(ID: 253) Comparative effectiveness of pharmacological treatments in managing physical function and joint stiffness in knee osteoarthritis: a component network meta-analysis
Abstract
Knee osteoarthritis (KNOA) is a chronic and burdensome disease associated with chronic pain, reduced physical function and increased joint stiffness [1]. KNOA’s clinical management is complex, and there remains considerable debate about the comparative performance of pharmacotherapeutics for core outcomes, including physical function and joint stiffness, which are essential in clinical decision making to improve patient outcomes. This Network Meta-analysis (NMA) addresses this critical gap in the clinical literature.
To evaluate the relative effectiveness of pharmacological interventions for joint stiffness and physical function among adult patients with KNOA using standard NMA and additive component NMA (CNMA).
We performed a comprehensive search of major electronic databases and trial registries from inception to January 2021 for randomised controlled trials (RCTs) that evaluated treatments for KNOA listed in NICE guidelines [2] including: paracetamol, NSAIDs, COX2-inhibitors, opioids, duloxetine, capsaicin, hyaluronic acid (HA) and corticosteroids (CS), administered via oral, topical, transdermal or intra-articular (IA) routes at four time windows: immediate, short, medium and long term. A random-effects NMA and additive CNMA estimated relative treatment effects within a frequentist framework using mean differences (MD) on a 0–10 scale [3]. Certainty of evidence was evaluated using the Confidence in Network Meta-Analysis (CINeMA) with risk of bias (RoB) assessed using the…
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