Pain and functional outcomes of the sacroiliac joint after platelet-rich plasma injection: a descriptive review

2021 ◽  
Vol 16 (1) ◽  
pp. 87-100
Author(s):  
Joshua B Rothenberg ◽  
Keshav Godha ◽  
David M Civitarese ◽  
Gerard Malanga ◽  
Jaspal Ricky Singh ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Functional Outcomes ◽  
Primary Outcome ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Review Of The Literature ◽  
Serious Adverse Events ◽  
Plasma Injection ◽  
The Status ◽  
Double Blinded

The purpose of this manuscript is to highlight and review the status of literature regarding efficacy of platelet-rich plasma (PRP) in the treatment of sacroiliac joint (SIJ) dysfunction. A review of the literature on PRP interventions on the SIJ or ligaments was performed. Seven studies had improvements in their respective primary end point and demonstrated a strong safety profile without any serious adverse events. Only five articles demonstrated clinical efficacy of >50% in their primary outcome measures. There appears to be inconsistent and insufficient evidence for a conclusive recommendation for or against SIJ PRP. There is a need for adequately powered well-designed, standardized, double-blinded randomized clinical trials to determine the effectiveness of PRP in SIJ-mediated pain.

scholarly journals Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

2020 ◽  
pp. 1-16
Author(s):  
David M. Robinson ◽  
Christine Eng ◽  
Steven Makovitch ◽  
Joshua B. Rothenberg ◽  
Stephanie DeLuca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Inclusion Criteria ◽  
Serious Adverse Events ◽  
Bias Risk ◽  
Glenohumeral Osteoarthritis ◽  
Functional Outcome Measures

BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.

scholarly journals Diagnosis and outcome measures in trials for neoplastic meningitis: a review of the literature and clinical experience

1998 ◽  
Vol 4 (6) ◽  
pp. E6 ◽  
Author(s):  
Michael J. Glantz ◽  
Marc C. Chamberlin ◽  
Beverly C. Walters
Keyword(s):  
Cerebrospinal Fluid ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Randomized Clinical Trials ◽  
Outcome Measure ◽  
Clinical Care ◽  
Primary Outcome Measure ◽  
Neoplastic Meningitis ◽  
Review Of The Literature ◽  
Cytological Examination

Innovative approaches to the treatment of neoplastic meningitis are being widely tested. Unfortunately, research on diagnostic strategies and outcome measures on which any advances in treatment ultimately depend, has not been avidly pursued. A critical review of the literature on neoplastic meningitis published since 1978 was undertaken by using MEDLINE and other English language databases. All articles addressing the issues of diagnostic or response criteria were included. Randomized clinical trials (RCTs) were emphasized. Prospectively collected data from the authors' institution correlating the results of cerebrospinal fluid (CSF) cytological examinations with Karnofsky Performance Scale (KPS) score are also discussed. Twenty-six studies (representing 1208 patients) fulfilled search criteria. Only three were RCTs. Cerebrospinal fluid cytology was the sole diagnostic criterion in two-thirds of studies. The results of CSF cytological examination alone or in combination with other clinical or laboratory endpoints constituted the primary outcome measure in 85%. Few studies attempted to address known deficiencies in the reliability and validity of these measures, and correlation between measures was poor. Quality of life was never used as a primary outcome measure. All currently available measurements, including CSF cytology, biochemistry, immunological, and molecular markers, neuroimaging studies, clinical examination, and survival, suffer from poor sensitivity and/or specificity, and often correlate poorly with each other. Although CSF cytological examination, performed according to a rigorous, research-supported protocol, may be the optimum diagnostic and outcome measure at this time, additional research is a prerequisite for any further advances in the clinical care of patients with neoplastic meningitis.

scholarly journals Efficacy of Platelet-Rich Plasma and Plasma for Symptomatic Treatment of Knee Osteoarthritis: A Double-Blinded Placebo-Controlled Randomized Clinical Trial.

2021 ◽  
Author(s):  
Murillo Dório ◽  
Rosa Maria Rodrigues Pereira ◽  
Alexandre Galeno Branco Luz ◽  
Leticia Alle Deveza ◽  
Ricardo Manoel Oliveira ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Primary Outcome ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Symptomatic Treatment ◽  
Treatment Alternative ◽  
Double Blind ◽  
Secondary Outcomes ◽  
Double Blinded ◽  
And Function

