Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

Objective: PRP is produced by centrifugation of whole blood containing highly concentrated platelets, associated growth factors, and other bioactive agents which has been shown to provide some symptomatic relief in early knee osteoarthritis (OA). The principal objective of our study was to evaluate the effectiveness and safety of standardized intra-articular injection of autologous PRP in early osteoarthritis knee. Methods: A total of 98 eligible symptomatic patients received two injections of standardized PRP 3 weeks apart. Clinical outcomes were evaluated using the VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before treatment and at 6 weeks, 3 months, 6 months, and 1 year after treatment. Secondary objectives were safety (side effects), and the effect of PRP on the different grades of knee degeneration. Results: There was a statistically significant improvement in mean VAS and WOMAC scores at 6 weeks, 3 months, 6 months, and slight loss of improvement at 1 year follow-up. There was also a correlation between the degree of degeneration and improvement in the mean scores. The decrease in mean pain score is more in grades 1 and 2 (early OA) than in grade 3. The intraarticular injection is safe, with no major complications. Conclusion: PRP is a safe and effective biological regenerative therapy for early OA Knees. It provides a significant clinical improvement in patients with some loss of improvement with time. More studies will be needed to confirm our findings.

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Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

The American Journal of Sports Medicine ◽

10.1177/0363546520909397 ◽

2020 ◽

Vol 49 (1) ◽

pp. 249-260 ◽

Cited By ~ 9

Author(s):

John W. Belk ◽

Matthew J. Kraeutler ◽

Darby A. Houck ◽

Jesse A. Goodrich ◽

Jason L. Dragoo ◽

...

Keyword(s):

Systematic Review ◽

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Symptomatic Relief ◽

Cochrane Library ◽

Knee Oa ◽

Level 1

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are 2 nonoperative treatment options for knee osteoarthritis (OA) that are supposed to provide symptomatic relief and help delay surgical intervention. Purpose: To systematically review the literature to compare the efficacy and safety of PRP and HA injections for the treatment of knee OA. Study Design: Meta-analysis of level 1 studies. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify level 1 studies that compared the clinical efficacy of PRP and HA injections for knee OA. The search phrase used was platelet-rich plasma hyaluronic acid knee osteoarthritis randomized. Patients were assessed via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and Subjective International Knee Documentation Committee (IKDC) scale. A subanalysis was also performed to isolate results from patients who received leukocyte-poor and leukocyte-rich PRP. Results: A total of 18 studies (all level 1) met inclusion criteria, including 811 patients undergoing intra-articular injection with PRP (mean age, 57.6 years) and 797 patients with HA (mean age, 59.3 years). The mean follow-up was 11.1 months for both groups. Mean improvement was significantly higher in the PRP group (44.7%) than the HA group (12.6%) for WOMAC total scores ( P < .01). Of 11 studies based on the VAS, 6 reported PRP patients to have significantly less pain at latest follow-up when compared with HA patients ( P < .05). Of 6 studies based on the Subjective IKDC outcome score, 3 reported PRP patients to have significantly better scores at latest follow-up when compared with HA patients ( P < .05). Finally, leukocyte-poor PRP was associated with significantly better Subjective IKDC scores versus leukocyte-rich PRP ( P < .05). Conclusion: Patients undergoing treatment for knee OA with PRP can be expected to experience improved clinical outcomes when compared with HA. Additionally, leukocyte-poor PRP may be a superior line of treatment for knee OA over leukocyte-rich PRP, although further studies are needed that directly compare leukocyte content in PRP injections for treatment of knee OA.

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Treatment of Knee Osteoarthritis with Autologous Expanded Bone Marrow Mesenchymal Stem Cells: 50 Cases Clinical and MRI Results at One Year Follow-Up

Journal of Stem Cell Research & Therapy ◽

10.4172/2157-7633.1000285 ◽

2015 ◽

Vol 05 (06) ◽

Cited By ~ 4

Author(s):

Soler Rich R Munar A

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Mesenchymal Stem Cells ◽

Knee Osteoarthritis ◽

Marrow Mesenchymal Stem Cells ◽

One Year

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Evaluation of efficacy and comparative frequency of adverse events in patients with ulcerative colitis receiving the original infliximab and its biosimilar. One year of observation

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.08.000331 ◽

2019 ◽

Vol 91 (8) ◽

pp. 41-46

Author(s):

O V Knyazev ◽

T V Shkurko ◽

A V Kagramanova ◽

A A Lishchinskaya ◽

M Yu Zvyaglova ◽

...

Keyword(s):

