Advertisement

Clinical Drug Investigation

, Volume 22, Issue 2, pp 87–97 | Cite as

Retrospective Study of Outcomes in Hyalgan®-Treated Patients with Osteoarthritis of the Knee

  • John P. BarrettEmail author
  • Paola Siviero
Original Research Article

Abstract

Objective: To evaluate therapeutic success [defined as lack of total knee replacement surgery (TKR) or other significant clinical intervention during a 6-month follow-up] and to identify baseline patient and disease characteristics associated with improved pain relief and quality of life (QOL) in patients in a clinical practice who were treated with a single course of Hyalgan® (intra-articular hyaluronan) for pain associated with osteoarthritis (OA) of the knee.

Design and setting: This was an uncontrolled, retrospective study conducted at a single US clinical orthopaedic practice.

Patients: 248 patients with moderate to severe OA of the knee.

Intervention: All patients received a single course of intra-articular Hyalgan® therapy during an 18-month period, and had a radiogram of the treated knee within the 6 months before treatment.

Results: A total of 218 of 363 (60.1%) knees (248 patients) with moderate to severe OA were judged successfully treated over a 6-month follow-up period; only 20.3% of cases required TKR. On the basis of a multivariate analysis that correlated improvements in pain and QOL assessed by a retrospective questionnaire with baseline patient and disease characteristics, taller patients (>165cm), patients with less severe OA, and patients with patellofemoral compartment involvement had the greatest improvement in pain relief and quality of life following treatment with Hyalgan®.

Conclusions: Hyalgan® was effective in patients with moderate to severe OA, and may have delayed TKR in 80% of patients. Taller patients, patients with less severe OA, and patients with patellofemoral compartment involvement showed the greatest pain relief and improvements in QOL.

Keywords

Total Knee Replacement Intervention Therapy Sodium Hyaluronate Contingency Table Analysis Primary Efficacy Outcome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

This study was supported in part by a grant from Sanofi-Synthelabo Inc. Statistical analysis support was provided by Fidia, SpA.

References

  1. 1.
    Laurent TC, Fraser JR. Hyaluronan. FASEB J 1992; 6: 2397–404PubMedGoogle Scholar
  2. 2.
    Dahl LB, Dahl IMS, Engstrom A, et al. Concentration and molecular weight of sodium hyaluronate in synovial fluid from patients with rheumatoid arthritis and other arthropathies. Ann Rheum Dis 1985; 44: 817–22PubMedCrossRefGoogle Scholar
  3. 3.
    Balazs EA, Denlinger JL. Viscosupplementation: anew concept in the treatment of osteoarthritis. J Rheumatol Suppl 1993; 39: 3–9Google Scholar
  4. 4.
    Synvisc® [prescribing information]. Philadelphia (PA): Wyeth-Ayerst, 2000Google Scholar
  5. 5.
    Hyalgan® [prescribing information]. New York: Sanofi Pharmaceuticals, Inc, 2000Google Scholar
  6. 6.
    Dougados M, Nguyen M, Listrat V, et al. High molecular weight sodium hyaluronate (hyalectin) in osteoarthritis of the knee: a 1 year placebo-controlled trial. Osteoarthritis Cartilage 1993; 1: 97–103PubMedCrossRefGoogle Scholar
  7. 7.
    Scali JJ. Intra-articular hyaluronic acid in the treatment of osteoarthritis of the knee: a long term study. Eur J Rheum Inflamm 1995; 15: 57–62Google Scholar
  8. 8.
    Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan®) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. J Rheumatol 1998; 25: 2203–12PubMedGoogle Scholar
  9. 9.
    Huskisson EC, Donnelly S. Hyaluronic acid in the treatment of osteoarthritis of the knee. Rheumatology 1999; 38: 602–7PubMedCrossRefGoogle Scholar
  10. 10.
    Kotz R, Kolarz G. Intra-articular hyaluronic acid: duration of effect and results of repeated treatment cycles. Am J Orthop 1999; 28(11 Suppl): 5–7PubMedGoogle Scholar
  11. 11.
    Carrabba M, Paresce E, Angelini M, et al. The safety and efficacy of different dose schedules of hyaluronic acid in the treatment of painful osteoarthritis of the knee with joint effusion. Eur J Rheumatol Inflamm 1995; 15: 25–31Google Scholar
  12. 12.
    Henderson EB, Smith EC, Pegley F, et al. Intra-articular injections of 750 kD hyaluronan in the treatment of osteoarthritis: a randomised single centre double-blind placebo-controlled trial of 91 patients demonstrating lack of efficacy. Ann Rheum Dis 1994; 53: 529–34PubMedCrossRefGoogle Scholar
  13. 13.
    Lussier A, Cividino AA, McFarlane CA, et al. Viscosupplementation with hylan for the treatment of osteoarthritis: findings from clinical practice in Canada. J Rheumatol 1996; 23: 1579–85PubMedGoogle Scholar
  14. 14.
    Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29: 1039–49PubMedCrossRefGoogle Scholar
  15. 15.
    American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis Rheum 2000; 43: 1905–15CrossRefGoogle Scholar
  16. 16.
    Barrett JP, Rashkoff E, Sirna EC, et al. Correlation of roentgenographic patterns and clinical manifestations of symptomatic idiopathic osteoarthritis of the knee. Clin Orthop Relat Res 1988; 253: 179–83Google Scholar
  17. 17.
    Singh G, Ramey DR, Morfeld D, et al. Gastrointestinal tract complications of nonsteroidal anti-inflammatory drug treatment for rheumatoid arthritis. Arch Intern Med 1996; 156: 1530–6PubMedCrossRefGoogle Scholar
  18. 18.
    Leardini G, Franceschini M, Mattara L, et al. Intra-articular sodium hyaluronate (Hyalgan®) in gonarthrosis. Clin Trial J 1987; 24: 341–50Google Scholar
  19. 19.
    Feine JS, Lavigne GJ, Dao TT, et al. Memories of chronic pain and perceptions of pain. Pain 1998; 77: 137–41PubMedCrossRefGoogle Scholar
  20. 20.
    National Institutes of Health. Osteoarthritis: new insights. Part I. Ann Intern Med 2000; 133: 635–6Google Scholar

Copyright information

© Adis International Limited 2002

Authors and Affiliations

  1. 1.The Florida Knee and Orthopedics CenterClearwaterUSA
  2. 2.FIDIA SpAPaduaItaly

Personalised recommendations