An open-label study of a second course of hylan G-F 20 for the treatment of pain associated with knee osteoarthritis

Waddell, David D.; Cefalu, Charles A.; Bricker, DeWayne C.

doi:10.1185/030079903125002090

Cited by 30 publications

(21 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This incidence appears to be slightly elevated, but remains low compared to other therapies, in repeat courses of treatment [19,23]. In a recent retrospective trial of 1,489 knees treated with hylan G-F 20 [24], local treatment-related and procedurerelated AE rates were reported as 4.2% of patients and 2.4% of injections.…”

Section: Introductionmentioning

confidence: 99%

Prospective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study

Conrozier

Jerosch

Beks

et al. 2008

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Prospective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study

Conrozier

Jerosch

Beks

et al. 2008

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

“…In our prospective study of a second course of therapy, the mean time between first and second courses was 19 months. 46 To avoid local adverse events (knee pain and swelling) after injection, we instruct patients to rest the afternoon of the injection, use an ice pack for 2 to 3 hours, and resume normal activities the day after the injection, except for strenuous work or exercise, which should be resumed only after completion of therapy. We also provide patients with a prescription of hydrocodone and acetaminophen, pentazocine hydrogen chloride and acetaminophen, or tramadol hydrogen chloride and acetaminophen, to be used only if they experience postinjection pain and swelling.…”

Section: Treatment With Hylan G-f 20mentioning

confidence: 99%

“…While product information states that results of repeat use have not been established, 45 we have published 3 articles on 2 studies indicating the effectiveness and tolerability of repeat courses of hylan G-F 20. [46][47][48] In our practice, we repeat courses of hylan G-F 20 therapy after a patient experiences an initial beneficial response (≥20 mm reduction in physician VAS for OA knee pain) with the treatment. Subsequent courses of therapy are offered to patients if their VAS score worsens to 50% of their initial baseline VAS.…”

Section: Treatment With Hylan G-f 20mentioning

confidence: 99%

See 1 more Smart Citation

Total Knee Replacement Delayed With Hylan G-F 20 Use in Patients With Grade IV Osteoarthritis

Waddell¹,

Bricker²

2007

JMCP

Self Cite

View full text Add to dashboard Cite

steoarthritis (OA) and other rheumatic conditions are the leading cause of disability in the United States. 1 The prevalence of OA of the knee in various countries can be estimated as 18% of men and women as inferred by a recent meta-analysis.2 OA can also result in significant direct and indirect costs, which are higher with greater disability. 3 Current therapeutic options for OA are approved to treat the pain associated with the disorder. The American College of Rheumatology recommends the initial use of nonpharmacologic techniques, such as patient education, weight loss, and physical therapy, followed by pharmacologic therapies such as acetaminophen and cyclooxygenase (COX)-2-specific inhibitors. 4 Intra-articular hyaluronan therapy is recommended for patients who are no longer responsive to nonpharmacologic and pharmacologic treatments or who may be experiencing adverse side effects with nonselective nonsteroidal inflammatory drugs or COX-2-specific inhibitors. 4 Total knee replacement (TKR) is considered a last resort for treatment of OA knee pain in appropriate patients when other therapies fail. According to the National Hospital Discharge Survey published by the U.S. Department of Health & Human Services, approximately 326,000 patients in the United States received a TKR in 2001. 5 In a sample of 6,856 decedents aged ≥65 years, 2.1% were found to have received knee replacements. 6 The cost of knee replacement surgery at patient discharge was reported as $24,045 for 2001. 7 The success of TKR in most patients has been supported by more than 20 years of follow-up data. 8 While TKR is an effective option for OA pain relief for many patients, it is not medically desirable for some patients (age, heart disease, diabetes, pulmonary disease, obesity, or generalized medical debilitation) or is not preferred by others. Additionally, complications of the ABSTRACT BACKGROUND: Total knee replacement (TKR), a last resort for treating knee pain due to osteoarthritis (OA), is not always medically indicated or preferred by many patients. Hylan G-F 20 is a cross-linked hyaluronan derivative approved for the treatment of pain due to OA of the knee after other conservative approaches have failed.OBJECTIVE: The objectives of this study were to (1) determine the effect of hylan G-F 20 on patient need for TKR as measured by time from hylan G-F 20 injection to TKR, and (2) assess patient factors that might influence time from hylan G-F 20 therapy to TKR.METHODS: This is a retrospective case series review of the medical records of patients seen in 1 orthopedic specialty practice. The incidence and time to TKR in patients who were TKR candidates (100% grade IV OA [severe]) treated with 1 or more courses of intra-articular hylan G-F 20 injections (3 weekly injections per course) were determined from October 1997 to November 2003. Survival analysis was used to evaluate time to TKR and the effects of age, gender, ethnicity, body mass index (BMI), and presence of effusion on this outcome. Logistic regression was also used to assess...

show abstract

“…Furthermore, increased production of endogenous hyaluronan has recently been shown in which concentrations of hyaluronan were measured in knee aspirates at the time of VIS injection and at 3 and 6 months following injection [Bagga et al 2006]. Although the positive clinical effect of therapy can last from 612 months after initial treatment, Waddell and colleagues showed a mean time to the second course of hylan G-F 20 of 19 months in 70 patients [Waddell et al 2003]. …”

Section: Biochemical Effects Of Hyaluronanmentioning

confidence: 99%

Viscosupplementation with hylan G-F 20 in patients with osteoarthrosis of the knee

Bert

Waddell²

2010

Therapeutic Advances in Musculoskeletal

Self Cite

View full text Add to dashboard Cite

Viscosupplementation (VIS) is one of several treatment modalities for osteoarthritis of the knee. It is useful in the treatment of osteoarthritis when other methods of conservative care have failed and it may be a safer method of treatment than oral chemical therapy which can have significant side effects with even short-term usage. The biochemical effects of hyaluronic acid are incompletely understood, however there are several accepted modes of action which result in a positive clinical effect on the function of the knee joint. There is some evidence that hyaluronic acid preparations with a higher molecular weight may be more beneficial to the patient. It is commonly used after arthroscopic meniscectomy and or debridement of the knee in a patient with chondral disease. The clinical effects have been well documented in multiple studies in patients with mild to moderate osteoarthritis in study groups before or after arthroscopic surgery of the knee. Adverse events do occur and are easily treated with only rare case reports of systemic effects. Furthermore, there is some evidence that VIS can prolong the need for total knee arthroplasty in the older patient as well.

show abstract

An open-label study of a second course of hylan G-F 20 for the treatment of pain associated with knee osteoarthritis

Abstract: A second course of hylan G-F 20 therapy is an appropriate therapy for the treatment of OA knee pain in patients who had a previous favorable clinical response. For continued relief of osteoarthritis knee pain, this study supports repeat use of hylan G-F 20 in these patients.

Cited by 30 publications

References 10 publications

Prospective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study

Prospective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study

Total Knee Replacement Delayed With Hylan G-F 20 Use in Patients With Grade IV Osteoarthritis

Viscosupplementation with hylan G-F 20 in patients with osteoarthrosis of the knee

Contact Info

Product

Resources

About