Abstract
ObjectiveTanezumab is a new therapeutic intervention for patients with osteoarthritis (OA) of the knee. We performed the present meta-analysis to appraise the efficacy and safety of tanezumab for patients with knee OA.MethodsWe systematically searched randomized controlled trials from PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The primary outcomes were mean change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, the WOMAC physical function and patient's global assessment (PGA). Outcomes were reported as the standard mean difference (SMD) or relative risk (RR) with 95% confidence interval (CI). We assessed the pooled data using a random-effects model.ResultsOf the identified studies, four were eligible and were included in this meta-analysis (N = 1839 participants). Compared with the placebo groups, tanezumab yielded a significant reduction in mean change in the WOMAC pain (SMD = 0.51, 95% CI 0.34 to 0.69, P<0.00001), the WOMAC physical function (SMD = 0.56, 95% CI 0.38 to 0.74, P<0.00001) and PGA (SMD = 0.34, 95% CI 0.22 to 0.47, P<0.00001). There was no significant difference in serious adverse events (RR = 1.06, 95% CI 0.59 to 1.92, P = 0.84) between the tanezumab and placebo groups. Tanezumab significantly increased discontinuations due to adverse events (RR = 2.89, 95% CI 1.59 to 5.26, P = 0.0005), abnormal peripheral sensations (RR = 3.14, 95% CI 2.12 to 4.66, P<0.00001), and peripheral neuropathy (RR = 6.05, 95% CI 2.32 to 15.81, P = 0.0002).ConclusionTanezumab can alleviate pain and improve function for patients with OA of the knee. However, considering the limited number of studies, this conclusion should be interpreted cautiously and more clinical randomized controlled trials are needed to verify the efficacy and safety of tanezumab for OA of the knee.
Highlights
Osteoarthritis (OA) of the knee is the most common location of OA[1], which causes pain, limits activity, and leads to a decreased quality of life[2, 3]
Compared with the placebo groups, tanezumab yielded a significant reduction in mean change in the WOMAC pain (SMD = 0.51, 95% confidence interval (CI) 0.34 to 0.69, P
There was no significant difference in serious adverse events (RR = 1.06, 95% CI 0.59 to 1.92, P = 0.84) between the tanezumab and placebo groups
Summary
Osteoarthritis (OA) of the knee is the most common location of OA[1], which causes pain, limits activity, and leads to a decreased quality of life[2, 3]. Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as the first line treatment drugs for painful knee OA[5]. All experimental and clinical trials indicate that antagonism of NGF may be a feasible therapeutic option for chronic pain[12,13,14,15,16]. Recent randomized controlled trials[18,19,20,21] have suggested that tanezumab significantly alleviates pain and improves physical function in patients with OA of the knee, the relatively small number of participants have made their conclusions inconclusive. In a previous meta-analysis comparing an anti-NGF antibody treatment with a placebo in patients with OA of the hip or the knee, Schnitzer and colleagues[22] found that tanezumab appeared to be efficacious in improving symptomatic OA.
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