National, multicentre, prospective study of quality of life in patients with osteoarthritis of the knee treated with hylane G-F 20
- 336 Downloads
The efficacy of viscosupplementation for the relief of pain and disability caused by knee osteoarthritis has been demonstrated, but its effects on Quality of Life (QoL) are less well known. The aim of this study was to describe the changes in QoL in patients receiving hylane G-F 20 in routine practice for the treatment of knee osteoarthritis and to determine the factors associated with changes in QoL. An observational, prospective, multicentre study was carried out in private ambulatory care patients. The study population consisted of patients receiving hylane G-F 20 injections for symptomatic, radiological Kellgren stage II or III knee osteoarthritis. The clinical and demographic data were recorded at inclusion and the QoL, SF36 and OsteoArthritis Knee and Hip Quality Of Life (OAKHQOL) questionnaires administered before the first injection and then during the 3- and 6-month visits. Three hundred patients were enrolled in the study (61% female, mean age 67 ± 11 years, 45% Kellgren stage II). After 3 and 6 months, all the SF36 scores and three OAKHQOL scores had significantly improved. In the multivariate analysis, low QoL scores at inclusion were correlated with a more marked improvement (p < 0.0001). Prior treatment with a viscosupplement was associated with a less substantial improvement in the SF36 physical functioning (β = 11.2, p = 0.03) and OAKHQOL mental health scores (β = 9.1, p = 0.01). The presence of effusion was only associated with changes on the SF36 physical functioning score (β = 15.4, p = 0.005). Administered in routine practice for symptomatic knee osteoarthritis, hylane G-F 20 improves QoL. Both joint effusion and prior viscosupplementation could be associated with a more modest improvement in QoL.
KeywordsHyaluronic acid Knee osteoarthritis Quality of life
The authors would like to thank Genzyme SAS for their financial and practical support during this study, particularly Olivier Lescale and Françoise Grazian.
AC Rat and F Guillemin received grant support for consulting services to Genzyme. C Baumann has nothing to disclose.
- 6.Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, Gunther K, Hauselmann H, Herrero-Beaumont G, Kaklamanis P, Lohmander S, Leeb B, Lequesne M, Mazieres B, Martin-Mola E, Pavelka K, Pendleton A, Punzi L, Serni U, Swoboda B, Verbruggen G, Zimmerman-Gorska I, Dougados M (2003) 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 62:1145–1155PubMedCrossRefGoogle Scholar
- 8.Wang CT, Lin J, Chang CJ, Lin YT, Hou SM (2004) Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials. J Bone Jt Surg Am 86-A:538–545Google Scholar
- 9.Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G (2006) Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev (2):CD005321Google Scholar
- 13.Acquadro C, Berzon R, Dubois D, Leidy NK, Marquis P, Revicki D, Rothman M (2003) Incorporating the patient’s perspective into drug development and communication: an ad hoc task force report of the Patient-Reported Outcomes (PRO) Harmonization Group meeting at the Food and Drug Administration, February 16, 2001. Value Health 6:522–531PubMedCrossRefGoogle Scholar
- 16.Kosinski M, Keller SD, Hatoum HT, Kong SX, Ware JE Jr (1999) The SF-36 Health Survey as a generic outcome measure in clinical trials of patients with osteoarthritis and rheumatoid arthritis: tests of data quality, scaling assumptions and score reliability. Med Care 37:10–22Google Scholar
- 17.Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY (2004) Health-related quality of life in total hip and total knee arthroplasty. a qualitative and systematic review of the literature. J Bone Jt Surg Am 86:963–974Google Scholar
- 20.Rat AC, Pouchot J, Coste J, Baumann C, Spitz E, Retel-Rude N, Baumann M, Le Quintrec JS, Dumont-Fischer D, Guillemin F (2006) Development and testing of a specific quality-of-life questionnaire for knee and hip osteoarthritis: OAKHQOL (OsteoArthritis of Knee Hip Quality of Life). Jt Bone Spine 73:697–704CrossRefGoogle Scholar
- 21.Rat AC, Guillemin F, Pouchot J (2008) Mapping the osteoarthritis knee and hip quality of life (OAKHQOL) instrument to the international classification of functioning, disability and health and comparison to five health status instruments used in osteoarthritis. Rheumatol Oxf 47:1719–1725CrossRefGoogle Scholar
- 24.Tubach F, Ravaud P, Baron G, Falissard B, Logeart I, Bellamy N, Bombardier C, Felson D, Hochberg M, van der Heijde D, Dougados M (2005) Evaluation of clinically relevant states in patient reported outcomes in knee and hip osteoarthritis: the patient acceptable symptom state. Ann Rheum Dis 64:34–37PubMedCrossRefGoogle Scholar
- 25.Tubach F, Ravaud P, Baron G, Falissard B, Logeart I, Bellamy N, Bombardier C, Felson D, Hochberg M, van der Heijde D, Dougados M (2005) Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement. Ann Rheum Dis 64:29–33PubMedCrossRefGoogle Scholar
- 26.Ware JE, Kosinski M, Keller SK (1994) SF-36 physical and mental health summary scale: a user’s manual. Boston, MA: The Health InstituteGoogle Scholar
- 28.Raynauld JP, Torrance GW, Band PA, Goldsmith CH, Tugwell P, Walker V, Schultz M, Bellamy N (2002) A prospective, randomized, pragmatic, health outcomes trial evaluating the incorporation of hylan G-F 20 into the treatment paradigm for patients with knee osteoarthritis (part 1 of 2): clinical results. Osteoarthritis Cartilage 10:506–517PubMedCrossRefGoogle Scholar