Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis
Authors' conclusion
Triamcinolone had the highest probabilities to have a treatment effect beyond the MID at weeks 2-6. Large RCTs with lower risk of bias indicate that the effects of 16 intra-articular interventions in knee or hip OA were smaller than the MID, and that most were consistent with placebo effects.
Study context
- Population
- Knee and hip osteoarthritis (OA); large English-language randomized controlled trials (RCTs) from CENTRAL and regulatory agency websites (inception-2023)
- Participants
- 22,795 participants57 RCTs
- Comparison
- 18 intra-articular interventions, usual care or placebo
- Outcome
- Pain intensity (SMD; MID −0.37 SMD)
Methodological detailsBayesian random-effects, large RCTs (≥100 patients/group), main analysis excluding high-risk-of-bias trials
- Bayesian random-effects
- Large RCTs (≥100 patients/group)
- Main analysis excluding high-risk-of-bias trials
Pooled result
As reported in the abstract
Pain intensity, SMD vs placebo
Each group vs placeboSMD (95% CrI)
Triamcinoloneweek 2; 75.3% probability of reaching MID; 1 trial; CrI
−0.48(−0.85 to −0.10)
Triamcinoloneweek 6; 90% probability of reaching MID; 1 trial; CrI
−0.53(−0.79 to −0.27)
Tr14/Ze14week 6; 63.5% probability of reaching MID; 1 trial; CrI
−0.42(−0.71 to −0.11)
Hyaluronic acid11 trials; CrI
−0.04(−0.19 to 0.11)
Safety
| Outcome | OR (95% CrI) | |
|---|---|---|
| Dropouts due to adverse eventsHyaluronic acidvs PlaceboCrI | 2.01 (1.08–3.77) | |
| Serious adverse eventsHyaluronic acidvs PlaceboCrI | 1.86 (1.16–3.03) | |
| 0.20.5125Odds ratio (log scale) |
- Dropouts due to adverse events: 95% CrI
- Serious adverse events: 95% CrI
Original publication
Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis. Osteoarthritis Cartilage. Published 10 September 2024. doi:10.
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