Abstract Background: Platelet-rich plasma (PRP) has a still conflicting efficacy for knee osteoarthritis (KOA) and might be a minimally invasive and safe treatment alternative. The potential benefit of only plasma (non-enriched) has never been investigated. Our aim was to evaluate the efficacy of intra-articular platelet-rich plasma (PRP) and plasma to improve pain and function in participants with KOA over 24 weeks. Methods: Randomized, double-blind, placebo-controlled trial with 3 groups (n = 62): PRP (n = 20), plasma (n = 21) and saline (n = 21). Two ultrasound-guided knee injections were performed with a 2-week interval. The primary outcome was visual analog scale 0-10 cm (VAS) for overall pain at week 24, with intermediate assessments at weeks 6 and 12. Main secondary outcomes were: KOOS, OMERACT-OARSI criteria and TUGT. Results: At baseline, 92% of participants were female, with a mean age of 65 years, mean BMI of 28.0 Kg/m2and mean VAS pain of 6.2 cm. Change in pain from baseline at week 24 were -2.9 (SD 2.5), -2.4 (SD 2.5) and -3.5 cm (SD 3.3) for PRP, plasma and saline, respectively (p intergroup = 0.499). There were no differences between the three groups at weeks 6 and 12. Similarly, there were no differences between groups regarding secondary outcomes. The PRP group showed higher frequency of adverse events (65% versus 24% and 33% for plasma and saline, respectively, p = 0.02), mostly mild transitory increase in pain.Conclusions: PRP and plasma were not superior to placebo for pain and function improvement in KOA over 24 weeks. The PRP group had a higher frequency of mild transitory increase in pain.Trial registration: ClinicalTrials.gov, NCT03138317, 03/05/2017.

Comparative Safety of Smoking Cessation Pharmacotherapies During a Government-Sponsored Reimbursement Program

2020 ◽  
Author(s):  
Greg Carney ◽  
Malcolm Maclure ◽  
Suzanne Malfair ◽  
Ken Bassett ◽  
James M Wright ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Relative Risk ◽  
Adverse Events ◽  
Primary Outcome ◽  
Randomized Clinical Trials ◽  
Boxed Warning ◽  
Serious Adverse Events ◽  
Adjusted Risk ◽  
Relative Safety ◽  
Comparative Safety

Abstract Introduction The British Columbia Ministry of Health launched a Smoking Cessation Program on September 30, 2011, providing financial coverage for smoking cessation pharmacotherapies. Although pharmacotherapies have been shown to have a moderate short-term benefit as a quitting aid, substantial cardiovascular and neuropsychiatric safety concerns have been identified in adverse-reporting databases, leading to prescription label warnings by Health Canada and the U.S. Food and Drug Administration. However, recent studies indicate these warnings may be without merit. This study examined the comparative safety of medications commonly used to aid smoking cessation. Aims and Methods Population-based retrospective cohort study using B.C. administrative data to assess the relative safety between varenicline, bupropion, and nicotine replacement therapies (NRTs). The primary outcome was a composite of cardiovascular hospitalizations. Secondary outcomes included mortality, a composite of neuropsychiatric hospitalizations, and individual components of the primary outcome. Statistical analysis used propensity score-adjusted log-binomial regression models. A sensitivity analysis excluded patients with a history of cardiovascular disease. Results The study included 116 442 participants. Compared with NRT, varenicline was associated with a 10% 1-year relative risk decrease of cardiovascular hospitalization (adjusted risk ratio [RR] = 0.90, 95% confidence interval (CI): 0.82 to 1.00), a 20% 1-year relative risk decrease of neuropsychiatric hospitalization (RR: 0.80, CI: 0.7 to 0.89), and a 19% 1-year relative risk decrease of mortality (RR: 0.81, CI: 0.71 to 0.93). We found no significant association between NRT and bupropion for cardiovascular hospitalizations, neuropsychiatric hospitalizations, or mortality. Conclusions Compared with NRT, varenicline is associated with fewer serious adverse events and bupropion the same number of serious adverse events. Implications This study addresses the need for comparative safety evidence in a real-world setting of varenicline and bupropion against an active comparator. Compared with NRT, varenicline was associated with a decreased risk of mortality, serious cardiovascular events, and neuropsychiatric events during the treatment, or shortly after the treatment, in the general population of adults seeking pharmacotherapy to aid smoking cessation. These results provide support for the removal of the varenicline boxed warning for neuropsychiatric events and add substantively to the cardiovascular safety findings of previous observational studies and randomized clinical trials.

scholarly journals Intra-Ovarian Platelet-Rich Plasma Injections: Single-Centre Experience.

