Objective

2

To investigate the differences in clinical efficacy of different medication regimens of

Wangbi Tablets

（尪痹片） for knee osteoarthritis （KOA） in a real-world setting， providing a basis for rational clinical use of

Wangbi Tablets

.

Methods

2

A prospective registry study was conducted， involving 2，999 KOA patients registered in 30 hospitals nationwide from January 26th， 2019， to December 17th， 2021. Based on the use of

Wangbi Tablets

during the observation period， patients were divided into a monotherapy group （1，507 cases） and a combination therapy group （1，492 cases）， and the combination group can be further divided into

Wangbi Tablets

plus Chinese medicine （CM），

Wangbi Tablets

plus western medicine （WM）， and

Wangbi Tablets

plus Chinese and western medicine （CM+WM） subgroups. The baseline data of patients in the monother

apy group and the combination group were compared， including age， gender， body weight， medication time， clinical stage， K-L grade， and others. Efficacy indicators included the Visual Analog Scale （VAS） score， Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） score， and EuroQol five-dimensional （EQ-5D） health index， which were evaluated before and after 4-， 8- and 12-week treatment， and the difference before and after treatment was calculated after 4， 8 and 12 weeks of treatment. The difference between the baseline and 12 weeks of treatment of all the above indicators was used as the dependent variables， and gender， age， body mass index （BMI）， course of disease， K-L grade， and clinical stage were used as independent variables， when multiple linear regression was taken to explore the influencing factors of the efficacy. At the same time， the occurrence of major symptoms （including morning stiffness， joint swelling， soreness of waist and knees， fear of wind， and fear of cold） was counted， and the disappearance of symptoms at each time point was counted after 4， 8， and 12 weeks of treatment.

Results

2

At baseline， there were no statistically significant differences in gender and age distribution between the monotherapy and combination therapy groups （

P

＞0.05）； the proportion of patients in the acute stage and recovery stage was higher in the monotherapy group than in the combination therapy group， while the proportion in the remission stage was lower （

P

＜0.05）； the VAS score was higher in the monotherapy group， and the EQ-5D index was lower （

P

＜0.01）， with no statistically significant difference in total WOMAC score between the two groups （

P

＞0.05）. Compared to those measured before treatment and at previous timepoint， the VAS score and WOMAC total score significantly decreased in both groups， while EQ-5D value increased （

P

＜0.05）. The difference in VAS score between baseline and after 12-

week treatment was higher in the monotherapy group than the combination group， while the differences in WOMAC total score and EQ-5D value between baseline and after 4-， 8- and 12-week treatment were higher in the combination group （

P

＜0.05）. Multiple linear regression showed that VAS score before treatment had greatest impact on pain improvement （

P

＜0.01）， and compared to

Wangbi Tablets

monotherapy， the combination of

Wangbi tablets

with WM or CM had larger associations with pain improvement （

P

＜0.05）； and

Wangbi Tablets

had better efficacy when the course of treatment was ＞28 days （

P

＜0.01）.

Wangbi Tablets

plus WM had a better effect on improving the overall function of the knee joint than

Wangbi Tablets

alone （

P

＜0.01）； and the efficacy of

Wangbi Tablets

with a course of treatment ＞28 days was better （

P

＜0.05）. The improvement of quality of life of patients in the attack and remission stages was more obvious than that in the recovery stage （

P

＜0.01）；

Wangbi Tablets

plus WM or CM had a better effect on improving quality of life than

Wangbi Tablets

alone （

P

＜0.05）. Before treatment， the proportion of patients with morning stiffness， soreness of waist and knees， fear of wind and chills in the monotherapy group was higher than that in the combination group （

P

＜0.01）. The proportion of main symptoms in both groups decreased after 4， 8 and 12 weeks of treatment （

P

＜0.05）. After 4 weeks of treatment， the disappearance rate of each main symptom in the combination group was higher than that in the monotherapy group， and after 12 weeks of treatment， the disappearance rate of fear of wind in the monotherapy group was higher than that in the combination group， while the disappearance rate of joint swelling and soreness of waist and

knees was lower （

P

＜0.05）.

Conclusion

2

Wangbi Tablets

， whether used alone or in combination with other medications， is effective throughout the course of KOA， with greater benefits in improving joint function and quality of life during the acute and remission stages compared to the recovery stage. Combination therapy had a faster onset of effect， but began to converge with monotherapy after 8 weeks. The best efficacy was observed with the combination of

Wangbi Tablets

with WM， followed by combination with CM.