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Hyaluronic Acid (Supartz®)

A Review of its Use in Osteoarthritis of the Knee

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Abstract

Hyaluronic acid (Supartz®; molecular weight 620–1170 kDa) is a sterile, viscoelastic, non-pyogenic solution that is indicated as a medical device for the treatment of pain in patients with osteoarthritis of the knee who have failed to respond adequately to conservative nonpharmacological therapy and simple analgesics.

Intra-articular injections of Supartz® were significantly more effective than control injections, according to an integrated longitudinal analysis of pooled data from five randomized, double-blind, vehicle-controlled, multicentre trials in patients with osteoarthritis of the knee. Supartz®, compared with the phosphate-buffered saline control, significantly reduced the total Lesquésne Index score in the post-injection period. Data from the individual trials demonstrated that the reduction in the total Lesqueésne Index score was significantly greater than the control in two of the five studies. According to another efficacy endpoint (the mean reduction in the Western Ontario and McMaster Universities Osteoarthritis Index), which was assessed in only one of these trials, Supartz® was significantly more effective than the control in reducing the pain and stiffness subscale scores.

Clinical scores of pain/inflammation and visual analogue scale (VAS) scores of pain during walking improved from baseline values for up to 6 months after treatment with Supartz® or a corticosteroid, with no significant between-group differences, in a small, randomized, open-label, multicentre trial in patients with osteoarthritis of the knee.

Intra-articular injections of both Supartz® and Synvisc®, as well as a phosphate-buffered saline control, significantly reduced VAS scores of weight-bearing pain versus baseline after 26 weeks of therapy in a well designed trial; however, there were no significant differences between the three treatment groups. Neither hyaluronic acid formulation had a longer duration of clinical benefit than the saline control.

Supartz® was well tolerated in patients with osteoarthritis of the knee. An integrated analysis of the five, well designed clinical trials demonstrated no significant difference between the Supartz® or control groups in the incidence of adverse events. The most common adverse events reported in Supartz® recipients were arthralgia, arthropathy/arthrosis/arthritis, back pain, nonspecific pain, injection-site reaction, headache and injection-site pain.

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References

  1. Migliore A, Granata M. Intra-articular use of hyaluronic acid in the treatment of osteoarthritis. Clin Interv Aging 2008; 3(2): 365–9

    PubMed  CAS  Google Scholar 

  2. Rosier RN, O’Keefe RJ. Hyaluronic acid therapy. Instr Course Lect 2000; 199–206

    Google Scholar 

  3. Tammi MI, Day AJ, Turley EA. Hyaluronan and homeostasis: a balancing act. J Biol Chem 2002 Feb 15; 277(7): 4581–4

    Article  PubMed  CAS  Google Scholar 

  4. Itano N. Simple primary structure, complex turnover regulation and multiple roles of hyaluronan. J Biochem 2008 Aug; 144(2): 131–7

    Article  PubMed  CAS  Google Scholar 

  5. Marshall KW. Intra-articular hyaluronan therapy. Curr Opin Rheumatol 2000 Sep; 12(5): 468–74

    Article  PubMed  CAS  Google Scholar 

  6. Fraser JR, Laurent TC, Laurent UB. Hyaluronan: its nature, distribution, functions and turnover. J Intern Med 1997 Jul; 242(1): 27–33

    Article  PubMed  CAS  Google Scholar 

  7. Dahl LB, Dahl IM, Engström-Laurent 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 Dec; 44(12): 817–22

    Article  PubMed  CAS  Google Scholar 

  8. Balazs EA, Watson D, Duff IF, et al. Hyaluronic acid in synovial fluid. I. Molecular parameters of hyaluronic acid in normal and arthritis human fluids. Arthritis Rheum 1967 Aug; 10(4): 357–76

    Article  PubMed  CAS  Google Scholar 

  9. Balazs EA, Denlinger. Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl 1993 Aug; 39: 3–9

    PubMed  CAS  Google Scholar 

  10. Parkes HG, Grootveld MC, Henderson EB, et al. Oxidative damage to synovial fluid from the inflamed rheumatoid joint detected by 1H NMR spectroscopy. J Pharm Biomed Anal 1991; 9(1): 75–82

