Efficacy and safety of hylan G-F 20 injection in treatment of knee osteoarthritis in Chinese patients: results of a prospective, multicentre, longitudinal study

Yan, Chun Hoi; Chan, Wai Lam; Yuen, Wai-Hong; Yung, Patrick Shu‐Hang; Ip, Kotova; Fan, Jason Chi Ho; Chiu, K. Y.

doi:10.12809/hkmj144329

Cited by 18 publications

(22 citation statements)

References 17 publications

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“…No serious adverse events were noted in this study. These findings match those noted for human patients and IAHA is generally considered safe for treatment of knee OA …”

Section: Discussionsupporting

confidence: 87%

Hyaluronic acid versus saline intra‐articular injections for amelioration of chronic knee osteoarthritis: A canine model

Pashuck

Kuroki

Cook

et al. 2016

Journal Orthopaedic Research

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The objective of this study was to assess the safety and efficacy of intra-articular injections of hyaluronic acid (HA) versus saline for symptomatic treatment of osteoarthritis (OA). Twenty-five adult purpose-bred dogs underwent meniscal release of one knee. Clinical, arthroscopic, and radiographic signs of OA were confirmed in all dogs prior to treatment. Dogs were randomized into five groups: HA-1 (n = 5), HA-3 (n = 5), HA-5 (n = 5), Saline-1 (n = 5), and Saline-3 (n = 5). Each dog received intra-articular injections of the respective substance into the affected knee at the pre-determined time points. Dogs were assessed for heat, swelling, and erythema after each injection and for lameness, pain, effusion, range of motion, kinetics, radiographic OA scoring, and arthroscopic scoring prior to treatment and for 6 months after injection. Dogs were then humanely euthanatized and the knees assessed grossly and histologically. Only mild heat, swelling, and/or erythema were noted in some dogs following injection and resolved within 1 week. Dogs treated with HA-1, HA-3, and HA-5 were significantly (p < 0.05) better than dogs treated with Saline-1 and Saline-3 at the 4, 8, and 12 week time points based on at least one outcome measure. OA severity was not significantly different among groups at any time point, but increased in severity over time in all groups. Gross and histologic OA scores were not significantly different among groups. These data suggest the three HA injection protocols were safe, superior to saline for short-term amelioration of symptoms associated with chronic OA, and can be translated to human OA treatment. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1772-1779, 2016.

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“…No serious adverse events were noted in this study. These findings match those noted for human patients and IAHA is generally considered safe for treatment of knee OA …”

Section: Discussionsupporting

confidence: 87%

Hyaluronic acid versus saline intra‐articular injections for amelioration of chronic knee osteoarthritis: A canine model

Pashuck

Kuroki

Cook

et al. 2016

Journal Orthopaedic Research

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“…Ten studies [22–31], including 1904 patients investigated intra-articular hyaluronic acid (IAHAs) as treatment for KOA using WOMAC scores to evaluate the clinical outcome. Seven studies [22, 24, 27–31] demonstrated clinically significant improvement to WOMAC score from baseline while three studies [23, 25, 26] showed no or insignificant difference in pain and function outcomes. The most common side-effects were self-limiting pain and swelling at the injection site and no major adverse events were reported (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…This is important because KOA is diagnosed on average at 55-years of age and typically people live with the disease for about 30-years. Lifestyle modifications (moderate exercise [9–13] and weight loss [12–14]), paracetamol [18], glucosamine [15, 16], IAHA [22–31] and PRP injections [32, 33] found to have a low risk of harm and beneficial treatments outcomes at ≥12 months.…”

Section: Discussionmentioning

confidence: 99%

Osteoarthritis- a systematic review of long-term safety implications for osteoarthritis of the knee

