[en] The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) treatment algorithm recommends intra-articular (IA) hyaluronic acid (HA) for management of knee osteoarthritis (OA) as second-line treatment in patients who remain symptomatic despite use of non-steroidal anti-inflammatory drugs (NSAIDs). This recommendation is based upon accumulating evidence that IA HA provides a significant benefit in knee OA. There is good evidence that IA HA injections reduce pain and increase function in knee OA, and the benefits are long-lasting as compared with IA corticosteroids. Evidence from real-life studies of repeat courses of IA HA demonstrates an improvement in pain or function lasting up to 40 months (12 months after the last injection cycle), a reduction in use of concomitant analgesia by up to 50%, and suggests that there may be a delay in the need for total knee replacement (TKR) of around 2 years. The clinical benefit of IA HA on knee OA may
be 2-fold: (i) mechanical viscosupplementation of the joint (allowing lubrication and shock absorption) and (ii) the re-establishment of joint homeostasis through induction of endogenous HA production, which continues long after the exogenous injection has left the joint.The magnitude of the clinical effect may be different for different HA products, but this has not been proven so far and requires further investigation. IA HA injections are generally considered to be safe,although a slightly higher number of cases of local reactions and post-injection non-septic arthritis has been reported with high molecular weight cross-linked HAs. The use of IA HA in knee OA patients with mild–moderate disease, and for more severe patients wishing to delay TKR surgery,is recommended by the ESCEO taskforce.
Further investigation into the OA patient types most likely to benefit from IA HA is warranted.
Viscosupplementation with IA HA is a safe and effective component of the multi-modal management of knee OA.
Disciplines :
General & internal medicine
Author, co-author :
Maheu, E.
Rannou, F.
Reginster, Jean-Yves ; Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Efficacy and safety of hyaluronic acid in the management of osteoarthritis : Evidence from real-life setting trials and surveys.
Publication date :
2016
Journal title :
Seminars in Arthritis and Rheumatism
ISSN :
0049-0172
eISSN :
1532-866X
Publisher :
W.B. Saunders, Philadelphia, United States - Pennsylvania
Bruyere O., Cooper C., Pelletier J.P., Branco J., Brandi M.L., Guillemin F., et al. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 2014, 44:253-263.
Rutjes A.W., Juni P., da Costa B.R., Trelle S., Nuesch E., Reichenbach S. Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Ann Intern Med 2012, 157:180-191.
Bannuru R.R., Schmid C.H., Kent D.M., Vaysbrot E.E., Wong J.B., McAlindon T.E. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann Intern Med 2015, 162:46-54.
Jordan K.M., Arden N.K., Doherty M., Bannwarth B., Bijlsma J.W.J., Dieppe P., et al. EULAR Recommendations 2003: an evidence-based approach to the management of knee osteoarthritis: report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003, 62:1145-1155.
Hochberg M.C., Altman R.D., April K.T., Benkhalti M., Guyatt G., McGowan J., et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res 2012, 64:465-474.
McAlindon T.E., Bannuru R.R., Sullivan M.C., Arden N.K., Berenbaum F., Bierma-Zeinstra S.M., et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014, 22:363-388.
Bellamy N., Campbell J., Robinson V., Gee T., Bourne R., Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006, [CD005321].
Bannuru R.R., Vaysbrot E.E., Sullivan M.C., McAlindon T.E. Relative efficacy of hyaluronic acid in comparison with NSAIDs for knee osteoarthritis: a systematic review and meta-analysis. Semin Arthritis Rheum 2014, 43:593-599.
Miller L.E., Block J.E. US-approved intra-articular hyaluronic acid injections are safe and effective in patients with knee osteoarthritis: systematic review and meta-analysis of randomized, saline-controlled trials. Clin Med Insights Arthritis Musculoskelet Disord 2013, 6:57-63.
