PMID- 35282570
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220316
IS  - 1759-720X (Print)
IS  - 1759-7218 (Electronic)
IS  - 1759-720X (Linking)
VI  - 14
DP  - 2022
TI  - Efficacy and safety of biologic agents for the treatment of osteoarthritis: a 
      meta-analysis of randomized placebo-controlled trials.
PG  - 1759720X221080377
LID - 10.1177/1759720X221080377 [doi]
LID - 1759720X221080377
AB  - BACKGROUND: We aimed to evaluate the efficacy and safety of biologic agents 
      targeting three main cytokines, that is, nerve growth factor (NGF), interleukin-1 
      (IL-1), and tumor necrosis factor-alpha (TNF-alpha), for osteoarthritis (OA) treatment. 
      METHODS: Databases (PubMed, Embase, and Cochrane Library) and ClinicalTrials.gov 
      were systematically searched for randomized placebo-controlled trials (RCTs) of 
      biologic agents from inception to November 15, 2020. The outcomes were the mean 
      change in pain, function scores, and the risk of adverse effects (AEs). RESULTS: 
      Out of the 28 studies with 29 RCTs (8555 individuals) included, biologic agents 
      were superior to placebo in pain relief (standardized mean difference 
      [SMD] = 0.28, 95% confidence interval [CI] = 0.17-0.38, p < 0.001) and function 
      improvement (SMD = 0.30, 95% CI = 0.18-0.43, p < 0.001). The incidence of any AEs 
      (risk ratio [RR] = 1.09, 95% CI = 1.05-1.14, p < 0.001) and discontinuations due 
      to AEs (RR = 1.39, 95% CI = 1.05-1.83, p = 0.021) were higher following treatment 
      with biologic agents while no significant difference was found in serious AEs. 
      Subgroup analyses showed that NGF inhibitors provided superior pain relief 
      (SMD = 0.36, 95% CI = 0.26-0.47, p < 0.001) and function improvement (SMD = 0.41, 
      95% CI = 0.30-0.51, p < 0.001), whereas IL-1 inhibitors and TNF-alpha inhibitors did 
      not. Meanwhile, NGF inhibitors increased the incidence of any AEs (RR = 1.12, 95% 
      CI = 1.07-1.17, p < 0.001) and discontinuations due to AEs (RR = 1.48, 95% 
      CI = 1.07-2.06, p = 0.018). IL-1 inhibitors and TNF-alpha inhibitors showed no 
      difference in safety compared with placebo. CONCLUSIONS: The efficacy and safety 
      of biologic agents vary by mechanism of action. NGF inhibitors can relieve 
      OA-related pain and improve function but involve safety concerns. IL-1 inhibitors 
      and TNF-alpha inhibitors are relatively safe options but with limited efficacy.
CI  - (c) The Author(s), 2022.
FAU - Meng, Fanqiang
AU  - Meng F
AUID- ORCID: 0000-0003-2200-1859
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Li, Hui
AU  - Li H
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Feng, Haoran
AU  - Feng H
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Long, Huizhong
AU  - Long H
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Yang, Zidan
AU  - Yang Z
AD  - Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central 
      South University, Changsha, China.
FAU - Li, Jiatian
AU  - Li J
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Wang, Yuqing
AU  - Wang Y
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 
      China.
FAU - Xie, Dongxing
AU  - Xie D
AUID- ORCID: 0000-0003-2672-4544
AD  - Department of Orthopaedics, Xiangya Hospital, Central South University, 87 
      Xiangya Road, Changsha, Hunan 410008, China.
LA  - eng
PT  - Address
DEP - 20220308
PL  - England
TA  - Ther Adv Musculoskelet Dis
JT  - Therapeutic advances in musculoskeletal disease
JID - 101517322
PMC - PMC8908403
OTO - NOTNLM
OT  - IL-1
OT  - NGF
OT  - TNF-alpha
OT  - biologic agents
OT  - meta-analysis
OT  - osteoarthritis
COIS- Conflict of interest statement: The authors declared no potential conflicts of 
      interest with respect to the research, authorship and/or publication of this 
      article.
EDAT- 2022/03/15 06:00
MHDA- 2022/03/15 06:01
PMCR- 2022/03/08
CRDT- 2022/03/14 05:35
PHST- 2021/08/12 00:00 [received]
PHST- 2022/01/25 00:00 [accepted]
PHST- 2022/03/14 05:35 [entrez]
PHST- 2022/03/15 06:00 [pubmed]
PHST- 2022/03/15 06:01 [medline]
PHST- 2022/03/08 00:00 [pmc-release]
AID - 10.1177_1759720X221080377 [pii]
AID - 10.1177/1759720X221080377 [doi]
PST - epublish
SO  - Ther Adv Musculoskelet Dis. 2022 Mar 8;14:1759720X221080377. doi: 
      10.1177/1759720X221080377. eCollection 2022.