ORCID Profile
0000-0002-8087-436X
Current Organisation
Zhujiang Hospital
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Publisher: Springer Science and Business Media LLC
Date: 2023
Publisher: Wiley
Date: 13-10-2022
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.BBRC.2018.09.031
Abstract: Necroptosis, a necrotic cell death pathway regulated by receptor interacting protein (RIP) 1 and 3, plays a key role in pathophysiological processes, including rheumatoid arthritis (RA). However, whether necroptosis is involved in RA articular cartilage damage processes remain unclear. The aim of present study was to investigate the dynamic changes in arthritic chondrocyte necroptosis and the effect of RIP1 inhibitor necrostatin-1 (Nec-1) and acid-sensing ion channels (ASICs) inhibitor amiloride on arthritic cartilage injury and acid-induced chondrocyte necroptosis. Our results demonstrated that the expression of RIP1, RIP3 and mixed lineage kinase domain-like protein phosphorylation (p-MLKL) were increased in adjuvant arthritis (AA) rat articular cartilage in vivo and acid-induced chondrocytes in vitro. High co-expression of ASIC1a and RIP1 showed in AA rat articular cartilage. Moreover, Nec-1 and amiloride could reduce articular cartilage damage and necroinflammation in AA rats. In addition, acid-induced increase in necroptosis markers RIP1/RIP3 were inhibited by Nec-1, ASIC1a-specific blocker psalmotoxin-1 (PcTx-1) or ASIC1a-short hairpin RNA respectively, which revealed that necroptosis is triggered in acid-induced chondrocytes and mediated by ASIC1a. These findings indicated that blocking ASIC1a-mediated chondrocyte necroptosis may provide potential therapeutic strategies for RA treatment.
Publisher: Cold Spring Harbor Laboratory
Date: 26-07-2020
DOI: 10.1101/2020.07.20.20157669
Abstract: Hydroxychloroquine (HCQ) is a conventional disease-modifying antirheumatic drug (DMARD), which is considered as relatively safe, and offers a modest efficacy profile for the treatment of inflammatory rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. In view of the anecdotal evidence on its immunomodulatory and anti-inflammatory properties, HCQ has been used as an off-label option in patients with osteoarthritis (OA), mainly for the treatment of inflammatory OA. Recently, many investigators have evaluated the safety and efficacy of HCQ for the treatment of OA in various randomized control trials (RCTs). While most RCTs have evaluated the HCQ in inflammatory OA (erosive hand OA), there are studies constituting knee OA patients as well. Currently, there are no systematic reviews that have summarized the evidence on the efficacy and safety of HCQ in OA population. Hence, this study aims to systematically review the evidence from RCTs assessing the efficacy and safety of HCQ for the treatment of OA. Biomedical databases such as PubMed, Embase, and Google Scholar will be searched to identify the RCTs of HCQ in patients with OA (hand, knee, hip, or any other OA). Cochrane risk of bias tool will be used to assess the quality of included studies. Review Manager 5 (Rev Man) and STATA Version 16 will be used to conduct the statistical analysis.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2021
Publisher: Elsevier BV
Date: 04-2020
Publisher: Korean Association of Internal Medicine
Date: 2022
Abstract: Background/Aims: Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA.Methods: MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments.Results: Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA.Conclusions: HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2023
Publisher: BMJ
Date: 19-05-2021
DOI: 10.1136/ANNRHEUMDIS-2021-EULAR.2762
