| News from Arthritis Week of August 31, 2003 / Vol. 3 No. 35 |
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Study: Good Trials Lacking of Non-Drug Therapies Osteoarthritis |
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A team of French researchers found that studies about such non-drug therapies for osteoarthritis as surgery, arthroscopy, joint lavage, rehabilitation, acupuncture, behavioral interventions and spa therapy are not cut from the same cloth studies involving prescription drugs. After analyzing 110 articles published between 1992 and 2002 in 28 general medical and specialty journals, including 50 on the effectiveness of non-drug treatments and 60 on the effectiveness of drug treatments, the researchers found that non-drug studies were of lower quality than the drug studies. Non-drug treatments were less often compared with a placebo than drug treatments (28 percent versus 72 percent) and less often blinded from patients (26 percent versus 97 percent) and providers (6 percent versus 82 percent). The skill of providers, such as surgeons, was also found to possibly have influenced the effectiveness of the non-drug treatments in 84 percent of the non-drug studies versus 23 percent of the drug studies. The researchers excused non-drug trials somewhat because of the technical and ethical difficulty of conducting a "sham intervention" on participants and the frequent impossibility of keeping study participants from correctly concluding whether they were in the control group. Drug companies have also received a push from regulatory agencies to conduct randomized and controlled trials in order for drug approvals to be granted. "Despite the challenges posed by non-pharmacological treatment studies, the same expectations of quality should be applied to non-pharmacological treatment trials as are applied to pharmacological treatment trials," the researchers concluded. Other
sources: Journal of the American Medical Association 2003;290:1062-1070
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