One-year efficacy and safety of single or one to three weekly injections of hylan G-F 20 for knee osteoarthritis: a systematic literature review and meta-analysis

Abstract

The aim of this study was to evaluate the long-term efficacy and safety of single or 1–3 weekly injections of hylan G-F 20 at 1 year following the first injection for knee osteoarthritis (OA). Searches were conducted in PubMed/MEDLINE, Embase, and CENTRAL and included relevant conference proceedings (January 1, 1995–August 17, 2020). Randomized controlled trials (RCTs), non-randomized trials, and observational studies investigating 1-year efficacy and safety of 1–3 weekly injections or single hylan G-F 20 injection for knee OA were included. Primary outcomes were WOMAC pain, physical function, and stiffness. Meta-analyses of RCTs and non-randomized studies were conducted separately. Our search identified 24 eligible studies. Hylan G-F 20, in the meta-analyses of RCTs, showed statistically significant improvement in WOMAC pain (SMCC − 0.98, 95% CI − 1.50, − 0.46), physical function (SMCC − 1.05, 95% CI − 1.28, − 0.83), and stiffness (SMCC − 1.07, 95% CI −1.28, −0.86). Improvement was also seen for VAS pain, SF-36 MCS (mental component summary), and SF-36 PCS (physical component summary). Analyses of non-randomized studies showed similar efficacy estimates. There were no significant differences in efficacy based on injection schedule, nor between RCT and non-randomized studies. Rates of adverse events (AEs) were low for most types of AEs. Hylan G-F 20 (either as single or 1–3 weekly injections) showed improvement in 1-year efficacy outcomes in comparison to baseline and was generally well tolerated. While further research will inform the medical field regarding viscosupplementation treatment options for knee OA, these findings show that hylan G-F 20 at both frequencies/dosages are efficacious and generally well tolerated for long-term use.

Biomimetic hydrogels designed for cartilage tissue engineering

“…It is important to note that product containing active biomolecules and/or genes require more complex procedures, regulation, and funding which can limit the sustainability 13 . In the US market, FDA approved cell-free hydrogel are Gel-One®, Synvisc and Synvisc-One® 165,166 . Whereas, hydrogelbased with autologous chondrocytes product include CaReS®, a type I collagen and Cartipatch®, which uses agarose-alginate hydrogel.…”

Efficacy of Hyaluronic Acid Injections in the Treatment of Osteoarthritis of the Knee

“…This study evaluated a single shot consisting of a higher volume of product vs. 3 once-weekly injections of a smaller volume of product. This study focused on the specific formulation of Hylan G-F 20, which is a cross-linked higher-molecular-weight hyaluronan 10 . Measures were taken by patient ratings of Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores for pain, stiffness, and function as well as the visual analog scale (VAS) pain score.…”

Viscosupplementation in the Therapy for Osteoarthritic Knee

“…[48] Meta-analysis pro Six months of treatment IA HA and the combination of IA HA and triamcinolone improve pain and/or physical function in patients suffering from knee OA. 2021 [50] Meta-analysis pro Hylan G-F 20 at both frequencies (either as single or 1-3 weekly injections) are efficacious and generally well tolerated for long-term use.…”

“…Radiologic chondrocalcinosis is not a contraindication to HA [69]. For severe OA, HA is not contraindication, but it is known to be ineffective [50]. Eymard et al have reported that IA HA should be considered only in patients with low BMI and low radiologic severity because high BMI and radiologic severity significantly increase the risk of IA HA failure [71].…”