Effectiveness of intra-articular therapies in osteoarthritis: a literature review

Osteoarthritis is a painful, chronic disease with widespread burden on patients, communities, health and social care systems. Conservative therapies, such as nonpharmacological interventions, systemic drug treatment and intra-articular therapies are used before resorting to surgery; nonetheless, disease control often remains inadequate. Recent advances in osteoarthritis management have aimed to provide greater variety of treatment options. Here, we summarize a targeted literature review evaluating efficacy and safety of intra-articular therapies for osteoarthritis. Injections of intra-articular therapies directly into the joint avoid conventional barriers to joint entry, increase bioavailability and lower systemic toxicity. Intra-articular corticosteroids and hyaluronic acid are established United States Food and Drug Administration (US FDA)/European Medicines Agency (EMA)-approved treatments; however, concerns exist regarding effect duration, safety, effectiveness across populations and heterogeneity. Newer therapies, such as autologous blood products and mesenchymal stem cells, are in development. Benefits of autologous blood products (e.g. platelet-rich plasma, autologous conditioned serum) include an expected improved safety profile and direct targeting of osteoarthritis-related pathophysiology. Autologous conditioned serum is cell-free and manufactured by a standardized process, whereas platelet-rich plasma composition and characteristics can vary. Currently, only limited efficacy comparisons between these biological treatments can be drawn; long-term clinical and safety studies are needed to increase the efficacy evidence base and earn consideration in treatment frameworks.

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What elements of a systems’ approach to bereavement are most effective in times of mass bereavement? A narrative systematic review with lessons for COVID-19

Palliative Medicine ◽

10.1177/0269216320946273 ◽

2020 ◽

Vol 34 (9) ◽

pp. 1165-1181 ◽

Cited By ~ 1

Author(s):

Emily Harrop ◽

Mala Mann ◽

Lenira Semedo ◽

Davina Chao ◽

Lucy E Selman ◽

...

Keyword(s):

Systematic Review ◽

Disaster Response ◽

Social Care ◽

Systems Approach ◽

Evidence Base ◽

System Level ◽

Service Improvement ◽

Current Crisis ◽

Health And Social Care ◽

Care Systems

Background: The global COVID-19 pandemic has left health and social care systems facing the challenge of supporting large numbers of bereaved people in difficult and unprecedented social conditions. Previous reviews have not comprehensively synthesised the evidence on the response of health and social care systems to mass bereavement events. Aim: To synthesise the evidence regarding system-level responses to mass bereavement events, including natural and human-made disasters as well as pandemics, to inform service provision and policy during the COVID-19 pandemic and beyond. Design: A rapid systematic review was conducted, with narrative synthesis. The review protocol was registered prospectively ( www.crd.york.ac.uk/prospero , CRD 42020180723). Data sources: MEDLINE, Global Health, PsycINFO and Scopus databases were searched for studies published between 2000 and 2020. Reference lists were screened for further relevant publications, and citation tracking was performed. Results: Six studies were included reporting on system responses to mass bereavement following human-made and natural disasters, involving a range of individual and group-based support initiatives. Positive impacts were reported, but study quality was generally low and reliant on data from retrospective evaluation designs. Key features of service delivery were identified: a proactive outreach approach, centrally organised but locally delivered interventions, event-specific professional competencies and an emphasis on psycho-educational content. Conclusion: Despite the limitations in the quantity and quality of the evidence base, consistent messages are identified for bereavement support provision during the pandemic. High quality primary studies are needed to ensure service improvement in the current crisis and to guide future disaster response efforts.

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198 The Next Steps: The Development of Dementia Post-diagnostic Psychoeducational Support Guidance

Age and Ageing ◽

10.1093/ageing/afz103.117 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Matthew Gibb ◽

Dearbhla O'Caheny ◽

Cecilia Craig ◽

Emer Begley

Keyword(s):

