変形性膝関節症患者に対するプレガバリンの効果とヘモグロビンA1cとの関連性

Relationship Between Hemoglobin A1c and Efficacy of Pregabalin in Patients with Osteoarthritis of the Knee

　背景：ヘモグロビン(Hb)A1cが高値の変形性膝関節症(膝OA)患者ほどプレガバリンの併用投与が有効か否かを検証した．

　対象と方法：37例の膝OA患者を，ヒアルロン酸(HA)注射だけを受けるHA群(20例)と，HAとプレガバリンを投与するHA＋プレガバリン群(17例)に無作為に分類した．改善点数は治療前と4週間治療後のLequesne重症度指数を使って評価した．HbA1cは高速液体クロマトグラフィで計測した．

　結果：改善点数はHA群とHA＋プレガバリン群の間で有意差がなかった(P＝0.3)．HA＋プレガバリン群では，HbA1cと改善点数は有意な相関性を示した(P＝0.002)．このような有意な相関性はHA群ではなかった(P＝0.92)．

　まとめ：糖尿病の疑いがある膝OA患者にはHAとプレガバリンの併用療法が有効な可能性がある．

　Background：We evaluated whether the combination therapy of hyaluronic acid plus pregabalin is useful or not for patients with osteoarthritis of the knee (knee OA) who had high level of hemoglobin A1c (HbA1c).

　Method：The subjects of this randomized prospective study were 37 patients with osteoarthritis of the knee (knee OA).　They were divided into a hyaluronic acid (HA) group (n＝20) and an HA＋pregabalin group (n＝17).　Improvement was evaluated on the basis of Lequesne Index scores before treatment and after 4 weeks of treatment.　HbA1c was analyzed by high-performance liquid chromatography.

　Outcome：The difference between the improvements in score in the HA group and HA＋pregabalin group was not significant (P＝0.3).　The HbA1c values of the HA＋pregabalin group were significantly correlated with the improvements in their scores (P＝0.002), but the correlation in the HA group was not significant (P＝0.92).

　Conclusion：The results indicated that HA＋pregabalin combination therapy would be useful for patients with knee OA who were suspected of having diabetes as a complication.