    Article  PubMed  CAS  Google Scholar 

  11. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis Rheum 2000 Sep; 43(9): 1905–15

    Article  Google Scholar 

  12. Seikagaku Corporation. Supartz® (sodium hyaluronate): US prescribing information. Memphis (TN): Smith and Nephew, Inc., 2007 Jan 30

    Google Scholar 

  13. Kato Y, Nakamura S, Nishimura M. Beneficial actions of hyaluronan (HA) on arthritic joints: effects of molecular weight of HA on elasticity of cartilage matrix. Biorheology 2006; 43(3–4): 347–54

    PubMed  Google Scholar 

  14. Grecomoro G, La Sala F, Francavilla G. Rheologic changes in the synovial fluid of patients with gonarthritis induced by intraarticular infiltration of hyaluronic acid. Int J Tissue React 2001; 23(2): 67–71

    PubMed  CAS  Google Scholar 

  15. Iwata H. Pharmacologic and clinical aspects of intraarticular injection of hyaluronate. Clin Orthop 1993; 289: 285–91

    PubMed  Google Scholar 

  16. Ghosh P. The role of hyaluronic acid (hyaluronan) in health and disease: interactions with cells, cartilage and components of synovial fluid. Clin Exp Rheumatol 1994; 12(1): 75–82

    PubMed  CAS  Google Scholar 

  17. Gaffney J, Matou-Nasri S, Grau-Olivares M, et al. Therapeutic applications of hyaluronan. Mol Biosyst 2010 Mar; 6(3): 437–43

    Article  PubMed  CAS  Google Scholar 

  18. Hodge-Dufour J, Noble PW, Horton MR, et al. Induction of IL-12 and chemokines by hyaluronan requires adhesion-dependent priming of resident but not elicited macrophages. J Immunol 1997 Sep 1; 159(5): 2492–500

    PubMed  CAS  Google Scholar 

  19. Siegelman MH, DeGrendele HC, Estess P. Activation and interaction of CD44 and hyaluronan in immunological systems. J Leukoc Biol 1999 Aug; 66(2): 315–21

    PubMed  CAS  Google Scholar 

  20. Pozo MA, Balazs EA, Belmonte C. Reduction of sensory responses to passive movements of inflamed knee joints by hylan, a hyaluronan derivative. Exp Brain Res 1997 Aug; 116(1): 3–9

    Article  PubMed  CAS  Google Scholar 

  21. Gomis A, Miralles A, Schmidt RF, et al. Intra-articular injections of hyaluronan solutions of different elastoviscosity reduce nociceptive nerve activity in a model of osteoarthritic knee joint of the guinea pig. Osteoarthritis Cartilage 2009 Jun; 17(6): 798–804

    Article  PubMed  CAS  Google Scholar 

  22. Gomis A, Miralles A, Schmidt RF, et al. Nociceptive nerve activity in an experimental model of knee joint osteoarthritis of the guinea pig: effect of intra-articular hyaluronan application. Pain 2007 Jul; 130(1–2): 126–36

    Article  PubMed  CAS  Google Scholar 

  23. Gomis A, Pawlak M, Balazs EA, et al. Effects of different molecular weight elastoviscous hyaluronan solutions on articular nociceptive afferents. Arthritis Rheum 2004 Jan; 50(1): 314–26

    Article  PubMed  CAS  Google Scholar 

  24. Aihara S, Murakami N, Ishii R, et al. Effects of sodium hyaluronate on the nociceptive response of rats with experimentally induced arthritis [in Japanese]. Nippon Yakurigaku Zasshi 1992 Oct; 100(4): 359–65

    Article  PubMed  CAS  Google Scholar 

  25. Gotoh S, Onaya J, Abe M, et al. Effects of the molecular weight of hyaluronic acid and its action mechanisms on experimental joint pain in rats. Ann Rheum Dis 1993 Nov; 52(11): 817–22