Literature Review ◽

Social Care ◽

Cost Effective ◽

Evidence Base ◽

Extensive Literature ◽

Guidance Document ◽

Additional Material ◽

People With Dementia ◽

Health And Social Care ◽

Diagnosis Of Dementia

Abstract Background There is often a `care gap' where people are given a clinical diagnosis of dementia but receive no useful support. (Foley, T. et al., 2019) However, the early stages of dementia are a crucial time for supportive interventions such as advice and strategies to cope with impairments and improve wellbeing and signposting through complex healthcare systems to access key supports and services. In February 2018 the National Dementia Office (NDO) commissioned the Dementia Services Information and Development Centre (DSIDC) to develop a guidance document to support health and social care professionals (HSCPs) establish, organise and facilitate evidence-based post-diagnostic pyschoeducatonal interventions in the community. Methods The DSIDC undertook an extensive literature review examining the evidence for multi-component psychoeducational interventions. An experienced group of health and social care professionals provided additional material and expertise resulting in the development of the final guidance document. Members of the Irish Working Group of People with Dementia and the Dementia Carers Campaign Network also reviewed the document. Results The literature review found a growing evidence base for dyadic interventions. These interventions, directed at the person with dementia and their care partner, were diverse in their content, outcomes, the measures they used, their frequency and the professional background of the facilitators. They were flexible and cost-effective and drew on the HSCP's own professional knowledge, service resources and experiences of what works and what doesn't. Conclusion Dyadic interventions (and psychoeducational programmes in particular) have the potential to benefit both people with dementia and their care partners by decreasing depression and anxiety, increasing knowledge and coping skills and helping improve cognitive function. (Moon and Betts Adams, 2012) The practical guidance document developed from this review provides HSCPs with useful advice and information to facilitate the setting up and running of post-diagnostic psychoeducational support programmes.

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Autologous blood products and their role within dentistry

Dental Update ◽

10.12968/denu.2019.46.7.676 ◽

2019 ◽

Vol 46 (7) ◽

pp. 676-683

Author(s):

Arif Razzak ◽

Sarah Jenkins ◽

Keith Smart

Keyword(s):

Whole Blood ◽

Clinical Relevance ◽

Tooth Extraction ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Blood Products ◽

New Materials ◽

Platelet Rich Fibrin ◽

Implant Placement ◽

Dental Practitioners

Use of autologous blood products, such as platelet rich plasma (PRP) and platelet rich fibrin (PRF) is increasing within the field of dentistry. Such products aim to promote bone regeneration which is valuable in a range of procedures, including implant placement, post tooth extraction, and periodontal surgery. Dental practitioners should be aware of what these new materials are, and the beneficial role that they may play in modern dentistry. CPD/Clinical Relevance: This article aims to inform the reader regarding the range of available autologous blood products, their uses in dentistry, how they are derived from whole blood, as well as cost and time implications.

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Functional repertoire of EV-associated miRNA profiles after lipoprotein depletion via ultracentrifugation and size exclusion chromatography from autologous blood products

Scientific Reports ◽

10.1038/s41598-021-84234-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alexander Otahal ◽

Olga Kuten-Pella ◽

Karina Kramer ◽

Markus Neubauer ◽

Zsombor Lacza ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Autologous Blood ◽

Enrichment Analysis ◽

Functional Enrichment Analysis ◽

Functional Enrichment ◽

Size Exclusion ◽

Blood Products ◽

Particle Yield ◽

Exclusion Chromatography ◽

Regenerative Approach

AbstractCartilage breakdown, inflammation and pain are hallmark symptoms of osteoarthritis, and autologous blood products such as citrate-anticoagulated platelet-rich plasma (CPRP) or hyperacute serum (hypACT) have been developed as a regenerative approach to rebuild cartilage, inhibit inflammation and reduce pain. However, mechanisms of action of these blood derivatives are still not fully understood, in part due to the large number of components present in these medical products. In addition, the discovery of extracellular vesicles (EVs) and their involvement in intercellular communication mediated by cargo molecules like microRNAs (miRNAs) opened up a whole new level of complexity in understanding blood products. In this study we focused on the development of an isolation protocol for EVs from CPRP and hypACT that can also deplete lipoproteins, which are often co-isolated in EV research due to shared physical properties. Several isolation methods were compared in terms of particle yield from CPRP and hypACT. To gain insights into the functional repertoire conveyed via EV-associated miRNAs, we performed functional enrichment analysis and identified NFκB signaling strongly targeted by CPRP EV miRNAs, whereas hypACT EV miRNAs affect IL6- and TGFβ/SMAD signaling.

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Characterization and Therapeutic Use of Extracellular Vesicles Derived from Platelets

International Journal of Molecular Sciences ◽

10.3390/ijms22189701 ◽

2021 ◽

Vol 22 (18) ◽

pp. 9701

Author(s):

Timea Spakova ◽

Jana Janockova ◽

Jan Rosocha

Keyword(s):

Signal Transduction ◽

Growth Factors ◽

Regenerative Medicine ◽

Extracellular Vesicles ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

The Body ◽

Blood Products ◽

Isolation Methods ◽

Main Components

Autologous blood products, such as platelet-rich plasma (PRP), are gaining increasing interest in different fields of regenerative medicine. Although growth factors, the main components of PRP, are thought to stimulate reparation processes, the exact mechanism of action and main effectors of PRP are not fully understood. Plasma contains a high amount of extracellular vesicles (EVs) produced by different cells, including anucleated platelets. Platelet-derived EVs (PL-EVs) are the most abundant type of EVs in circulation. Numerous advantages of PL-EVs, including their ability to be released locally, their ease of travel through the body, their low immunogenicity and tumourigenicity, the modulation of signal transduction as well as the ease with which they can be obtained, has attracted increased attention n. This review focuses briefly on the biological characteristics and isolation methods of PL-EVs, including exosomes derived from platelets (PL-EXOs), and their involvement in the pathology of diseases. Evidence that shows how PL-EVs can be used as a novel tool in medicine, particularly in therapeutic and regenerative medicine, is also discussed in this review.

