24/07/2025
๐๐จ๐ฎ๐ซ๐ง๐๐ฅ ๐๐ฅ๐ฎ๐ (๐๐)
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Performed on: Friday, May 16, 2025
๐๐๐๐ ๐๐๐๐ - ๐๐๐ญ๐๐จ๐ซ๐ฆ๐ข๐ง ๐๐จ๐ซ ๐๐ง๐๐ ๐๐ฌ๐ญ๐๐จ๐๐ซ๐ญ๐ก๐ซ๐ข๐ญ๐ข๐ฌ ๐ข๐ง ๐๐ฑ๐ฌ ๐_ ๐๐ฏ๐๐ซ๐ฐ๐๐ข๐ ๐ก๐ญ ๐จ๐ซ ๐๐๐๐ฌ๐ข๐ญ๐ฒ (๐ฉ๐๐ง) [๐๐๐].๐ฉ๐๐
Codified by ๐๐๐ผ๐ผ๐๐พ แดฎแดผ (ABFL)
1. ๐๐๐พ BS โฉ Y, J, C โ T โ N โ t โ P I C O:
2. ๐๐๐พ BS ๐ฐ 2025, JAMA, AUS โ par_db_RCT โ 54 ๐ 53 โ6m of intervention โ total 2y (2021 to 2023), last f-up Feb 2024 โ P I C O:
- P: symp_knee OSTEOARTHRITIS + overweight OR obesity
- ๐
ธ: metformin 2g/d
- ๐
ฒ: placebo
- O: pOC = change in knee pain (VAS) | sOC = WOMACS + AQoL
3. EVIDENCE:
- Preclinical + preliminary โฉ โ inflammation โ preserves cartilage โ โ knee pain
- OA IN 365M
- Knee OA โฉ โ weight joints, inflammation, imp_GLU & LIP metabolism โถ SYST inflammation + oxidative stress + metabolic DYS in JOINT TISSUES (cartilage degradation + DIS progression)
- METFORMIN >60y known as 1st line for DM
- SAFE, inexpensive, well-tolerated biguanide
- โ liver_GLU production โ โ IR โ โ ENDOGENOUS hyperINSULINEMIA
- Modest weight loss โ โ inflammation (w_ & wo_DM)
- PLEIOTROPIC EFFECTS: โ knee pain in OA
* Inflammatory properties
* โ GLU & LIP metabolism โฉ โ โ AMPk
4. METHODS.
- ๐๐ก โ pain (>4/10 VAS) โ BMI โฅ25 โ >40yo โ โฅ6m painโ know OA by criteria ACR
- ๐๐ซ โ sev_Xray knee OA (Kellgren-Lawrence grade 4) โ Severe knee pain (>80 mm VAS) โ Inflammatory arthritis โ Significant knee injury โ DM โ Knee surgery (past year or next 6 m) โ Intra-articular hyaluronic acid ๐ (past 6 m) โ Corticosteroid ๐ (past 3 m) โ investigational drug or device (30d prior to randomization) โ Conditions affecting lower limb function (NEURO disorders, stroke) โ โพ & liver IMPAIRMENT.
- RANDOM โ contacted by website, email, phone โlocal and social media advertisements.
๐ฉ๐ฒ๐ฟ ๐บรก๐ ๐ฒ๐ป: https://www.inaaqc.org/journal_club_2025
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๐ฃ๐ฟ๐ถ๐บ๐ฎ๐ฟ๐ ๐๐ผ๐๐ฟ๐ฐ๐ฒ: https://doi.org/10.1001/jama.2025.3471
๐๐ก๐๐๐ค๐ ๐น๐ถ๐ฏ๐ฟ๐ฎ๐ฟ๐: https://bit.ly/4lE0ARx