    Article  PubMed  CAS  Google Scholar 

  26. Goto M, Hanyu T, Yoshio T, et al. Intra-articular injection of hyaluronate (SI-6601D) improves joint pain and synovial fluid prostaglandin E2 levels in rheumatoid arthritis: a multicenter clinical trial. Clin Exp Rheumatol 2001 Jul–Aug; 19(4): 377–83

    PubMed  CAS  Google Scholar 

  27. Yasuda T. Hyaluronan inhibits prostaglandin E2 production via CD44 in U937 human macrophages. Tohoku J Exp Med 2010; 220(3): 229–35

    Article  PubMed  CAS  Google Scholar 

  28. Yasui T, Akatsuka M, Tobetto K, et al. The effect of hyaluronan on interleukin-1 alpha-induced prostaglandin E2 production in human osteoarthritic synovial cells. Agents Actions 1992 Sep; 37: 155–6

    Article  PubMed  CAS  Google Scholar 

  29. Punzi L, Schiavon F, Cavasin F, et al. The influence of intra-articular hyaluronic acid on PGE2 and cAMP of synovial fluid. Clin Exp Rheumatol 1989; 7(3): 247–50

    PubMed  CAS  Google Scholar 

  30. Forrester JV, Balazs EA. Inhibition of phagocytosis by high molecular weight hyaluronate. Immunology 1980 Jul; 40(3): 435–46

    PubMed  CAS  Google Scholar 

  31. Wang C-T, Lin Y-T, Chiang B-L, et al. High molecular weight hyaluronic acid down-regulates the gene expression of osteoarthritis-associated cytokines and enzymes in fibroblast-like synoviocytes from patients with early osteoarthritis. Osteoarthritis Cartilage 2006; 14(12): 1237–47

    Article  PubMed  Google Scholar 

  32. Comer JS, Kincaid SA, Baird AN, et al. Immunolocalization of stromelysin, tumor necrosis factor (TNF) alpha, and TNF receptors in atrophied canine articular cartilage treated with hyaluronic acid and transforming growth factor beta. Am J Vet Res 1996 Oct; 57(10): 1488–96

    PubMed  CAS  Google Scholar 

  33. Sato H, Takahashi T, Ide H, et al. Antioxidant activity of synovial fluid, hyaluronic acid, and two subcomponents of hyaluronic acid: synovial fluid scavenging effect is enhanced in rheumatoid arthritis patients. Arthritis Rheum 1988 Jan; 31(1): 63–71

    Article  PubMed  CAS  Google Scholar 

  34. Zhao H, Tanaka T, Mitlitski V, et al. Protective effect of hyaluronate on oxidative DNA damage in WI-38 and A549 cells. Int J Oncol 2008 Jun; 32(6): 1159–67

    PubMed  CAS  Google Scholar 

  35. Smith MM, Ghosh P. The synthesis of hyaluronic acid by human synovial fibroblasts is influenced by the nature of the hyaluronate in the extracellular environment. Rheumatol Int 1987; 7(3): 113–22

    Article  PubMed  Google Scholar 

  36. Homandberg GA, Hui F, Wen C, et al. Hyaluronic acid suppresses fibronectin fragment mediated cartilage chondrolysis: I. In vitro. Osteoarthritis Cartilage 1997; 5(5): 309–19

    Article  PubMed  CAS  Google Scholar 

  37. Williams JM, Plaza V, Hui F, et al. Hyaluronic acid suppresses fibronectin fragment mediated cartilage chondrolysis: II. In vivo. Osteoarthritis Cartilage 1997; 5(4): 235–40

    Article  PubMed  CAS  Google Scholar 

  38. Takahashi K, Hashimoto S, Kubo T, et al. Effect of hyaluronan on chondrocyte apoptosis and nitric oxide production in experimentally induced osteoarthritis. J Rheumatol 2000 Jul; 27(7): 1713–20

    PubMed  CAS  Google Scholar 

  39. Lisignoli G, Grassi F, Zini N, et al. Anti-Fas-induced apoptosis in chondrocytes reduced by hyaluronan: evidence for CD44 and CD54 (intercellular adhesion molecule 1) involvement. Arthritis Rheum 2001 Aug; 44(8): 1800–7