Abstract: There is increasing use of complementary and alternative medicines (CAMs) alone or as an adjuvant therapy to conventional palliative medicines. 1 However, there remains clinical uncertainty about the benefit of CAMs in the management of osteoarthritis in older population. To describe the association between CAM use (alone or in combination with conventional analgesics) with knee symptoms and structural changes amongst a representative s le of Tasmanian older adults. A total of 1,099 participants were selected from the Tasmania Older Adult Cohort Study (TASOAC), an ongoing prospective population-based study. Exposure to CAM and conventional medications was classified into four categories according to the national drug code directory: 2 CAM only, conventional analgesics only, both CAM and conventional analgesics, and neither CAMs nor conventional analgesics. Knee pain was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a 1.5-T MRI of the right knee was performed at baseline and follow-up (around 2.6 years). Longitudinal associations were assessed using mixed effect linear models. At baseline, participants‘ mean age was 63, 86.5% (n=951) reported any medication use. The prevalence of CAM use was 35.0% and of conventional analgesics was 58.6%. Over follow-up, the analgesic only group had a significant increase in WOMAC pain, function, and stiffness scores compared to those who took neither CAMs nor conventional analgesics. There was a statistically significant femoral cartilage volume loss across all four groups, and no statistical difference was found between participants who takes both CAMs and analgesics group and the reference group, but participant in the CAM only or the analgesics only groups loss statistically significant more femoral cartilage volume than the reference group (Table 1). Table 1. Association of change in clinical knee symptoms and knee structural changes over 2.6 years with different medications groups. Mean change for reference group* Change for each category, coefficient (95% confident intervals) CAMs Both Analgesics Reference group* No. of participants 327 128 257 387 327 WOMAC pain (5-50) -0.95 (-1.42, -0.48) 0.04 (-0.85, 0.93) 0.32 (-0.4, 1.04) 0.78 (0.13, 1.43) Ref WOMAC function (17-170) -3.09 (-4.52, -1.67) 1.02 (-1.7, 3.73) 1.39 (-0.81, 3.59) 2.32 (0.33, 4.31) Ref WOMAC stiffness (2-20) -0.39 (-0.62, -0.17) 0.15 (-0.28, 0.58) 0.35 (0, 0.7) 0.40 (0.09, 0.72) Ref Femoral cartilage volume (mL) -187.98 (-228.79, -147.18) -113.81 (-192.60, -35.03) -1.92 (-65.00, 61.17) -127.19 (-186.31, -68.06) Ref *Reference group=participants taken neither CAMs nor conventional analgesics CAM use alone or in combination with conventional analgesics may associate with slower progression of knee pain. Conclusive evidence on the longitudinal benefits of CAM in the management of osteoarthritis among older adults warrants more studies. [1] Steel A, McIntyre E, Harnett J, et al . Complementary medicine use in the Australian population: Results of a nationally-representative cross-sectional survey. Sci Rep 2018 8 :17325. [2] National Center for Health Statistics . Long-term Care Drug Database System: Drugs by NDC Class Code, Drug Code and Name 2007 Available from: chs/data/nnhsd/DrugsbyNDCClass3.pdf [accessed date: 2020 23 December]. The data were fitted using mixed effect linear models, which were constructed by entering baseline medication group, phase, the interaction between medication group and phase, covariates (baseline age, sex, body mass index [BMI], baseline value of outcome), the interaction between the covariates and phase, random intercept, and random slope on phase (time). None declared
Publisher: Elsevier BV
Date: 10-2017
Publisher: BMJ
Date: 18-08-2023
Abstract: This study aims to identify circulating proteins that are causally associated with osteoarthritis (OA)-related traits through Mendelian randomisation (MR)-based analytical framework. Large-scale two-s le MR was employed to estimate the effects of thousands of plasma proteins on 12 OA-related traits. Additional analyses including Bayesian colocalisation, Steiger filtering analysis, assessment of protein-altering variants and mapping expression quantitative trait loci to protein quantitative trait loci were performed to investigate the reliability of the MR findings protein–protein interaction, pathway enrichment analysis and evaluation of drug targets were conducted to deepen the understanding and identify potential therapeutic targets of OA. Dozens of circulating proteins were identified to have putatively causal effects on OA-related traits, and a majority of these proteins were either drug targets or considered druggable. Through MR analysis, we have identified numerous plasma proteins associated with OA-related traits, shedding light on protein-mediated mechanisms and offering promising therapeutic targets for OA.
