Effect of Intravenous Zoledronic Acid on Total Knee Replacement in Patients With Symptomatic Knee Osteoarthritis and Without Severe Joint Space Narrowing: A Prespecified Secondary Analysis of a Two-Year, Multicenter, Double-Blind, Placebo-Controlled Clinical Trial.

Autor: Cai G; Anhui Medical University, Hefei, Anhui, China, and University of Tasmania, Hobart, Tasmania, Australia., Laslett LL; University of Tasmania, Hobart, Tasmania, Australia., Thompson M; Royal Hobart Hospital, Hobart, Tasmania, Australia., Cicuttini F; Monash University, Melbourne, Victoria, Australia., Hill C; The Queen Elizabeth Hospital and University of Adelaide, Adelaide, South Australia, Australia., Wluka AE; Monash University, Melbourne, Victoria, Australia., March L; The University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia., Wang Y; Monash University, Melbourne, Victoria, Australia., Otahal P; University of Tasmania, Hobart, Tasmania, Australia., Stoney JD; St. Vincent's Hospital, Melbourne, Victoria, Australia, and Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia., Antony B; University of Tasmania, Hobart, Tasmania, Australia., Buttigieg K; University of Tasmania, Hobart, Tasmania, Australia., Winzenberg T; University of Tasmania, Hobart, Tasmania, Australia., Jones G; University of Tasmania, Hobart, Tasmania, Australia., Aitken D; University of Tasmania, Hobart, Tasmania, Australia.
Jazyk: angličtina
Zdroj: Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2024 Jul; Vol. 76 (7), pp. 1047-1053. Date of Electronic Publication: 2024 Mar 13.
DOI: 10.1002/art.42831
Abstrakt: Objective: To determine the effect of zoledronic acid (ZA) on the risk of total knee replacement (TKR) in patients with symptomatic knee osteoarthritis and without severe joint space narrowing (JSN).
Methods: We included 222 participants (mean age 62 years, 52% female) from the two-year Zoledronic Acid for Osteoarthritis Knee Pain trial (113 received 5 mg of ZA annually and 109 received placebo) conducted between November 2013 and October 2017. Primary TKR were identified until February 22, 2022. The effect of ZA on TKR risk was evaluated using Cox proportional hazard regression models. Because the treatment effect failed the proportional hazards assumption, a time-varying coefficients analysis for treatment was conducted by splitting the study into two periods (ie, within and after two years of randomization).
Results: Over a mean follow-up of seven years, 39% and 30% of participants had any TKR in the ZA and placebo groups, and 28% and 18% had TKR in the study knee, respectively. Use of ZA was associated with a higher risk of TKR in any knee (hazard ratio [HR] 4.2, 95% confidence interval [CI] 1.2-14.7) and showed a trend in the study knee (HR 6.8, 95%CI 0.9-53.9) during the trial. In the posttrial period, the risk of TKR was similar in the ZA and the placebo groups for any knee (HR 1.2, 95%CI 0.5-1.8) and the study knee (HR 1.4, 95%CI 0.5-2.2).
Conclusion: These results suggest that ZA is not protective against TKR in patients with symptomatic knee osteoarthritis and without severe JSN.
(© 2024 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
Externí odkaz: