATHIC PAIN; TANEZUMAB; EFFICACY; SAFETY; KNEE;
D O I
10.1016/j.semarthrit.2016.12.001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Biologic drugs are novel therapeutic agents with demonstrated effectiveness in the management of a variety of chronic inflammatory disorders. Unmet needs in the treatment of chronic pain have led physicians to utilize a similar approach to patients suffering from conditions not characterized by systemic inflammation such as osteoarthritis (OA). The aim of this review is to discuss the current knowledge on the use of commonly used biologic agents [i.e., anti-tumor necrosis factor alpha (anti-TNF alpha) and anti-nerve growth factor (anti-NGF)] for the management of OA. Methods: A narrative literature review of studies investigating the use of biologic agents for the management of osteoarthritis was conducted. We searched MEDLINE and EMBASE for English language publications. A hand-search of reference lists of relevant studies was also performed. Results: Current evidence does not support TNF-alpha inhibition for the management of OA, although a selected subgroup of these patients with a marked inflammatory profile may benefit from this therapy. Anti-NGF therapy has been shown to reduce pain and improve function compared to placebo and non steroidal anti-inflammatory drugs in OA but concerns remain regarding the safety of such treatment. The discrepant results observed in RCTs of biologic agents may be related to heterogeneity, small sample sizes, and differences in the mode of administration of these drugs. Conclusion: Anti-NGF therapy is efficacious for pain in patients with hip and knee OA. Despite the fact that current data suggests that anti-cytokine treatments have limited efficacy in patients with chronic osteoarthritic pain, larger and better designed studies in more selected populations are justified to determine whether such therapeutic approaches can improve outcomes in this disabling condition where our medical treatment armamentarium is relatively poor. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:687 / 691
页数:5
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