Date of Award

2014

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: To determine whether or not Autologous conditioned IL-1 antagonist (ACS) reduces pain in patients with OA or lumbar radiculopathy.

STUDY DESIGN: Review of 3 randomized, double-blind controlled clinical trials in 2007, 2008, and 2009, all in English.

DATA SOURCES: Two randomized, double-blinded controlled clinical trials comparing the effectiveness of intra-articular injections of an autologous IL-1 receptor antagonist solution versus a control in OA and one randomized, double-blinded controlled clinical trials comparing autologous IL-1 receptor antagonist epidural injection versus 5 and 10 mg triamcinolone in patients with lumbar radiculopathy.

OUTCOMES MEASURED: The outcomes in this study were measured using the Western Ontario and McMaster Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Scale (VAS), and the Oswestry Disability Index (ODI).

RESULTS: Baltzer et al. determined a statistically significant reduction in OA-related pain when compared to both saline and hyaluronic acid. Yang et al. failed to show pain reduction in ACS-treated patients when compared to placebo. Becker et al. reported significant reductions in pain, but were not statistically significant when compared to the control arm.

CONCLUSION:Results of the mentioned studies proved that ACS does decrease pain in patients with OA and LR; however, this pain reduction was not universally statistically significant and thus requiring further, more uniform trials. The Baltzer et al. results were encouraging, however, and do warrant future investigation.

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