medwireNews: Low-dose radiation therapy (LDRT) has no significant effect on symptoms or inflammatory markers when used in the treatment of knee osteoarthritis (OA), study findings indicate.
Based on their results, “and the absence of other high-quality evidence,” Elien Mahler (Sint Maartenskliniek, Nijmegen, the Netherlands) and co-investigators “advise against the use of LDRT as treatment for knee OA.”
The study included 55 patients (mean age 65 years, 51% women) with knee OA based on clinical ACR criteria who had a pain score of at least 5 out of 10 and had not responded to analgesics or exercise therapy. Patients were randomly assigned to receive either LDRT six times in 2 weeks (1 Gy/fraction) or sham treatment at the same intervals.
At 3 months’ postintervention, 44% of the 27 patients who received LDRT had a response to treatment according to OMERACT-OARSI criteria.
This did not significantly differ from the 43% response rate observed among the 28 patients in the sham group.
There were also no significant differences between the two groups with regard to improvements in pain, function, and stiffness at 3 months, as assessed using the WOMAC OA index scale.
Nor were there any significant differences in inflammation as assessed by ultrasound (synovial effusion and synovial thickness), magnetic resonance imaging (effusion synovitis), and serum inflammatory markers (erythrocyte sedimentation rate and C-reactive protein).
Writing in the Annals of the Rheumatic Diseases, Mahler and team point out that LDRT is still widely used for the treatment of knee OA in some countries. Therefore “future efforts should focus on deimplementation of LDRT, by changing the beliefs of involved clinicians and health professionals about the efficacy of LDRT that are not based on scientific grounds,” they say.
“Additionally, it is important that future research should also focus on the quality of the scientific evidence of LDRT treatment for other benign (musculoskeletal) disorders, for which high-quality studies are also lacking,” the authors conclude.
By Laura Cowen
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