Publisher: MDPI AG
Date: 07-06-2017
Publisher: Elsevier BV
Date: 04-2021
Publisher: Wiley
Date: 21-08-2022
DOI: 10.1002/CPDD.1144
Abstract: Eldecalcitol is an active vitamin D 3 derivative that is used for the prevention and treatment of osteoporosis. The objectives of this study were to evaluate the bioequivalence and safety of 2 formulations of eldecalcitol capsule (0.75 μg) in healthy Chinese male and female volunteers, as well as to investigate the food effect on the pharmacokinetics of this drug. An open label, randomized, 3‐period, 3‐sequence, reference replicated crossover clinical study was performed in 27 healthy Chinese volunteers under fasting conditions, while a 2‐way crossover study was carried out in 28 healthy Chinese volunteers under fed conditions. Volunteers were administered a single oral dose of 0.75 μg eldecalcitol after fasting overnight. Blood s les were collected at scheduled time points from 0 to 168 hours after administration of eldecalcitol. The 90%CIs of the test/reference geometric mean ratio (area under the plasma concentration–time curve and maximum plasma concentration) of eldecalcitol after a single‐dose administration were within the acceptance criteria based on the average bioequivalence method. The time to maximum concentration of the test and reference formulations were elevated by ≈2.3‐fold and 1.7‐fold, respectively, after a high‐fat meal. Only mild and transient adverse events were reported in this study, and no severe adverse events occurred. These results indicated that the 2 formulations of eldecalcitol were bioequivalent under both fasting and fed conditions. Food intake prolonged the oral absorption of eldecalcitol but did not significantly influence systemic exposure.
Publisher: Springer Science and Business Media LLC
Date: 24-01-2023
DOI: 10.1007/S10067-022-06477-5
Abstract: To determine the feasibility of a randomized controlled trial (RCT) examining outdoor walking on knee osteoarthritis (KOA) clinical outcomes and magnetic resonance imaging (MRI) structural changes. This was a 24-week parallel two-arm pilot RCT in Tasmania, Australia. KOA participants were randomized to either a walking plus usual care group or a usual care control group. The walking group trained 3 days/week. The primary outcome was feasibility assessed by changes being required to the study design, recruitment, randomization, program adherence, safety, and retention. Exploratory outcomes were changes in symptoms, physical performance/activity, and MRI measures. Forty participants (mean age 66 years (SD 1.4) and 60% female) were randomized to walking ( n = 24) or usual care ( n = 16). Simple randomization resulted in a difference in numbers randomized to the two groups. During the study, class sizes were reduced from 10 to 8 participants to improve supervision, and exclusion criteria were added to facilitate program adherence. In the walking group, total program adherence was 70.0% and retention 70.8% at 24 weeks. The walking group had a higher number of mild adverse events and experienced clinically important improvements in symptoms (e.g., visual analogue scale (VAS) knee pain change in the walking group: − 38.7 mm [95% CI − 47.1 to − 30.3] versus usual care group: 4.3 mm [− 4.9 to 13.4]). This study supports the feasibility of a full-scale RCT given acceptable adherence, retention, randomization, and safety, and recruitment challenges have been identified. Large symptomatic benefits support the clinical usefulness of a subsequent trial. 12618001097235. Key Points • This pilot study is the first to investigate the effects of an outdoor walking program on knee osteoarthritis clinical outcomes and MRI joint structure, and it indicates that a full-scale RCT is feasible. • The outdoor walking program (plus usual care) resulted in large improvements in self-reported knee osteoarthritis symptoms compared to usual care alone. • The study identified recruitment challenges, and the manuscript explores these in more details and provides recommendations for future studies.
Publisher: Cold Spring Harbor Laboratory
Date: 09-09-2020
DOI: 10.1101/2020.09.07.20190215
Abstract: Osteoarthritis (OA) is a common chronic joint disease with limited pharmacological management options. Boswellia extracts (BE) or formulations containing BE are generally considered as safe and offers a modest efficacy for the treatment of OA. Although previous systematic reviews have assessed the efficacy of BE in OA, these reviews had excluded trials assessing various formulations containing BE and excluded various combinations of BE. Hence, this study aims to systematically review the evidence from RCTs assessing the efficacy and safety of both BE and formulations containing BE for the treatment of OA. Biomedical databases such as PubMed, Embase, and Google Scholar will be searched to identify the RCTs of BE or formulations containing BE in patients with OA (hand, knee, hip, or any other OA). Cochrane risk of bias tool will be used to assess the quality of included studies. Review Manager 5 (Rev Man) and STATA Version 16 will be used to conduct the statistical analysis.
