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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제56권 제5호
발행연도
2015.1
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1,379 - 1,383 (5page)

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Purpose: Osteoarthritic (OA) pain is largely considered to be inflammatory pain. However, during the last stage of knee OA, sensorynerve fibers in the knee are shown to be significantly damaged when the subchondral bone junction is destroyed, and this can induce neuropathic pain. Several authors have reported that tumor necrosis factor-α (TNFα) in a knee joint plays a crucial role in pain modulation. The purpose of the current study was to evaluate the efficacy of etanercept, a TNFα inhibitor, for pain in knee OA. Materials and Methods: Thirty-nine patients with knee OA and a 2–4 Kellgren-Lawrence grading were evaluated in this prospectivestudy. Patients were divided into two groups; hyaluronic acid (HA) and etanercept injection. All patients received a single injectioninto the knee. Pain scores were evaluated before and 4 weeks after injection using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and they were compared between the groups. Results: Before injection, VAS and WOMAC scores were not significantly different between the groups (p>0.05). Significant pain relief was found in the etanercept group at 1 and 2 weeks by VAS, and at 4 weeks by WOMAC score, compared with the HA group (p<0.05). No adverse events were observed in either group. Conclusion: Direct injection of etanercept into OA knee joints was an effective treatment for pain in moderate and severe OA patients. Furthermore, this finding suggests that TNFα is one factor that induces OA pain.
#Etanercept #knee osteoarthritis #pain

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참고문헌 (1)

참고문헌 신청
Centers for Disease Control and Prevention / / National Center for Chronic Disease Prevention and Health Promotion | 2. [학술지(정기간행물)] - van der Kraan PM / 1989 / Development of osteoarthritic lesions in mice by “metabolic” and “mechanical” alterations in the knee joints / Am J Pathol 135 : 1001 ~ 1014 | 3. [학술지(정기간행물)] - Ochiai N / 2007 / Extracorporeal shock wave therapy improves motor dysfunction and pain originating from knee osteoarthritis in rats / Osteoarthritis Cartilage 15 : 1093 ~ 1096 | 4. [학술지(정기간행물)] - Ivanavicius SP / 2007 / Structural pathology in a rodent model of osteoarthritis is associated with neuropathic pain: increased expression of ATF-3 and pharmacological characterisation / Pain 128 : 272 ~ 282 | 5. [학술지(정기간행물)] - Hochman JR / 2010 / The nerve of osteoarthritis pain / Arthritis Care Res (Hoboken) 62 : 1019 ~ 1023 | 6. [학술지(정기간행물)] - Seiji Ohtori / 2012 / Existence of a Neuropathic Pain Component in Patients with Osteoarthritis of the Knee / Yonsei Medical Journal 53 (4) : 801 ~ 805 | 7. [학술지(정기간행물)] - Orita S / 2011 / Associations between proinflammatory cytokines in the synovial fluid and radiographic grading and pain-related scores in 47 consecutive patients with osteoarthritis of the knee / BMC Musculoskelet Disord 12 : 144 ~ | 8. [학술지(정기간행물)] - Ogino S / 2009 / Detection of pain-related molecules in the subchondral bone of osteoarthritic knees / Clin Rheumatol 28 : 1395 ~ 1402 | 9. [학술지(정기간행물)] - Walsh DA / 2010 / Angiogenesis and nerve growth factor at the osteochondral junction in rheumatoid arthritis and osteoarthritis / Rheumatology (Oxford) 49 : 1852 ~ 1861 | 10. [학술지(정기간행물)] - Nelson AE / 2014 / A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U.S. bone and joint initiative / Semin Arthritis Rheum 43 : 701 ~ 712 | 11. [학술지(정기간행물)] - Bellamy N / 1988 / Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee / J Rheumatol 15 : 1833 ~ 1840 | 12. [학술지(정기간행물)] - Kellgren JH / 1957 / Radiological assessment of osteoarthritis / Ann Rheum Dis 16 : 494 ~ 501 | 13. [학술지(정기간행물)] - Lane NE / 2010 / Tanezumab for the treatment of pain from osteoarthritis of the knee / N Engl J Med 363 : 1521 ~ 1531 | 14. [학술지(정기간행물)] - Balanescu AR / 2014 / Efficacy and safety of tanezumab added on to diclofenac sustained release in patients with knee or hip osteoarthritis: a double-blind, placebo-controlled, parallel-group, multicentre phase III randomised clinical trial / Ann Rheum Dis 73 : 1665 ~ 1672 | 15. [학술지(정기간행물)] - Nagashima H / 2011 / Preliminary assessment of the safety and efficacy of tanezumab in Japanese patients with moderate to severe osteoarthritis of the knee: a randomized, double-blind, dose-escalation, placebo-controlled study / Osteoarthritis Cartilage 19 : 1405 ~ 1412 | 16. [학술지(정기간행물)] - Ohtori S / 2004 / Spinal neural cyclooxygenase-2 mediates pain caused in a rat model of lumbar disk herniation / J Pain 5 : 385 ~ 391 | 17. [학술지(정기간행물)] - Olmarker K / 1998 / Tumor necrosis factor alpha and nucleuspulposus-induced nerve root injury / Spine (Phila Pa 1976) 23 : 2538 ~ 2544 | 18. [학술지(정기간행물)] - Korhonen T / 2004 / Efficacy of infliximab for disc herniation-induced sciatica: one-year follow-up / Spine (Phila Pa 1976) 29 : 2115 ~ 2119 | 19. [학술지(정기간행물)] - Ohtori S / 2012 / Epidural administration of spinal nerves with the tumor necrosis factor-alpha inhibitor, etanercept, compared with dexamethasone for treatment of sciatica in patients with lumbar spinal stenosis: a prospective randomized study / Spine (Phila Pa 1976) 37 : 439 ~ 444 | 20. [학술지(정기간행물)] - Maksymowych WP / 2012 / Targeting tumour necrosis factor alleviates signs and symptoms of inflammatory osteoarthritis of the knee / Arthritis Res Ther 14 : R206 ~ google schola

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