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Platelet-rich plasma products in traumatology and orthopaedics: classification issues (literature review)

Aspirantskiy Vestnik Povolzhiya ◽

10.17816/2072-2354.2020.20.3.106-113 ◽

2020 ◽

Vol 20 (5-6) ◽

pp. 106-113

Author(s):

Gennady P. Kotelnikov ◽

Dmitry A. Dolgushkin ◽

Vladimir A. Lazarev ◽

Alexander N. Bratiichuk ◽

Kirill M. Bogdanov

Keyword(s):

Growth Factors ◽

Literature Review ◽

Musculoskeletal System ◽

Whole Blood ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Biological Therapies ◽

Biological Growth ◽

Time Of Application ◽

Advantages And Disadvantages

In recent years, biological growth factors contained in platelet-rich plasma (PRP) obtained from the whole blood have been actively used to regenerate tissues of the musculoskeletal system. There are a lot of methods for preparing PRP, devices and modes for obtaining it, including ready-made services for use in traumatology and orthopedics. A number of well-known protocols miss important points and features of handling biological material, and fail to give clear characteristics of the resulting product. At the same time, there are a number of products that are completely opposite in composition, method, place of application and time of application, which the authors denote as PRP. In the domestic and foreign literature, several attempts have been made to characterize and classify the types of products containing plasma with platelets as a basis. In this article, we describe the existing systems used to classify PRP drugs, highlight their advantages and disadvantages. Of course, due to the active use of PRP in various fields of medicine, there remains a need for the standardized universal nomenclature for describing biological therapies, as well as for a comprehensive and reproducible classification system for products obtained from autologous blood.

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Two different regenerative injections in patients diagnosed with secondary hip osteoarthritis: A report of two cases

Journal of Experimental and Clinical Medicine ◽

10.52142/omujecm.38.2.27 ◽

2021 ◽

Vol 38 (2) ◽

pp. 204-207

Author(s):

Ferhat SAY ◽

İsmail BÜYÜKCERAN ◽

Sina COŞKUN

Keyword(s):

Growth Factors ◽

Platelet Rich Plasma ◽

Treatment Options ◽

Hip Osteoarthritis ◽

Developmental Dysplasia ◽

Effective Treatment Option ◽

Autologous Conditioned Serum ◽

Functional Scores ◽

Anti Inflammatory ◽

High Level

Non-surgical treatment options are limited in hip osteoarthritis secondary to developmental dysplasia of the hip (DDH). Treatment of Autologous Conditioned Serum (ACS) is based on the high level of anti-inflammatory cytokine production of leukocytes in peripheral blood. It is an effective treatment option which contains the cytokines and the growth factors. Platelet Rich Plasma (PRP) is a form of treatment that stimulates natural healing steps through growth factors in platelets. In this case report we aimed to present the results of ACS and PRP injection in two patients who developed secondary coxarthrosis after DDH surgery. At the 1-year follow-up examination, patient’s functional scores improved and requirement for non-steroid anti-inflammatory drugs had significantly reduced. Regenerative injections either autologous conditioned serum or platelet rich plasma treatments are safe and effective treatments and can be recommended particularly for cases of secondary hip osteoarthritis associated with DDH.

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Platelet Rich Plasma for Treatment of Rheumatoid Arthritis: Case Series and Review of Literature

Case Reports in Rheumatology ◽

10.1155/2020/8761485 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Humeira Badsha ◽

Ghita Harifi ◽

William D. Murrell

Keyword(s):

Rheumatoid Arthritis ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Treatment Options ◽

