氨糖在骨关节炎中的应用.pptxVIP

氨糖在骨关节炎中的应用第1页/共26页 Effects of glucosamine in patientswith osteoarthritisJune, 2018第2页/共26页 Osteoarthritis of hip and knee is increasingnon-steroidal anti-inflammatory drugs was used as the pain killerNSAIs cause serious gastrointestinal and cardiovascular adverse events, especially with long term useGlucosamine was used to be thought as disease modifying agents and recommended for yearsGlobal sales：$2bn (￡1.3bn, €0.8bn) in 2008, 60% compared with 2003, 2013 reaching $2.3bnResults from randomized trials about the effectiveness of chondroitin and glucosamine are conflictingIntroduction第3页/共26页 Article #12010 . BMJImpactor 20.75第4页/共26页 Article #1Aim: To determine the effect of glucosamine, chondroitin, or the two in combination on joint pain and on radiological progression of disease in osteoarthritis of the hip or kneeDesign: network meta-analysisOutcomes: pain release, change in minimal width of joint space Eligibility criteria: Large scale randomized controlled trials in more than 200 patients with osteoarthritis of the knee or hip that compared glucosamine, chondroitin, or their combination with placebo or head to headGeneral character: 10 trials in 3803 patients were included. 第5页/共26页 Method Statistical analysis: multivariable Bayesian hierarchical random effects modelsSignificant difference: we back transformed effect sizes to differences on a 10 cm visual analogue scale on the basis of a median pooled SD of 2.5 cm found in large scale osteoarthritis trials that assessed pain on a 10 cm visual analogue scale.We prespecified a minimal clinically important difference of 0.37 SD units, corresponding to 0.9 cm on a 10 cm visual analogue scale. joint space clinically important difference : SD of 1.2 mm 第6页/共26页 Result 第7页/共26页 Result 第8页/共26页 Result 第9页/共26页 Result tests for interaction were all negative (P≥0.20 for interaction) 第10页/共26页 Result Joint space: The difference was -0.2 mm (-0.3 to 0.0 mm) in glucosamine-0.1 mm (-0.3 to 0.1 mm) in favour of chondr