Ulcerative Colitis ◽

Adverse Events ◽

Real Life ◽

Fecal Calprotectin ◽

Biologic Drugs ◽

Real Life Data ◽

Bowel Diseases ◽

Significant Clinical Improvement ◽

One Year

Real - life data on the effectiveness and safety of biosimilar and biologic drugs licensed for treatment of inflammatory bowel diseases (IBD) is lacking. Aim. To investigate efficacy of original Infliximab (IFX) and its biosimilar in treating patients with ulcerative colitis (UC) and determine the frequency of adverse events during 1 year follow - up period. Materials and methods. Our cohort consisted of 98 ulcerative colitis patients, treated with original IFX and its biosimilar since December 2017 till December 2018 years. Original Infliximab was prescribed in 56 UC patients (57.1%) during 5 years and longer; 16 patients (16.3%) were switched to IFX biosimilar; 13 UC bio - naïve patients (13.3%) received original IFX, 29 (29.6%) patients - biosimilar IFX. In 14 patients (14.3%) original infliximab was rotated with biosimilar. We picked out 42 patients to assess efficacy of original IFX and biosimilar. Results and discussion. Twelve patients, received original IFX and 28 patients, treated with its biosimilar, showed significant clinical improvement by decreasing Mayo index from 9.7±0.4 and 10.2±0.2 points to 1.9±0.09 and 2.1±0.1 points, accordingly. Also we noticed positive change in laboratory markers - CRP decrease from 89.6±8.7 mg/l and 77.5±8.0 mg/l to 6.5±0.8 mg/l and 6.9±0.8 mg/l (p>0.05), albumin increase from 30.1±4.7 g/l and 29.6±3.6 g/l to 34.1±6.3 g/l and 32.8±5.9 g/l (p>0.05), increase of serum iron levels from 6.4±0.5 mcg/l and 7.1±0.65 mcg/l to 14.6±4.4 mcg/l and 15.9±5.1 mcg/l (p>0.05), hemoglobin increase from 104.7±9.8 g/l and 102.2±8.8 g/l till 124±11.3 g/l and 121±10.9 g/l (p>0.05), and fecal calprotectin decrease from 1680±134 mcg/g and 1720±126 mcg/g till 245.5±33.4 mcg/g and 230.5±29.8 mcg/g (p>0.05). During 1 year follow - up 12 UC patients, treated with original IFX and its biosimilar, developed adverse events. The majority of adverse events (n=8) were registered in patients, rotating administration of original IFX and its biosimilar. Conclusion. IFX biosimilar is effective as well as original IFX. Frequency of adverse events, occurred in patients, treated with original IFX, was comparable with adverse events frequency in patients, received biosimilar IFX. Frequency of adverse events was significantly higher in UC patients, rotating original IFX and its biosimilar.

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Management of early breast cancer

Drug and Therapeutics Bulletin ◽

10.1136/dtb.30.14.53 ◽

1992 ◽

Vol 30 (14) ◽

pp. 53-56

Keyword(s):

Breast Cancer ◽

Screening Programme ◽

Early Stage ◽

Public Awareness ◽

Develop Breast Cancer ◽

Early Disease ◽

The Past ◽

Disease Prognosis ◽

One Year

One in 12 women in Britain will develop breast cancer and in any one year 15000 women will die of the disease. Prognosis for patients with advanced breast cancer has altered little during the past 30 years, but for those diagnosed early outlook has improved. Greater public awareness coupled with a national screening programme has led more women to present at an early stage1 and gives them a greater opportunity to take advantage of improved management. In this, the first of two articles on breast cancer, we discuss developments in the management of early disease. A later article will examine the follow-up of patients with breast cancer.

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Secondary Prevention of Non-fatal Deliberate Self-harm

The British Journal of Psychiatry ◽

10.1192/bjp.163.1.111 ◽

1993 ◽

Vol 163 (1) ◽

pp. 111-112 ◽

Cited By ~ 116

Author(s):

H. G. Morgan ◽

E. M. Jones ◽

J. H. Owen

Keyword(s):

British Journal ◽

Early Stage ◽

Psychiatric Services ◽

Easy Access ◽

Deliberate Self Harm ◽

Self Harm ◽

One Year ◽

First Time ◽

Experimental Group

In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls.British Journal of Psychiatry (1993), 163, 111–112

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Knee osteoarthritis functional classification scheme – Validation of time dependent treatment effect. One year follow-up of 518 patients

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2016.01.231 ◽

2016 ◽

Vol 24 ◽

pp. S117

Author(s):

A. Herman ◽

A. Mor ◽

G. Segal ◽

N. Shazar ◽

Y. Beer ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Treatment Effect ◽

Classification Scheme ◽

Time Dependent ◽

Functional Classification ◽

One Year

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Changes in Knee Joint Space Width in Treatment with a New Hyaluronic-Based Hydrogel

Acta Medica Marisiensis ◽

10.1515/amma-2017-0017 ◽

2017 ◽

Vol 63 (3) ◽

pp. 125-128

Author(s):

Octav Marius Russu ◽

Andrei Marian Feier ◽

Tudor Sorin Pop ◽

Marcela Todoran ◽

István Gergely

Keyword(s):

Hyaluronic Acid ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Joint Space Narrowing ◽

Joint Space Width ◽

Joint Space ◽

One Year ◽

A Minor ◽

Space Width

AbstractObjective: Our purpose was to assess the effect of a new hyaluronic acid-based (Hymovis®) injections on joint space width narrowing in patients diagnosed with knee osteoarthritis.Methods: A prospective clinical trial was conducted in the Department of Orthopedics and Traumatology II from the Clinical County Hospital, Tîrgu Mureș, Romania. Thirty-five patients diagnosed with idiopathic knee osteoarthritis received two intraarticular injections with hyaluronic acid-based hydrogel (24 mg of hyaluronic acid/3 ml) at one-week interval. Anteroposterior radiographs were obtained before the injections, at six and twelve months after. Minimum joint space width was measured by two senior orthopaedics surgeons at each follow up. Each radiograph was measured again by the same evaluators two weeks apart.Results: Thirty-one patients were present at the final follow-up. A minor reduction in mean weight was noticed (from 82.2 kg ± 16.2 kg to 80.9 kg ± 16.0, p > 0.398) without any correlation with joint space width narrowing. There were no major changes at the first follow up (6 months) regarding joint space narrowing. A reduction in joint space width was observed however at 12 months varying from 4.4 mm (SD ± 1.64, range 1.8-7.1) at the first assessment to 4.3 mm (SD ± 1.26, range 0.0-6.8) at the final follow-up but with no statistical difference (p=0.237).Conclusion: No significant modification in joint space width at the final follow-up secondarily proved that two injections of Hymovis® may slow down narrowing in the knee joint space over a one-year period.

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