Bannuru R.R., Natov N.S., Obadan I.E., Price L.L., Schmid C.H., McAlindon T.E. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis. Arthritis Rheum 2009, 61:1704-1711.
Lo G.H., LaValley M., McAlindon T., Felson D.T. Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. J.Am Med Assoc 2003, 290:3115-3121.
Wang C.T., Lin J., Chang C.J., Lin Y.T., Hou S.M. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials. J Bone Joint Surg Am 2004, 86-A:538-545.
Arrich J., Piribauer F., Mad P., Schmid D., Klaushofer K., Mullner M. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. Can Med Assoc J 2005, 172:1039-1043.
Modawal A., Ferrer M., Choi H.K., Castle J.A. Hyaluronic acid injections relieve knee pain. J Fam Pract 2005, 54:758-767.
Medina J.M., Thomas A., Denegar C.R. Knee osteoarthritis: should your patient opt for hyaluronic acid injection?. J Fam Pract 2006, 55:669-675.
Reichenbach S., Blank S., Rutjes A.W., Shang A., King E.A., Dieppe P.A., et al. Hylan versus hyaluronic acid for osteoarthritis of the knee: a systematic review and meta-analysis. Arthritis Rheum 2007, 57:1410-1418.
Colen S., van den Bekerom M.P., Mulier M., Haverkamp D. Hyaluronic acid in the treatment of knee osteoarthritis: a systematic review and meta-analysis with emphasis on the efficacy of different products. BioDrugs 2012, 26:257-268.
Navarro-Sarabia F., Coronel P., Collantes E., Navarro F.J., de la Serna A.R., Naranjo A., et al. A 40-month multicentre, randomised placebo-controlled study to assess the efficacy and carry-over effect of repeated intra-articular injections of hyaluronic acid in knee osteoarthritis: the AMELIA project. Ann Rheum Dis 2011, 70:1957-1962.
Petrella R.J. Hyaluronic acid for the treatment of knee osteoarthritis: long-term outcomes from a naturalistic primary care experience. Am J Phys Med Rehabil 2005, 84:278-283.
Waddell D.D., Bricker D.C. Clinical experience with the effectiveness and tolerability of hylan G-20 in 1047 patients with osteoarthritis of the knee. J Knee Surg 2006, 19:19-27.
Kausch R., Lahne U., Thomas R., Kipshoven C., Schuld M. Intrarticular hyaluronic acid in the treatment of arthroses. Orthopädische Praxis 2009, 45:258-266.
Abbott T., Altman R.D., Dimef R., Fredericson M., Vad V., Vitanzo P.J. Do hyaluronic acid injections delay total knee replacement surgery?. Arthritis Rheum 2013, 65(Suppl. 1):S910-S911.
Waddell D.D., Bricker D.C. Total knee replacement delayed with Hylan G-20 use in patients with grade IV osteoarthritis. J Manag Care Pharm 2007, 13:113-121.
Mar J., Romero Jurado M., Arrospide A., Enrique Fidalgo A., Soler Lopez B. Cost-analysis of viscosupplementation treatment with hyaluronic acid in candidate knee replacement patients with osteoarthritis. Rev Esp Cir Ortop Traumatol 2013, 57:6-14.
Berenbaum F., Grifka J., Cazzaniga S., D'Amato M., Giacovelli G., Chevalier X., et al. A randomised, double-blind, controlled trial comparing two intra-articular hyaluronic acid preparations differing by their molecular weight in symptomatic knee osteoarthritis. Ann Rheum Dis 2012, 71:1454-1460.
Bagga H., Burkhardt D., Sambrook P., March L. Longterm effects of intraarticular hyaluronan on synovial fluid in osteoarthritis of the knee. J Rheumatol 2006, 33:946-950.
Ghosh P., Guidolin D. Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular weight dependent?. Semin Arthritis Rheum 2002, 32:10-37.