2020 ◽  
pp. 1-5
Keyword(s):  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Ovarian Tissue ◽  
Vitro Fertilization ◽  
Plasma Injection ◽  
Single Centre Experience ◽  
History Of ◽  
Improved Function ◽  
Shed Light

Objective: To describe the effects of intra-ovarian platelet-rich plasma injection on the ovarian stimulation outcomes in women referring to an in vitro fertilization center. Method: We conducted a single-center retrospective study on 179 women that underwent intra-ovarian platelet-rich plasma injection over the last three years. Inclusion criteria included women over age 35 with at least one ovary with a history of infertility, hormonal abnormalities, absence of menstrual cycle and premature ovarian failure. Results: Mean (±SD) patient age was 43 ± 4 years. Both serum FSH levels and serum E2 significantly reduced after treatment from 29.0 pg/ml to 18.0 pg/ml; p<0.0001 and from 65.6 pg/ml to 47.2 pg/ml; p= 0.034 respectively. None of the 179 women reported any complications post operatively. After PRP, 17/179 (9.49%) women became pregnant. Conclusion: The results of our observational study revealed that PRP intra-οvarian injection is associated with improved function of ovarian tissue. Future further randomized clinical trials in this field are needed to shed light in the use of PRP in ovarian rejuvenation.

scholarly journals Regenerative endodontic treatment performed with platelet-rich plasma presents better periapical healing than only induced blot clot: a systematic review

2021 ◽  
Vol 10 (13) ◽  
pp. e147101321219
Author(s):  
Christine Men Martins ◽  
Milena Filippini Knecht ◽  
Larissa dos Santos de Moraes ◽  
Victor Eduardo de Souza Batista
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Primary Outcome ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Periapical Healing ◽  
Regenerative Endodontic Treatment

This study comprehensively reviewed two different treatments for regenerative endodontic: platelet-rich plasma and induced blot clot, in regarding to periapical healing.  Two investigators performed a systematic review. MEDLINE/PubMed, Cochrane Library and Scopus supplied relevant data from studies published until December 2020 to answer the PICO question. Primary outcome was periapical healing. Eight randomized clinical trials fulfilled eligibility criteria. Primary outcome indicated that platelet-rich plasma results in similar or better periapical healing compared to blot clot group. The reported failures were related to blot clot group due to incomplete radiographic parameters, pain and reinfection; however, few cases of unsuccess were reported to platelet-rich plasma group. Only two studies observed better results to blot clot group in relation to increase of radiographic area and partial pulp canal obliteration. This review showed that procedures using platelet-rich plasma were successful in treating permanent teeth with root development.

scholarly journals Efficacy of platelet-rich plasma and plasma for symptomatic treatment of knee osteoarthritis: a double-blinded placebo-controlled randomized clinical trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Murillo Dório ◽  
Rosa Maria Rodrigues Pereira ◽  
Alexandre Galeno Branco Luz ◽  
Leticia Alle Deveza ◽  
Ricardo Manoel de Oliveira ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Primary Outcome ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Symptomatic Treatment ◽  
Treatment Alternative ◽  
Double Blind ◽  
Secondary Outcomes ◽  
Double Blinded ◽  
And Function

Abstract Background Platelet-rich plasma (PRP) has a still conflicting efficacy for knee osteoarthritis (KOA) and might be a minimally invasive and safe treatment alternative. The potential benefit of only plasma (non-enriched) has never been investigated. Our aim was to evaluate the efficacy of intra-articular platelet-rich plasma (PRP) and plasma to improve pain and function in participants with KOA over 24 weeks. Methods Randomized, double-blind, placebo-controlled trial with 3 groups (n = 62): PRP (n = 20), plasma (n = 21) and saline (n = 21). Two ultrasound-guided knee injections were performed with a 2-week interval. The primary outcome was visual analog scale 0-10 cm (VAS) for overall pain at week 24, with intermediate assessments at weeks 6 and 12. Main secondary outcomes were: KOOS, OMERACT-OARSI criteria and TUGT. Results At baseline, 92% of participants were female, with a mean age of 65 years, mean BMI of 28.0 Kg/m2and mean VAS pain of 6.2 cm. Change in pain from baseline at week 24 were -2.9 (SD 2.5), -2.4 (SD 2.5) and -3.5 cm (SD 3.3) for PRP, plasma and saline, respectively (p intergroup = 0.499). There were no differences between the three groups at weeks 6 and 12. Similarly, there were no differences between groups regarding secondary outcomes. The PRP group showed higher frequency of adverse events (65% versus 24% and 33% for plasma and saline, respectively, p = 0.02), mostly mild transitory increase in pain. Conclusions PRP and plasma were not superior to placebo for pain and function improvement in KOA over 24 weeks. The PRP group had a higher frequency of mild transitory increase in pain. Trial registration ClinicalTrials.gov, NCT03138317, 03/05/2017.

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