Publisher: Elsevier BV
Date: 04-2021
Publisher: Elsevier BV
Date: 04-2022
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/ANNRHEUMDIS-2020-EULAR.5139
Abstract: Pharmacological therapies are limited, associated with off-target effects, are frequently contraindicated, and only modestly effective for pain in osteoarthritis (OA). Effusion and synovitis are common in OA and are associated with symptomatic and structural progression of OA. Curcuma longa (Turmeric) extract has anti-inflammatory effects and is gaining popularity in the treatment of OA despite the lack of high-quality evidence. The CurKOA trial aimed to determine the efficacy of Curcuma longa extract for reducing knee symptoms and effusion-synovitis in patients with symptomatic knee OA and knee effusion-synovitis. In this randomised, double-blind, placebo-controlled trial, participants with significant knee pain (≥ 40 mm on a 100-mm visual analog scale [VAS]), symptomatic knee OA (by ACR criteria) and ultrasound defined effusion-synovitis were randomised to receive Curcuma longa extract (80% aqueous based extract standardized to turmerosaccharides + 20% curcuminoids, 2 × 500 mg capsules/day) or identical placebo for 12 weeks. Knee MRI scans were obtained at baseline and 12 weeks. Coprimary outcomes were changes in knee pain assessed by VAS and change in knee effusion-synovitis volume assessed by MRI over 12 weeks. Among 70 participants (36 received Curcuma longa , 34 received placebo, age 61.8±8.6 years, 56% female), Curcuma longa significantly improved VAS knee pain compared to placebo (-9.11mm, 95% confidence interval [CI] [- 17.79 to -0.44]) over 12 weeks, equivalent to a standardised effect size of 0.50. There was no significant between group difference in change in effusion-synovitis volume (3.24 mL [-0.33, 6.82]). There were significantly greater reductions in WOMAC knee pain (-47.22mm [-81.22, -13.22]), WOMAC function (-112.26mm [-222.79 to -1.74]) and significantly more OARSI-OMERACT treatment responders (63% treatment vs. 38% placebo [Risk Ratio=1.64 (1.00 to 2.70)]) in the Curcuma longa group compared to the placebo group. There was no significant between-group difference in lateral femoral cartilage T2 relaxation time (-0.38 ms [- 1.10 to 0.34]) assessed from compositional MRI. The incidence of adverse events was similar in the Curcuma longa (n=14 (39%)) and placebo (n=18 (53%)) groups over 12 weeks (P=0.24). An extract of Curcuma longa significantly improved knee pain in an inflammatory phenotype of knee OA patients over 12 weeks compared to placebo but had no effect on knee effusion-synovitis and cartilage composition assessed using MRI. The moderate effect size of the treatment supports the use of Curcuma longa extract for the symptomatic management of knee OA. None declared
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.PHYTOCHEM.2019.04.005
Abstract: Tree peonies (Paeonia Sect. Moutan) are well-known for their medicinal and ornamental uses but most wild species in the Moutan section are endangered. The comprehensive metabolomics evaluation of tree peonies is essential to distinguish different species and to identify undescribed compounds, thereby elucidating the ersity of their metabolites and discovering potential active ingredients. In this study, the metabolome variations of root barks of nine species and their varieties collected from one botanical garden after years of localization were systematically investigated. A digital database of specialized metabolites was established to improve feature identification or annotation and various bio- and cheminformatics tools were employed to analyse and visualize the profiled metabolomic data. As a result, 384 compounds were identified or annotated, including various monoterpene glycosides, flavonoids, phenols, terpenoids and steroids, tannins, stilbenes and others. All s les were clearly ided into two subsections: Vaginatae and Delavayanae. The distribution and abundance of metabolites were also analysed and discussed in order to find potential biomarkers in different wild tree peonies.
