Efficacy and Safety of Tanezumab on Osteoarthritis Knee and Hip Pains: A Meta-Analysis of Randomized Controlled Trials.

Abstract

To evaluate the efficacy and safety of tanezumab for management of osteoarthritis (OA) knee and hip pain. Articles about management of OA knee and hip pains by tanezumab were systematically searched in PubMed, EBSCO, EMBASE, ScienceDirect, Web of Science, OVID, and Cochrane Library from the available date of inception until January 2016. Randomized controlled trials (RCTs) comparing the efficacy and safety of tanezumab with placebo/active comparator for management of OA knee and hip pains were included, and those with confounding conditions were excluded. Study quality was assessed using the Jadad five-point score. Finally, a meta-analysis of all eligible RCTs was performed on Review Manager 5.3 and STATA 12.0. Nine studies with 10 RCTs that enrolled 7,665 patients were included. The reductions in pain intensity are significantly different between tanezumab-treated patients and placebo-treated patients (5,879 patients, mean difference [MD] = -0.98, 95% confidence interval [CI] = -1.18- -0.79). Both functional improvement (6,078 patients, MD = -1.10, 95% CI = -1.28- -0.92) and Patient's Global Assessment (PGA; 5,366 patients, MD = -0.27, 95% CI = -0.34- -0.20) are significantly different. There are significantly more discontinued patients due to adverse events (AEs) after treatment with tanezumab (6,537 patients, risk ratio = 1.62, 95% CI = 1.29-2.03). However, differences in serious AEs are not significant. Moreover, tanezumab-treated patients suffer from significantly more paraesthesia, arthralgia, hypoaesthesia, and peripheral edema. Tanezumab vs placebo provides superior pain relief and improvement in physical function and PGA in knee and hip osteoarthritis patients and is generally well tolerated with acceptable AEs. Low-dose tanezumab (10 or 25 µg/kg and 2.5 mg) provides similar effectiveness in reducing pain and improving function and is associated with fewer AEs. The long-term safety of tanezumab on osteoarthritis knee and hip pain needs further investigation.