Does sex affect the efficacy of systemic pharmacological treatments of pain in knee osteoarthritis? A systematic review

Santiago Espinosa-Salas , Leila Bagherzadeh , Q. Eileen Wafford , Graeme Witte , Thomas J. Schnitzer
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Abstract

Objective

To determine whether sex influences the analgesic efficacy of systemic pharmacological treatment in patients with knee osteoarthritis.

Design

A systematic review, guided by Cochrane methods, sourced studies from Medline, Cochrane Library, Embase, and CINAHL Plus with Full Text as of October 10, 2022. Eligible studies were double-blind RCTs evaluating systemic pharmacological treatments for knee osteoarthritis in adults, with minimum 30-day treatment duration, reporting sex-specific results or mentioning sex subgroup analysis for analgesic efficacy. The risk of bias was assessed using the Cochrane Risk of Bias tool version 2 (RoB 2).

Results

9 studies (5201 participants) met inclusion criteria, analyzing drugs including duloxetine, etoricoxib, tapentadol, naproxcinod, lutikizumab, and rofecoxib. Only one study reported sex-specific results. Review findings suggested no significant sex-based differences in treatment efficacy, however, data were limited due to a lack of sex-specific reporting or inclusion of sex in subgroup analyses.

Conclusions

Current evidence does not support the existence of sex differences in the analgesic efficacy of systemic knee osteoarthritis treatments. However, this conclusion is substantially limited by the paucity of sex-specific reporting of results or subgroup analyses in most primary studies, emphasizing the need for future research to report on sex-stratified data to allow for comprehensive, personalized treatment strategies.

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性别是否会影响膝骨关节炎疼痛系统药物治疗的疗效?系统回顾
目标确定性别是否会影响膝骨关节炎患者接受系统药物治疗的镇痛效果。设计在 Cochrane 方法的指导下进行系统综述,从 Medline、Cochrane 图书馆、Embase 和 CINAHL Plus 中获取截至 2022 年 10 月 10 日的全文研究。符合条件的研究均为评估成人膝骨关节炎系统性药物治疗的双盲 RCT,疗程不少于 30 天,报告了性别特异性结果或提到了镇痛疗效的性别亚组分析。结果9项研究(5201名参与者)符合纳入标准,分析的药物包括度洛西汀、依托考昔、他喷他多、萘普西诺德、鲁替珠单抗和罗非昔布。只有一项研究报告了特定性别的结果。综述结果表明,治疗效果没有明显的性别差异,但由于缺乏性别特异性报告或将性别纳入亚组分析,因此数据有限。结论目前的证据不支持全身性膝骨关节炎治疗的镇痛效果存在性别差异,但由于大多数主要研究很少报告特定性别的结果或进行亚组分析,因此这一结论受到很大限制。
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来源期刊
Osteoarthritis and cartilage open
Osteoarthritis and cartilage open Orthopedics, Sports Medicine and Rehabilitation
CiteScore
3.30
自引率
0.00%
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0
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Editorial Board Contents MicroRNA-181a/b-1 enhances chondroprogenitor anabolism and downregulates aquaporin-9 Safety and preliminary efficacy of transcutaneous auricular vagus nerve stimulation on chronic knee pain: A pilot trial Study protocol for the PICASSO trial: A randomized placebo-controlled trial to investigate the efficacy and safety of intraarticular steroid injections and an occupational therapy intervention in painful inflammatory carpometacarpal-1 osteoarthritis
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