Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis

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SCIENCE
Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis
Key Take-Away: 

Osteoarthritis involves gradual degradation of subchondral bone, articular cartilage along with problem like synovitis. Mesenchymal stromal cells are the clinically explored option to manage the severe condition of osteoarthritis but only short-term evidence are present, and therefore this study is conducted to explore long-term outcomes of the Mesenchymal stromal cells therapy.

Introduction
Mesenchymal stromal cells (MSCs) are one of the favourable choices to manage knee osteoarthritis (OA). Various short-term clinical trials evident the usefulness and safety of MSCs. However, very less evidence is present to govern the MSCs effects on osteoarthritis management. The patients involved in our previous randomized clinical trial (CMM-ART, NCT02123368) were used to evaluate MSCs long-term clinical effect.

 

Methods
A phase I/II randomized multicenter clinical trial with active control was introduced from 2012 to 2014. A total of 30 patients randomized to hyaluronic acid (intraarticularly) alone, or to two treatment groups, hyaluronic acid together with 10 × 106 or 100 × 106 cultured autologous bone marrow-derived MSCs (BM-MSCs), and Control group. A follow-up was done for one year. The clinical evolution and adverse effects were assessed using VAS and WOMAC after a follow-up of four years.

 

Results
After the administration of BM-MSCs or during the follow-up, no adverse effects were noted. Patients who received BM-MSCs get improved as per VAS and the median value of Low-dose, High-dose and control groups were changed from 7, 6 and 5 to 2, 3 and 7, respectively at the follow-up end. The patients received BM-MSCs also improved as per WOMAC, whereas the median noticed for Low-dose, High-dose and control groups were − 18, − 10 and 4, respectively (Low-dose vs Control group p = 0.043). The BM-MSCs receiving groups showed no clinical difference.

 

Conclusions
The in vitro expanded autologous BM-MSCs single intraarticular injection is a feasible and safe approach that exhibits long-term functional and clinical outcomes in knee OA management.

Source:

Journal of Translational Medicine

Link to the source:

https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-018-1591-7

Original title of article:

Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis: long-term follow up of a multicenter randomized controlled clinical trial (phase I/II)

Authors:

José María Lamo-Espinosa et al.

Therapeutic, Knee Osteoarthritis, Knee Joints, Multicenter Randomized Controlled Clinical Trial, Efficacy, VAS, WOMAC, Intra-articular
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