Publisher: Elsevier BV
Date: 2023
Publisher: Informa UK Limited
Date: 07-2021
DOI: 10.2147/DDDT.S323169
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.BBADIS.2017.10.004
Abstract: The acute-phase proinflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) demonstrate high-level expression and pleiotropic biological effects, and contribute to the progression and persistence of rheumatoid arthritis (RA). Acid hydrarthrosis is also an important pathological characteristic of RA, and the acid-sensing ion channel 1a (ASIC1a) plays a critical role in acidosis-induced chondrocyte cytotoxicity. However, the roles of IL-1β and TNF-α in acid-induced apoptosis of chondrocytes remain unclear. Rat adjuvant arthritis and primary articular chondrocytes were used as in vivo and in vitro model systems, respectively. ASIC1a expression in articular cartilage was increased and highly colocalized with nuclear factor (NF)-κB expression in vivo. IL-1β and TNF-α could upregulate ASIC1a expression. These cytokines activated mitogen-activated protein kinase and NF-κB pathways in chondrocytes, while the respective inhibitors of these signaling pathways could partially reverse the ASIC1a upregulation induced by IL-1β and TNF-α. Dual luciferase and gel-shift assays and chromatin immunoprecipitation-polymerase chain reaction demonstrated that IL-1β and TNF-α enhanced ASIC1a promoter activity in chondrocytes by increasing NF-κB DNA-binding activities, which was in turn prevented by the NF-κB inhibitor ammonium pyrrolidinedithiocarbamate. IL-1β and TNF-α also decreased cell viability but enhanced LDH release, intracellular Ca
Publisher: Wiley
Date: 11-07-2023
Abstract: There is increasing use of complementary and alternative medicines (CAMs) alone or as an adjuvant therapy to conventional medicines in osteoarthritis (OA) patients. This study aimed to describe the prevalence and correlates of the use of CAMs among community‐dwelling older adults. Data from the Tasmania Older Adult Cohort Study (TASOAC, n = 1099) were used to describe the prevalence of CAM use. Correlates of CAM use were assessed by comparing CAM users and non‐users. To further assess correlates of CAM use, participants with at least one joint with pain were classified into four categories: CAM‐only, analgesics‐only, co‐therapy, and “neither CAMs nor analgesics” (NCNA). In all, 385 (35.0%) of our participants reported use of CAM s, among which vitamins/minerals were used most (22.6%, n = 232). Compared with CAM non‐users, CAM users were more likely to be female, were less likely to be overweight, were better educated, had more joints with OA , had fewer WOMAC scores, and did more steps per day. Among participants with any joint pain, the CAM‐only group were less likely to be overweight, consumed more alcohol, had higher quality of life, had more steps per day, and had fewer pain‐related symptoms compared with the analgesic‐only group. Complementary and alternative medicines were commonly used among Tasmanian older adults, with 35% of the population using CAMs either alone or in combination with conventional analgesics. CAM users were more likely to be female, be better educated, have more joints with OA, and had healthier lifestyles, including lower body mass index and higher number of steps per day.
Publisher: Cold Spring Harbor Laboratory
Date: 11-05-2020
DOI: 10.1101/2020.05.06.20092726
Abstract: Turmeric extracts have been used as a remedy for treating arthritis in traditional medicine. Recent years have witnessed the rise of different extracts from turmeric and randomised clinical trials (RCTs) evaluating the efficacy and safety of these extracts for the treatment of knee osteoarthritis (OA). This planned systematic review and meta-analysis aims to assess the efficacy and safety of turmeric extracts for the treatment of knee OA. Biomedical databases such as PubMed, Scopus, and Embase will be searched for RCTs reporting safety and efficacy of turmeric extracts for the treatment of knee OA. Cochrane risk of bias tool will be used to assess the methodological quality of the included studies, and a meta-analysis will be performed to pool the effect estimates.
