PubMed, EMBASE, the Cochrane Library, and Web of Science were comprehensively searched for clinical trials published before 1 May 2021. Patients were assessed via efficacy and safety outcomes.
RESULTS: Twelve randomized controlled trials including 6022 patients were identified. Both low and moderate doses of
tanezumab significantly improved efficacy outcomes. However, only the point estimates (mean difference, MD) of moderate-dose
tanezumab significantly exceeded the minimal clinically important differences (MCIDs). There were no significant differences in the incidence of treatment-related adverse events (AEs), withdrawals due to AEs, serious AEs, and
total joint replacement between the
tanezumab and placebo groups, whereas the incidence of AEs was higher in the
tanezumab group (relative risk, RR = 1.10; 95% confidence interval, 95% CI = 1.04-1.17). The incidence of rapidly progressive OA was significantly higher in the combined low- and moderate-dose
tanezumab groups than in the placebo group (RR = 5.01; 95% CI = 1.17-21.33). Furthermore, both low and moderate doses of
tanezumab significantly increased the incidence of abnormal peripheral sensation (RR = 1.99, 95% CI = 1.21-3.28; RR = 2.64, 95% CI = 1.91-3.67, respectively). Compared with nonsteroidal anti-inflammatory drugs (
NSAIDs) and
opioids,
tanezumab showed significantly improved efficacy outcomes (p < 0.05). However, the point estimates (MD) of
tanezumab were not greater than the MCID. Pooled analysis showed no significant differences between
tanezumab and
NSAIDs and
opioids in safety outcomes (p > 0.05).
CONCLUSION:
Tanezumab is efficacious in patients with hip or knee OA.
Tanezumab is relatively well tolerated and safe but increases the incidence of AEs and reversible abnormal peripheral sensation. Additional studies on the occurrence of rapidly progressive OA are needed. A moderate dose of
tanezumab may maximize the benefits for hip or knee OA.