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Meta-Analysis
. 2019 Sep;98(39):e17386.
doi: 10.1097/MD.0000000000017386.

The efficacy and safety of polydeoxyribonucleotide for the treatment of knee osteoarthritis: Systematic review and meta-analysis of randomized controlled trials

Man Soo Kim  1 , Ryu Kyoung Cho, Yong In
Affiliations
Meta-Analysis

The efficacy and safety of polydeoxyribonucleotide for the treatment of knee osteoarthritis: Systematic review and meta-analysis of randomized controlled trials

Man Soo Kim et al. Medicine (Baltimore). 2019 Sep.

Abstract

Introduction: The purpose of this study was to use meta-analysis techniques to evaluate the efficacy and safety of polydeoxyribonucleotide (PDRN) injections for knee osteoarthritis (OA) treatment.

Methods: Multiple comprehensive databases, including MEDLINE, EMBASE, and the Cochrane Library, were searched in November 2018 for studies that compared the effectiveness and safety of intra-articular PDRN injection for the knee joint with hyaluronic acid (HA) injection. Two reviewers independently determined study inclusion and they extracted data using a standardized data extraction form. The predefined primary outcome was Visual Analogue Scale. Secondary outcomes included Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), and adverse events.

Results: Five randomized controlled trials were included in the meta-analysis. After 1 and 2 months, patients in the PDRN group showed significantly better improvement in pain than the HA group (P = .04 and P = .02, respectively). There was no significant difference in pain after 4 months. The pooled analysis showed that no significant differences were seen in function (KOOS and KSS) scores between the PDRN and HA groups (all P > .05) at all time points. There was no significant difference in adverse events between 2 groups (relative risks = 2.15, 95% confidential interval: 0.17-26.67, P = .55).

Conclusion: The intra-articular use of PDRN was similar in function to HA, and the pain-relief effect was superior to HA for 2 months post-injection. Therefore, it could be a favorable alternative to HA to treat persistent pain associated with knee OA while avoiding side effects.Level of evidence I.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart illustrating the literature search.
Figure 2
Figure 2
Risk of bias summary: review authors’ judgments for each risk of bias item for each included study. ? = unclear risk of bias, + = low risk of bias, − = high risk of bias.
Figure 3
Figure 3
Forest plot of comparisons: PDRN versus HA for pain VAS score at 1 month (A), 2 months (B), and 4 months (C). CI = confidence interval, HA = hyaluronic acid, PDRN = polydeoxyribonucleotide, SD = standard deviation, VAS = Visual Analogue Scale.
Figure 4
Figure 4
Forest plot of comparison: PDRN versus HA versus function (KOOS total and ADL scores, KSS total score). ADL = activity of daily living functions, CI = confidence interval, HA = hyaluronic acid, KOOS = Knee injury and Osteoarthritis Outcome Score, KSS = Knee Society Score, PDRN = polydeoxyribonucleotide, SD = standard deviation.
Figure 5
Figure 5
Subgroup meta-analyses of PDRN injection versus HA injection for function at 1, 2, 4, and 6 months. CI = confidence interval, HA = hyaluronic acid, PDRN = polydeoxyribonucleotide, SD = standard deviation.
See this image and copyright information in PMC

References

    1. Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014;73:1323–30. - PubMed
    1. Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol 2014;28:5–15. - PubMed
    1. Quintana JM, Arostegui I, Escobar A, et al. Prevalence of knee and hip osteoarthritis and the appropriateness of joint replacement in an older population. Arch Intern Med 2008;168:1576–84. - PubMed
    1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Rheum Dis Clin North Am 2008;34:515–29. - PMC - PubMed
    1. Bellamy N, Campbell J, Robinson V, et al. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006;Cd005328. - PubMed