    Article  PubMed  CAS  Google Scholar 

  40. Tobetto K, Yasui T, Ando T, et al. Inhibitory effects of hyaluronan on [14C]arachidonic acid release from labeled human synovial fibroblasts. Jpn J Pharmacol 1992 Oct; 60(2): 79–84

    Article  PubMed  CAS  Google Scholar 

  41. Waddell DD, Kolomytkin OV, Dunn S, et al. Hyaluronan suppresses IL-1 β-induced metalloproteinase activity from synovial tissue. Clin Orthop Relat Res 2007; (465): 241–8

    Google Scholar 

  42. Takahashi K, Goomer RS, Harwood F, et al. The effects of hyaluronan on matrix metalloproteinase-3 (MMP-3), inter-leukin-1β(IL-1β), and tissue inhibitor of metalloproteinase-1 (TIMP-1) gene expression during the development of osteoarthritis. Osteoarthritis Cartilage 1999 Mar; 7(2): 182–90

    Article  PubMed  CAS  Google Scholar 

  43. Yatabe T, Mochizuki S, Takizawa M, et al. Hyaluronan inhibits expression of ADAMTS4 (aggrecanase-1) in human osteoarthritic chondrocytes. Ann Rheum Dis 2009 Jun; 68(6): 1051–8

    Article  PubMed  CAS  Google Scholar 

  44. Tanaka M, Masuko-Hongo K, Kato T, et al. Suppressive effects of hyaluronan on MMP-1 and RANTES production from chondrocytes. Rheumatol Int 2006 Jan; 26(3): 185–90

    Article  PubMed  CAS  Google Scholar 

  45. Hiramitsu T, Yasuda T, Ito H, et al. Intercellular adhesion molecule-1 mediates the inhibitory effects of hyaluronan on interleukin-1 β-induced matrix metalloproteinase production in rheumatoid synovial fibroblasts via down-regulation of NF-kB and p38. Rheumatology (Oxford) 2006 Jul; 45(7): 824–32

    Article  CAS  Google Scholar 

  46. Sasaki A, Sasaki K, Konttinen YT, et al. Hyaluronate inhibits the interleukin-1 β-induced expression of matrix metalloproteinase (MMP)-1 and MMP-3 in human synovial cells. Tohoku J Exp Med 2004 Oct; 204(2): 99–107

    Article  PubMed  CAS  Google Scholar 

  47. Hashizume M, Koike N, Yoshida H, et al. High molecular weight hyaluronic acid relieved joint pain and prevented the progression of cartilage degeneration in a rabbit osteoarthritis model after onset of arthritis. Mod Rheumatol. Epub 2010 Apr 21

    Google Scholar 

  48. Zhou J-L, Liu S-Q, Qiu B, et al. The protective effect of sodium hyaluronate on the cartilage of rabbit osteoarthritis by inhibiting peroxisome proliferator-activated receptor-gamma messenger RNA expression. Yonsei Med J 2009; 50(6): 832–7

    Article  PubMed  CAS  Google Scholar 

  49. Nonaka T, Kikuchi H, Ikeda T, et al. Hyaluronic acid inhibits the expression of u-PA, PAI-1, and u-PAR in human synovial fibroblasts of osteoarthritis and rheumatoid arthritis. J Rheumatol 2000; 27(4): 997–1004

    PubMed  CAS  Google Scholar 

  50. Nonaka T, Kikuchi H, Sohen S, et al. Comparison of the inhibitory effects of two types (90kDa and 190kDa) of hyaluronic acid on the expression of fibrinolytic factors in human synovial fibroblasts. Mod Rheumatol 2002; 12(2): 160–6

    Article  CAS  Google Scholar 

  51. Yoshioka M, Shimizu C, Harwood FL, et al. The effects of hyaluronan during the development of osteoarthritis. Osteoarthritis Cartilage 1997 Jul; 5(4): 251–60