Charlesworth

Fitzpatrick

Perera

et al. 2019

BMC Musculoskelet Disord

147

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Background There is no cure for knee osteoarthritis (KOA) and typically patients live approximately 30-years with the disease. Most common medical treatments result in short-term palliation of symptoms with little consideration of long-term risk. This systematic review aims to appraise the current evidence for the long-term (≥12 months) safety of common treatments for knee osteoarthritis (KOA). Methods Cochrane Database of Systematic Reviews, Medline and PubMed were systematically searched from 1990 to July 2017, inclusive. Inclusion criteria were 1) peer-reviewed publications investigating treatments for KOA referred to in the Australian Clinical Care Standard and/or Therapeutic Guidelines: Rheumatology 2) specifically addressing safety of the treatments 3) with ≥12 months of follow-up and 4) Downs and Black quality score ≥ 13. Results Thirty-four studies fulfilled the inclusion criteria. Lifestyle modifications (moderate exercise and weight loss), paracetamol, glucosamine, Intraarticular Hyaluronic Acid (IAHA) and platelet-rich-plasma (PRP) injections have a low risk of harm and beneficial ≥12 month outcomes. Although Nonsteroidal Anti-inflammatory Drugs (NSAIDs) provide pain relief, they are associated with increased risk of medical complications. Cortisone injections are associated with radiological cartilage degeneration at > 12 months. Arthroscopy for degenerative meniscal tears in KOA leads to a 3-fold increase in total knee arthroplasty (TKA). TKA improves primary outcomes of KOA but has a low rate of significant medical complications. Conclusions Given the safety and effectiveness of lifestyle interventions such as weight loss and exercise, these should be advocated in all patients due to the low risk of harm. The use of NSAIDs should be minimized to avoid gastrointestinal complications. Treatment with opioids has a lack of evidence for use and a high risk of long-term harm. The use of IAHA and PRP may provide additional symptomatic benefit without the risk of harm. TKA is associated with significant medical complications but is justified by the efficacy of joint replacement in late-stage disease. Trial registration PROSPERO International prospective register for systematic reviews; registration number CRD42017072809 . Electronic supplementary material The online version of this article (10.1186/s12891-019-2525-0) contains supplementary material, which is available to authorized users.

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“…The Amelia [29] study results showed that intra-articular injections of HA improved knee OA symptoms for up to 1 year. Yan et al [10] showed that in- Huang et al [36] showed that five weekly IA-HA administration of sodium hyaluronate (Hyalgan ® , 500 -730 kDa) is safe, well tolerated, can improve joint functions and can provide sustained relief of pain in Asian patients with knee OA. Regarding the safety, adverse effects noted was mild or moderate.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic Acid in the Treatment of Knee Osteoarthritis: Review

Koiri¹,

Yang²,

Kui³

2018

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Knee osteoarthritis (OA) is a progressive disease in which the cartilage (cushioning between joints) wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This causes rubbing of bones, resulting in pain, swelling, stiffness, decreased ability to move and formation of bone spurs. Osteoarthritis develops slowly and the pain it causes worsens over time. Although there is no cure, there are many treatment options available to help manage pain and keep people staying active. Intra-articular (IA) hyaluronic acid (HA) injection is one of the treatment options. Hyaluronic acid is a polysaccharide, an anionic, non-sulfated glycosaminoglycan and is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. People with knee osteoarthritis have lower concentration and altered volume of hyaluronic acid than normal in their joints. Due to lower concentration and volume, exogenous hyaluronic acid may be injected into the knee joint. Treatment with exogenous hyaluronic acid contributes to restore the elastic and viscous properties of the synovial fluid, pain reduction and functional improvement. It is indicated for patients who have failed to respond adequately to conservative non-pharmacological therapy and simple analgesic.

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Efficacy and safety of hylan G-F 20 injection in treatment of knee osteoarthritis in Chinese patients: results of a prospective, multicentre, longitudinal study

Cited by 18 publications

References 17 publications

Hyaluronic acid versus saline intra‐articular injections for amelioration of chronic knee osteoarthritis: A canine model

Hyaluronic acid versus saline intra‐articular injections for amelioration of chronic knee osteoarthritis: A canine model

Osteoarthritis- a systematic review of long-term safety implications for osteoarthritis of the knee

Hyaluronic Acid in the Treatment of Knee Osteoarthritis: Review

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