Pozo M.A., Balazs E.A., Belmonte C. Reduction of sensory responses to passive movements of inflamed knee joints by hylan, a hyaluronan derivative. Exp Brain Res 1997, 116:3-9.
Smith M.M., Ghosh P. The synthesis of hyaluronic acid by human synovial fibroblasts is influenced by the nature of the hyaluronate in the extracellular environment. Rheumatol Int 1987, 7:113-122.
Diaz-Gallego L., Prieto J.G., Coronel P., Gamazo L.E., Gimeno M., Alvarez A.I. Apoptosis and nitric oxide in an experimental model of osteoarthritis in rabbit after hyaluronic acid treatment. J Orthop Res 2005, 23:1370-1376.
Campo G.M., Avenoso A., Campo S., D'Ascola A., Traina P., Rugolo C.A., et al. Differential effect of molecular mass hyaluronan on lipopolysaccharide-induced damage in chondrocytes. Innate Immun 2010, 16:48-63.
Aviad A.D., Houpt J.B. The molecular weight of therapeutic hyaluronan (sodium hyaluronate): how significant is it?. J Rheumatol 1994, 21:297-301.
Karlsson J., Sjogren L.S., Lohmander L.S. Comparison of two hyaluronan drugs and placebo in patients with knee osteoarthritis. A controlled, randomized, double-blind, parallel-design multicentre study. Rheumatology (Oxford) 2002, 41:1240-1248.
Kirchner M., Marshall D. A double-blind randomized controlled trial comparing alternate forms of high molecular weight hyaluronan for the treatment of osteoarthritis of the knee. Osteoarthritis Cartilage 2006, 14:154-162.
Juni P., Reichenbach S., Trelle S., Tschannen B., Wandel S., Jordi B., et al. Efficacy and safety of intraarticular hylan or hyaluronic acids for osteoarthritis of the knee: a randomized controlled trial. Arthritis Rheum 2007, 56:3610-3619.
Maheu E., Zaim M., Appelboom T., Jeka S., Trc T., Berenbaum F., et al. Comparative efficacy and safety of two different molecular weight (MW) hyaluronans F60027 and Hylan G-F20 in symptomatic osteoarthritis of the knee (KOA). Results of a non inferiority, prospective, randomized, controlled trial. Clin Exp Rheumatol 2011, 29:527-535.
Pavelka K., Uebelhart D. Efficacy evaluation of highly purified intra-articular hyaluronic acid (Sinovial(R) vs hylan G-F20 [Synvisc(R)]) in the treatment of symptomatic knee osteoarthritis. A double-blind, controlled, randomized, parallel-group non-inferiority study. Osteoarthritis Cartilage 2011, 19:1294-1300.
Lussier A., Cividino A.A., McFarlane C.A., Olszynski W.P., Potashner W.J., De Medicis R. Viscosupplementation with hylan for the treatment of osteoarthritis: findings from clinical practice in Canada. J Rheumatol 1996, 23:1579-1585.
Conrozier T., Mathieu P., Schott A.M., Laurent I., Hajri T., Crozes P., et al. Factors predicting long-term efficacy of Hylan GF-20 viscosupplementation in knee osteoarthritis. Joint Bone Spine 2003, 70:128-133.
Daumen-Legré VP, T., Acquaviva P.C., Lafforgue P. Evaluation of safety and efficacy of viscosupplementation in knee osteoarthritis with chondrocalcinosis. Arthritis Rheum 1999, 42(Suppl. 9):S158.
Cutolo M., Berenbaum F., Hochberg M., Punzi L., Reginster J.Y. Commentary on recent therapeutic guidelines for osteoarthritis. Semin Arthritis Rheum 2014, 44:611-617.
Chen A.L., Desai P., Adler E.M., Di Cesare P.E. Granulomatous inflammation after Hylan G-20 viscosupplementation of the knee: a report of six cases. J Bone Joint Surg Am 2002, 84-A:1142-1147.