    Article  PubMed  CAS  Google Scholar 

  52. Masuko K, Murata M, Yudoh K, et al. Anti-inflammatory effects of hyaluronan in arthritis therapy: not just for viscosity. Int J Gen Med 2009; 2: 77–81

    PubMed  CAS  Google Scholar 

  53. Kikuchi T, Yamada H, Shimmei M. Effect of high molecular weight hyaluronan on cartilage degeneration in a rabbit model of osteoarthritis. Osteoarthritis Cartilage 1996 Jun; 4(2): 99–110

    Article  PubMed  CAS  Google Scholar 

  54. Armstrong S, Read R, Ghosh P. The effects of intraarticular hyaluronan on cartilage and subchondral bone changes in an ovine model of early osteoarthritis. J Rheumatol 1994 Apr; 21(4): 680–8

    PubMed  CAS  Google Scholar 

  55. Shimizu C, Yoshioka M, Coutts RD, et al. Long-term effects of hyaluronan on experimental osteoarthritis in the rabbit knee. Osteoarthritis Cartilage 1998 Jan; 6(1): 1–9

    Article  PubMed  CAS  Google Scholar 

  56. Mazzucco D, McKinley G, Scott RD, et al. Rheology of joint fluid in total knee arthroplasty patients. J Orthop Res 2002 Nov; 20(6): 1157–63

    Article  PubMed  Google Scholar 

  57. Shimizu M, Higuchi H, Takagishi K, et al. Clinical and biochemical characteristics after intra-articular injection for the treatment of osteoarthritis of the knee: prospective randomized study of sodium hyaluronate and corticosteroid. J Orthop Sci 2010 Jan; 15(1): 51–6

    Article  PubMed  CAS  Google Scholar 

  58. Hasegawa M, Nakoshi Y, Tsujii M, et al. Changes in biochemical markers and prediction of effectiveness of intraarticular hyaluronan in patients with knee osteoarthritis. Osteoarthritis Cartilage 2008 Apr; 16(4): 526–9

    Article  PubMed  CAS  Google Scholar 

  59. US FDA. Summary of safety and effectiveness data (Supartz™) [online]. Available from URL: http://www.accessdata.fda.gov/cdrh_docs/pdf/P980044b.pdf [Accessed 2010 Jun 30]

  60. Hamilton SR, Veiseh M, Tolg C, et al. Pharmacokinetics and pharmacodynamics of hyaluronan infused into healthy human volunteers. Open Drug Metab J 2009; 3: 43–55

    Article  CAS  Google Scholar 

  61. Wu JJ, Shih LY, Hsu HC, et al. The double-blind test of sodium hyaluronate (ARTZ) on osteoarthritis knee. Chung Hua Yao Hsueh Tsa Chih 1997 Feb; 59(2): 99–106

    CAS  Google Scholar 

  62. Day R, Brooks P, Conaghan PG, et al. A double blind, randomized, multicenter, parallel group study of the effectiveness and tolerance of intraarticular hyaluronan in osteoarthritis of the knee. J Rheumatol 2004 Apr; 31(4): 775–82

    PubMed  CAS  Google Scholar 

  63. Karlsson J, Sjogren LS, Lohmander LS. Comparison of two hyaluronan drugs and placebo in patients with knee osteoarthritis: a controlled, randomized, double-blind, parallel-design multicentre study. Rheumatology (Oxford) 2002 Nov; 41(11): 1240–8

    Article  CAS  Google Scholar 

  64. Puhl W, Bernau A, Greiling H, et al. Intra-articular sodium hyaluronate in osteoarthritis of the knee: a multicenter, double-blind study. Osteoarthritis Cartilage 1993 Oct; 1(4): 233–41

    Article  PubMed  CAS  Google Scholar 

  65. Lohmander LS, Dalen N, Englund G, et al. Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee: a randomised, double blind, placebo controlled multicentre trial. Hyaluronan Multicentre Trial Group. Ann Rheum Dis 1996 Jul; 55(7): 424–31

