Allogeneic platelet-rich plasma for knee osteoarthritis in patients with primary immune thrombocytopenia: A randomized clinical trial

Xiaohang Zhu; Lingying Zhao; Nicoletta Riva; Ziqiang Yu; Miao Jiang; Feng Zhou; Alexander Gatt; Peter V Giannoudis; Jiong Jiong Guo

doi:10.1016/j.isci.2024.109664

Allogeneic platelet-rich plasma for knee osteoarthritis in patients with primary immune thrombocytopenia: A randomized clinical trial

iScience. 2024 Apr 3;27(5):109664. doi: 10.1016/j.isci.2024.109664. eCollection 2024 May 17.

Authors

Xiaohang Zhu¹, Lingying Zhao^{2

3

4}, Nicoletta Riva⁵, Ziqiang Yu^{2

3}, Miao Jiang^{2

3}, Feng Zhou¹, Alexander Gatt^{5

6}, Peter V Giannoudis^{7

8}, Jiong Jiong Guo^{1

3

4}

Affiliations

¹ Department of Orthopedics and Sports Medicine, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China.
² Department of Hematology, National Clinical Research Center for Hematologic Disease, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China.
³ Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health of PR China, Suzhou, P.R. China.
⁴ China-Europe Sports Medicine Belt-and-Road Joint Laboratory, Ministry of Education of PRC, Suzhou, P.R. China.
⁵ Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
⁶ Department of Haematology, Mater Dei Hospital, Msida, Malta.
⁷ Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Leeds, UK.
⁸ NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK.

Abstract

The treatment of painful KOA in adult patients with ITP has not been well studied yet. We conducted a prospective, double-blind, randomized, placebo-controlled trial to evaluate the efficacy of intra-articular allogeneic PRP injections on symptoms and joint structure in patients with KOA and ITP. 80 participants were randomly allocated in a 1:1 ratio to allogeneic PRP group or saline group. The primary outcome was the WOMAC total score at 12 months post-injection. The number of patients in each group who achieved MCID of primary outcome showed a statistically significant difference only at 3-month (27/39 vs. 5/39, p = 0.001) and 6-month (15/39 vs. 3/38, p = 0.032). The difference in WOMAC total score exceeded the MCID only at 3 month (mean difference of -15.1 [95% CI -20.7 to -9.5], p < 0.001). Results suggest that allogeneic PRP was superior to placebo only with respect to symptoms at 3-month of follow-up.

Keywords: Clinical medicine; Immunology; Therapeutic procedure; Therapeutics.