The Efficacy of Platelet-Rich Plasma in the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review With Quantitative Synthesis

ORIGINAL RESEARCH ARTICLErischio, tra i quali il genere (le donne sono più predisposte), l'età, il tipo di attività lavorativa, l'obesità (1-3).Le patologie muscoloscheletriche sono l'ottava causa a livello mondiale, e la quarta nei Paesi occidentali, per anni di vita persi per disabilità (disability-adjusted life-year, DALY). Almeno la metà delle patologie muscoloscheletriche sono attribuibili all'osteoartrosi (4) ed essa risulta essere l'undicesima patologia per peso di contribuzione alla disabilità a livello mondiale su 291 patologie, e trentottesima per DALY (5).Il carico medico e sociale dell'OA determina un forte impatto economico sui sistemi sanitari (6, 7), in particolare nei Paesi occidentali dove l'incidenza è più elevata. I costi sanitari diretti sono dovuti ai farmaci utilizzati per ridurre il dolore e la limitazione funzionale, esami medici, ricoveri e interventi chirurgici di sostituzione dell'articolazione danneggiata (artroprotesi). The increasing incidence of total joint arthroplasty reflects the rises of osteoarthritis (OA) prevalence. OA is a degenerative pathology affecting joints with a significant impact on quality of life causing pain, leading to social life limitations and loss of work productivity. According to the World Health Organization, OA is one of the most important causes of people's disability. The burden of the disease is correlated with a huge economic impact on the health care systems. Intra-articular infiltration therapies are used between the pharmacological and the surgical phases, in order to delay surgery. This work aims to carry out an economic evaluation on the use of the Platelet-RichPlasma (PRP) therapy in the treatment of knee OA. The comparator is the hyaluronic acid, i.e. the standard therapy for drug-resistant OA that does not benefit or has short term benefits (<1 month) with intra-articular corticosteroids. Methods: A cost-effectiveness analysis has been performed using a decision-analytic model considering two scenarios: short period and medium period. The effectiveness outcomes are reported in term of quality-adjusted life-years (QALYs), while costs are expressed in euro (€). The adopted perspective is the Italian National Health System (INHS). The results are shown through the incremental cost-effectiveness ratio (ICER) examining the PRP versus the comparator. Moreover, deterministic and probabilistic sensitivity analyses have been performed to test the robustness of the results. Results: The PRP therapy, for patients with moderate to severe knee OA in the Italian context, is cost-effective versus HA with ICERs of €1,524/QALY in the 1 year and €162/QALY in the 5 year scenarios. Conclusions: In the short term, it seems that the PRP therapy is cost-effective in the treatment of knee OA versus the HA therapy. However, more research is needed to assess its cost-effectiveness in the long term and to figure out if this treatment may be an efficient resource allocation for the INHS.

show abstract

“…Diversi studi mostrano che il PRP ha un'efficacia superiore all'HA (34)(35)(36)(37)(38)(39)(40)(41)(42).…”

Section: Discussioneunclassified

“…di PRP considerato per un ciclo terapeutico è stato di tre come riportato da recenti metanalisi (39,40,42).…”

Section: Costiunclassified

Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Landi

Landa

Russo

2016

Global & Regional Health Technology Assessment

View full text Add to dashboard Cite

show abstract

“…However, the experimental group treated with PRP only did not show clinical improvements. It is important to highlight that the current study aimed to use PRP as a vehicle for MSC application, and studies have found that multiple and sequential applications are required to obtain improvements in OA and chondral defects when using PRP alone (Khoshbin et al, 2013). Recent investigations have shown that growth factors found in the PRP function as carriers, and may enhance, stimulate, or even extend the effects of MSCs (Vilar et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Effects of intra-articular injection of mesenchymal stem cells associated with platelet-rich plasma in a rabbit model of osteoarthritis

et al. 2016

View full text Add to dashboard Cite

ABSTRACT. The current study aims to evaluate the macroscopic and histological effects of autologous mesenchymal stem cells (MSC) and platelet-rich plasma on knee articular cartilage regeneration in an experimental model of osteoarthritis. Twenty-four rabbits were randomly divided into four groups: control group, platelet-rich plasma group, autologous MSC undifferentiated group, and autologous MSC differentiated into chondrocyte group. Collagenase solution was used to induce osteoarthritis, and treatments were applied to each group at 6 weeks following osteoarthritis induction. After 60 days of therapy, the animals were euthanized and the articular surfaces were subjected to macroscopic and histological evaluations. The adipogenic, chondrogenic, and osteogenic differentiation potentials of MSCs were evaluated. Macroscopic and histological examinations revealed improved tissue repair in the MSC-treated groups. However, no difference was found between MSC-differentiated and undifferentiated chondrocytes. We found that MSCs derived from adipose tissue and platelet-rich plasma were associated with beneficial effects in articular cartilage regeneration during experimental osteoarthritis.

show abstract

“…Since PRP is prepared from autologous blood, theoretically there are minimal risks for disease transmissions, immunogenic reactions or cancer [4]. In the musculoskeletal field, although no long-term outcome studies with PRP exist, a large number of patients have been treated worldwide [24][25][26][27]. In our review of the literature we did not come across RCT's that have comprehensively evaluated the safety of PRP treatment [10].…”

Section: Spine Research Issn 2471-8173mentioning

confidence: 99%

Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results

Cameron¹,

Thielen²

2017

Spine Res

View full text Add to dashboard Cite

The Efficacy of Platelet-Rich Plasma in the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review With Quantitative Synthesis

Cited by 208 publications

References 77 publications

Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Valutazione Economica Sull'utilizzo Del Plasma Arricchito di PiastrineVsAcido Ialuronico Per il Trattamento Dell'osteoartrosi al Ginocchio. Scenario a 1 Anno e a 5 Anni

Effects of intra-articular injection of mesenchymal stem cells associated with platelet-rich plasma in a rabbit model of osteoarthritis

Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results

Contact Info

Product

Resources

About