    Article  PubMed  CAS  Google Scholar 

  66. Strand V, Conaghan PG, Lohmander LS, et al. An integrated analysis of five double-blind, randomized controlled trials evaluating the safety and efficacy of a hyaluronan product for intra-articular injection in osteoarthritis of the knee. Osteoarthritis Cartilage 2006 Sep; 14(9): 859–66

    Article  PubMed  CAS  Google Scholar 

  67. Sun SF, Hsu CW, Hwang CW, et al. Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests. Osteoarthritis Cartilage 2006 Jul; 14(7): 696–701

    Article  PubMed  Google Scholar 

  68. Lequesne MG, Mery C, Samson M, et al. Indexes of severity for osteoarthritis of the hip and knee. Validation — value in comparison with other assessment tests. Scand J Rheumatol Suppl 1987; 65: 85–9

    Article  PubMed  CAS  Google Scholar 

  69. Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988 Dec; 15(12): 1833–40

    PubMed  CAS  Google Scholar 

  70. Gotoh M, Hanyu T, Yoshio T, et al. Intra-articular injection of hyaluronate (SI-6601D) improves joint pain and a synovial fluid prostaglandin E2 levels in rheumatoid arthritis: a multi-center clinical trial. Clin Exp Rheumatology 2001; 19: 377–83

    Google Scholar 

  71. Michael JW, Schluter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int 2010 Mar; 107(9): 152–62

    PubMed  Google Scholar 

  72. Centers for Disease Control and Prevention. Arthritis types — overview: osteoarthritis [online]. Available from URL: http://www.cdc.gov/arthritis/arthritis/osteoarthritis.htm [Accessed 2010 Jun 24]

  73. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum 2008 Jan; 58(1): 26–35

    Article  PubMed  Google Scholar 

  74. Dillon CF, Rasch EK, Gu Q, et al. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991–94. J Rheumatol 2006 Nov; 33(11): 2271–9

    PubMed  Google Scholar 

  75. Jordan KM, Arden NK, Doherty M, et al. 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 2003 Dec; 62(12): 1145–55

    Article  PubMed  CAS  Google Scholar 

  76. Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008; 16(2): 137–62

    Article  PubMed  CAS  Google Scholar 

  77. Amer M, Bead VR, Bathon J, et al. Use of nonsteroidal anti-inflammatory drugs in patients with cardiovascular disease: a cautionary tale. Cardiol Rev 2010 Jul–Aug 31; 18(4): 204–12

    Article  PubMed  Google Scholar 

  78. American Academy of Orthopaedic Surgeons. American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of osteoarthritis of the knee (non-arthroplasty) [online]. Available from URL: http://www.aaos.org/Research/guidelines/OAKguideline.pdf [Accessed 2010 Jun 25]

  79. Altman RD. Status of hyaluronan supplementation therapy in osteoarthritis. Curr Rheumatol Rep 2003 Feb; 5(1): 7–14

    Article  PubMed  Google Scholar 

  80. Bagga H, March L. Intra-articular hyaluronic acid for osteoarthritis of the knee. Med Today 2003; 4(10): 67–8

    Google Scholar 

  81. Campbell J, Ruddock B. Hyaluronic acid products for osteoarthritis of the knee. Can Pharmacists J 2007; 140(3): 194–6

    Google Scholar 

  82. Divine JG, Zazulak BT, Hewett TE. Viscosupplementation for knee osteoarthritis: a systematic review. Clin Orthop Relat Res 2007 Feb; 455: 113–22

    Article  PubMed  Google Scholar 

  83. Qvistgaard E, Christensen R, Torp-Pedersen S, et al. Intraarticular treatment of hip osteoarthritis: a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage 2006 Feb; 14(2): 163–70

    Article  PubMed  CAS  Google Scholar 

  84. Sun SF, Chou YJ, Hsu CW, et al. Efficacy of intra-articular hyaluronic acid in patients with osteoarthritis of the ankle: a prospective study. Osteoarthritis Cartilage 2006 Sep; 14(9): 867–74

