Clinical Effect Of Calcitonin For The Treatment Of Knee Osteoarthritis With Bone Marrow Lesions

ObjectiveGlobal prevalence of Osteoarthritis(OA)is increasing and the economic burden of the disease will rise.Knee is the most common site of OA.Bone marrow lesions(BMLs)are a severe imaging finding in terminal stages of knee OA.For patients with this issue,the best treatment is still unclear.The objective of the present research was to compare the short-term clinical effect of intramuscular calcitonin and oral celecoxib for the treatment of knee OA with BMLs.Patients and methodsBetween January 2016 and December 2018,according to the diagnostic criteria of osteoporotic and knee OA,the medical records of patients with BMLs in the knee OA with osteoporotic treated by intramuscular calcitonin or oral celecoxib were reviewed,therefore,patients were divided into celecoxib group and calcitonin group.A total of123 eligible patients who received calcitonin treatment(n=66)or celecoxib treatment(n=57)were included.All patients were followed up clinically and radiographically for 3 months.Knee pain and function were measured using the Visual Analog Scale(VAS)and the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC),respectively.BMLs were evaluated using MRI scans and were scored using the modified Whole-Organ MRI Score(WORMS).The safety of these two medications were also assessed.ResultsA total of 123 patients(45 men and 78 women)were enrolled with a mean±SD age of 64.47±9.54 years,and a mean bone mass index(BMI)of 25.84±4.83 kg/m~2.No statistical differences were found between the two groups in age,gender,smoking,BMI and the baseline of VAS,WOMAC and BMLs scores.After treatment,symptoms of the disease decreased over time in both therapeutic groups,but the VAS and WOMAC scores were significantly lower in the calcitonin group than the celecoxib group at each follow-up.For BMLs,the WORMS scores in the calcitonin group were significantly lower than the celecoxib group.In addition,there was an apparent significant difference between the two groups in the MRI improvement rate at 4 weeks(21.21%vs.7.01%;P=0.039)and 3 months(37.88%vs.15.79%;P=0.006).ConclusionIntramuscular calcitonin 50 IU once daily demonstrated better short-term effect for the treatment of knee OA with BMLs patients compared with oral celecoxib 200 mg twice per day.