Case Series ◽

Synovial Cell ◽

Joint Inflammation ◽

Inadequate Response ◽

Muscle Injuries ◽

Cell Proliferation And Differentiation

Platelet-rich plasma (PRP) is an autologous blood product with platelets above circulating levels and releases several growth factors after activation. PRP may help to decrease joint inflammation by modulating synovial cell proliferation and differentiation and inhibition of catabolic pathways in various articular conditions. Though PRP has shown good efficacy in osteoarthritis and other musculoskeletal conditions such as synovitis, epicondylitis, skeletal muscle injuries, and tendinopathy, there is limited experience for the use of PRP in patients with rheumatoid arthritis. Precise mechanisms of action of PRP are not known. We present clinical experience for treatment with PRP (2–4 ml) in four patients with rheumatoid arthritis who had inadequate response and persistent pain and inflammation with intra-articular steroids. Irrespective of past and ongoing treatments and duration of disease, all patients showed improvement in the visual analog scale and disease activity score of 28 joints at 4 and 8 weeks after injection. There was an improvement in joint inflammation on ultrasound imaging in some patients. These effects were sustained for up to 1 year. No adverse effects were reported in any patient. PRP may be a safe and useful therapy in patients with rheumatoid arthritis who fail to respond to one or more established treatment options.

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Sharing place and space to promote wellbeing for old and young people in a neighbourhood

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1170 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

N Raynes

Keyword(s):

Public Health ◽

Older People ◽

Evidence Base ◽

Public Health Approach ◽

Negative Stereotypes ◽

Head Teachers ◽

Place And Space ◽

Health And Social Care ◽

Care Systems ◽

The Impact

Abstract The increasing number of older people in many countries is often seen as a burden. Alternatively, these numbers can be seen as a longevity dividend, providing a resource for our communities. We sought to find a way to use the resource by working with schools in a range of socio- economic neighbourhoods & explore the benefit for all stakeholders & the sustainability of such an approach. The issues we addressed are of relevance in most of Europe, despite the variations in the school systems. Intergen is the name of the model developed over 20 years in England. 3 schools in a neighbourhood work in partnership.An older person is appointed by the school to recruit older people in the neighbourhood with the skills and knowledge the schools require to enhance the learning opportunities of their pupils.Coordinators in each school meet once a term to review progress, problems & organise a social gathering for volunteers. All stakeholders' views of the value of the programme were collected. Key questions to be answered are: Can older people be a resource for pupils to improve performance & wellbeing in both the younger & older populations?Is the model sustainable and affordable?How can it be mainstreamed? Results 26 schools, primary and secondary in 7 municipalities engaged in the project after 10 years development phase with 10 schools in one municipality. Schools in London and Greater Manchester areas. 15 schools remained in the programme paying for the service for 5 years. A review of the impact of the programme showed all head teachers thought it innovative, & made a difference in their pupils' wellbeing. Older people were seen as a positive resource by both teachers & pupils. Older people felt valued & part of community. Reduction of negative stereotypes occurred. Interactions went beyond the operational tasks set for the older people. Only a public health approach can promote sustainability of the model & its benefits for communities. Key messages A tried and tested model sharing place and space to promote wellbeing in neighbourhoods for old and young citizens. The important role of Public Health in promoting innovative practice in silo ridden health and social care systems building the evidence base and building bridges.

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2021 ISFM Consensus Guidelines on the Collection and Administration of Blood and Blood Products in Cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211007071 ◽

2021 ◽

Vol 23 (5) ◽

pp. 410-432

Author(s):

Samantha Taylor ◽

Eva Spada ◽

Mary Beth Callan ◽

Rachel Korman ◽

Ellie Leister ◽

...

Keyword(s):

Autologous Blood ◽

Good Health ◽

Evidence Base ◽

Blood Type ◽

Blood Collection ◽

Blood Transfusions ◽

Blood Products ◽

Naturally Occurring ◽

Cross Matching ◽

Recipient Selection

Practical relevance: Blood and blood products are increasingly available for practitioners to use in the management of haematological conditions, and can be lifesaving and therapeutically useful for patients with anaemia and/or coagulopathies. It is important for feline healthcare that donors are selected appropriately, and transfusions of blood or blood products are given to recipients that will benefit from them. Complications can occur, but can be largely avoided with careful donor management and recipient selection, understanding of blood type compatibility, and transfusion monitoring. Clinical challenges: Feline blood transfusion, while potentially a lifesaving procedure, can also be detrimental to donor and recipient without precautions. Cats have naturally occurring alloantibodies to red cell antigens and severe reactions can occur with type-mismatched transfusions. Blood transfusions can also transmit infectious agents to the recipient, so donor testing is essential. Finally, donors must be in good health, and sedated as appropriate, with blood collected in a safe and sterile fashion to optimise the benefit to recipients. Transfusion reactions are possible and can be mild to severe in nature. Autologous blood transfusions and xenotransfusions may be considered in certain situations. Evidence base: These Guidelines have been created by a panel of authors convened by the International Society of Feline Medicine (ISFM), based on available literature. They are aimed at general practitioners to provide a practical guide to blood typing, cross-matching, and blood collection and administration.

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