The OA Trial Bank initiates meta-analyses of the effect of treatment on predefined subgroups of osteoarthritis (OA) patients from existing studies, using Individual Patient Data (IPD). Based on the small to moderate effects of the wide range of symptomatic treatments in OA, and the heterogeneity of OA patients, treatment guidelines for OA have stressed the need for research on clinical predictors of response to different treatments.
Current Projects Involved In
In many studies of osteoarthritis treatment, there is an improvement in pain relief when a dummy ‘placebo’ treatment is compared to no treatment at all, but there is very little extra improvement when the real treatment is compared to placebo. This response to placebo varies greatly from patient to patient. Identifying the characteristics of a person who will best respond to placebo treatment, along with the factors that will predict a beneficial placebo response, will help maximise treatment effect and design future pain relief studies.
I presented the preliminary results from this study at the 2019 Osteoarthritis World Congress (OARSI) in Toronto. Our abstract of this IPD study was also selected for the OARSI 2019 abstract award in the category “Therapy".
Relative efficacy of topical non-steroidal anti-inflammatory drugs and topical capsaicin in osteoarthritis members
Pain is the most troubling issue for people with osteoarthritis (OA), yet current pharmacological treatments offer only small-to-moderate pain reduction. Current guidelines, therefore, emphasise the need to identify predictors of treatment response. In line with these recommendations, an individual patient data (IPD) meta-analysis will be conducted. The study aims to investigate the relative treatment effects of topical non-steroidal anti-inflammatory drugs (NSAIDs) and topical capsaicin in OA and to identify patient-level predictors of treatment response.
This research is among a number of studies we are undertaking to investigate the relative efficacy of topical non-steroidal anti-inflammatory drugs and capsaicin in osteoarthritis and neuropathic pain and to identify predictors of response.
Monica S M Persson, Joanne Stocks, Gyula Varadi, Mohammad Hashem Hashempur, Marienke van Middelkoop, Sita Bierma-Zeinstra, David A Walsh, Michael Doherty, Weiya Zhang, Predicting response to topical non-steroidal anti-inflammatory drugs in osteoarthritis: an individual patient data meta-analysis of randomized controlled trials, Rheumatology, Volume 59, Issue 9, September 2020, Pages 2207–2216, https://doi.org/10.1093//keaa113 [PDF]
Selected Conference Abstracts
OARSI World Congress 2019
J Stocks, MS Persson, M van Middelkoop, J Runhaar, S Bierma-Zeinstra, I Atchia, R Lambert, AD Sawitzke, T McAlindon, MH Hashempur, DA Walsh, M Doherty, W Zhang. Identifying predictors of placebo response in osteoarthritis clinical trials of three agents with different routes of delivery: A meta-analysis using individual patient data. Osteoarthritis and Cartilage April 2019 Volume 27, Supplement 1, Pages S83–S84 [PD