Publisher: American College of Physicians
Date: 12-2020
DOI: 10.7326/M20-0990
Publisher: Elsevier BV
Date: 06-2023
Publisher: BMJ
Date: 23-05-2022
DOI: 10.1136/ANNRHEUMDIS-2022-EULAR.4090
Abstract: Exercise therapy is recommended as first line treatment for knee osteoarthritis (OA), but it remains to be sub-optimally applied (1). Movement-evoked pain is a potential barrier to exercise adherence, but recent evidence suggests that such pain can be improved by training (2). Walking programs are low-cost, easily adopted and can be performed outdoors which can minimize the risk of SARS-CoV-2 transmission when in a group (3). To explore the acute pain trajectories of in iduals with knee OA during a 24-week outdoor walking intervention. In addition, to explore the effect of pain trajectories and/or baseline characteristics on retention and adherence. In iduals with clinical knee OA and bone marrow lesions (BMLs) on magnetic resonance imaging (MRI) were asked to follow a 24-week walking program. Every week consisted of two one hour supervised group sessions at various outdoor locations and one unsupervised session. At the start and end of every supervised group walk, knee pain was self-reported by participants to their trainer using a numerical rating scale (NRS) (0-10). The difference between the NRS pain values was considered as an acute pain change evoked by that walk. At baseline, the most affected knee of each participant was assessed using the Visual Analogue Scale (VAS) pain, the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) pain, stiffness and function, wellbeing (3 questionnaires) and the Osteoarthritis Research Society International (OARSI) recommended strength and performance measures. In total, N = 24 participants started the program of whom N = 7 (29%) withdrew. Pain at the start of each walk decreased from NRS 2.5 (SD 1.6) at the first walk (N = 24) to NRS 0.9 (SD 0.8) at the final walk (N = 17). This pain was estimated to decrease on NRS by -0.04 (95% CI -0.05 to -0.02) per supervised session, p 0.001 during the first 12 weeks and -0.01 (95% CI -0.02 to -0.004), p = 0.004 during the second twelve weeks of the program. The number (%) of participants who experienced an acute increase in pain decreased from 11 (45.8%) at the first walk to 4 (23.5%) at the last walk. At baseline, non-adherent participants ( % of group sessions) (N = 11) had lower physical performance scores, including the 30s Chair Stand Test (mean 10 (SD 1.7) stands versus mean 12.0 (SD 1.7) stands, p = 0.011), Fast Past Walk Test (1.23 (SD 0.14) meter per seconds (m/s) vs 1.50 (SD 0.20) m/s, p = 0.001), Six Minute Walk Test (418.8 (SD 75.9) m vs 529 (SD 72.6) m, p = 0.002), compared to adherent participants (N = 13). Non-adherent participants also had less severe self-reported symptoms including WOMAC stiffness (90.7 (SD 44.5) mm vs 121.5 (SD 17.0) mm, p = 0.031), compared to adherent participants. During the first two weeks of walking, acute increases in pain on average (mean ≥0.5 NRS) were reported by a greater number of non-adherent (N = 5 (45.5%)) than adherent participants (n = 4 (30.8%)). This was an exploratory study and results need to be interpreted with caution due to the small s le size. The walking program resulted in clinically important improvements (MCIIs) (≥ 1 on NRS) (4) in start pain and acute pain changes. Improvements in start pain during the first 12-weeks were comparable to improvements measured in the NEMEX program (2) and may suggest that 12 weeks of exercise is sufficient to achieve MCIIs in pain. Improvements in acute changes in pain were smaller, which may have been related to a floor effect (5). Lower physical performance scores at baseline and more acute increases in pain during the first two weeks was associated with non-adherence. Participants with these characteristics may benefit from a lighter introduction to exercise. [1]Bennell KL, et al. The Lancet Regional Health-Western Pacific. 2021 :100187. [2]Sandal LF, et al. Osteoarthritis and cartilage. 2016 (4):589-92. [3]Bulfone TC, et al. The Journal of infectious diseases. 2021 (4):550-61. [4]Perrot S, et al. Pain. 2013 (2):248-56. [5]McHorney CA, et al. Quality of life research. 1995 (4):293-307. We thank the participants who made this study possible. We would like to acknowledge the research staff, Kate Probert, Lizzy Reid, Simone Fitzgerald, Claire Roberts, Jasmin Ritchie, Dawn Simpson, and Tim Albion. We also thank Hamish Newsham-West for his contribution to the study design. Stan Drummen: None declared, Saliu Balogun: None declared, Lieke Scheepers Grant/research support from: Competitive Grant Program Inflammation ASPIRE 2020 Rheumatology International Developed Markets from Pfizer, Employee of: previously worked as an Associate Director Epidemiology at the Medical Evidence Observational Research Department at AstraZeneca., Ishanka Munugoda: None declared, aroub lahham: None declared, Kim Bennell: None declared, Rana Hinman: None declared, Michele Callisaya: None declared, Guoqi Cai: None declared, Petr Otahal: None declared, Tania Winzenberg Consultant of: received payment to create educational material by AMGEN, Zhiqiang Wang: None declared, Benny Antony: None declared, Johanne Martel-Pelletier Shareholder of: ArthroLab Inc., Jean-Pierre Pelletier Shareholder of: ArthroLab Inc., François Abram Consultant of: ArthroLab Inc., Employee of: Arthrolab Inc., Graeme Jones Speakers bureau: received payment for a speakers bureau from Novartis, Dawn Aitken: None declared
No related grants have been discovered for Zhiqiang Wang.