    Article  PubMed  Google Scholar 

  85. Roux C, Fontas E, Breuil V, et al. Injection of intraarticular sodium hyaluronidate (Sinovial) into the carpometacarpal joint of the thumb (CMC 1) in osteoarthritis: a prospective evaluation of efficacy. Joint Bone Spine 2007 Jul; 74(4): 368–72

    Article  PubMed  CAS  Google Scholar 

  86. Blaine T, Moskowitz R, Udell J, et al. Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial: a multicenter study. J Bone Joint Surg Am 2008 May; 90(5): 970–9

    Article  PubMed  Google Scholar 

  87. Waddell DD. Viscosupplementation with hyaluronans for osteoarthritis of the knee: clinical efficacy and economic implications. Drugs Aging 2007; 24(8): 629–42

    Article  PubMed  CAS  Google Scholar 

  88. Drug topics red book [CD-ROM]. Montvale (NJ): Medical Economics, 2006

  89. Rules and regulations. December 1, 2006. Fed Regist 2006; 71(231): 69803, 70003

    Google Scholar 

  90. Feering Pharmaceuticals Inc. Euflexxa® (1% sodium hyaluronate): product information [online]. Available from URL: http://www.euflexxa.com/files/euflexxa_physician.pdf [Accessed 2010 Jun 25]

  91. Sanofi-aventis. Hyalgan® (sodium hyaluronate): US prescribing information [online]. Available from URL: http://products.sanofi-aventis.us/hyalgan/hyalgan.pdf [Accessed 2010 Jun 28]

  92. Anika Therapeutic Inc. Orthovisc® (sodium hyaluronate): US prescribing information [online]. Available from URL: http://www.orthoviscline.com/sites/default/files/file/Orthovisc_Package_Insert.pdf [Accessed 2010 Jun 28]

  93. Genzyme Corporation. Synvisc® (hyalan G-F 20): US prescribing information [online]. Available from URL: http://www.synviscone.com [Accessed 2010 Jun 28]

  94. Genzyme Corporation. Synvisc One® (hyalan G-F 20): US prescribing information [online]. Available from URL: http://www.synviscone.com [Accessed 2010 June 28]

  95. Reichenbach S, Blank S, Rutjes AW, et al. Hylan versus hyaluronic acid for osteoarthritis of the knee: a systematic review and meta-analysis. Arthritis Rheum 2007 Dec 15; 57(8): 1410–8

    Article  PubMed  Google Scholar 

  96. Bellamy N, Campbell J, Robinson V, et al. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database System Rev 2006; (2): CD005321

    Google Scholar 

  97. Voelker R. Guideline provides evidence-based advice for treating osteoarthritis of the knee. JAMA 2009; 301(5): 475–6

    Article  PubMed  CAS  Google Scholar 

  98. National Collaborating Centre for Chronic Conditions. Osteoarthritis: the care and management of osteoarthritis in adults (clinical guideline no. 59). London: National Institute for Health and Clinical Excellence (NICE), 2008 Feb

    Google Scholar 

  99. Arrich J, Piribauer F, Mad P, et al. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. CMAJ 2005 Apr 12; 172(8): 1039–43

    Article  PubMed  Google Scholar 

  100. Bannuru RR, Natov NS, Obadan IE, et al. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis. Arthritis Rheum 2009 Dec 15; 61(12): 1704–11

    Article  PubMed  CAS  Google Scholar 

  101. Lo GH, LaValley M, McAlindon T, et al. Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. JAMA 2003; 290(23): 3115–21

    Article  PubMed  CAS  Google Scholar 

  102. Modawal A, Ferrer M, Choi HK, et al. Hyaluronic acid injections relieve knee pain. J Fam Pract 2005 Sep; 54(9): 758–67

    PubMed  Google Scholar 

  103. Wang C-T, Lin J, Chang C-J, et al. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee: a meta-analysis of randomized controlled trials. J Bone Joint Surg Am 2004; 86(3): 538–45

    PubMed  Google Scholar 

  104. Campbell J, Bellamy N, Gee T. Differences between systematic reviews/meta-analyses of hyaluronic acid/hyaluronan/hylan in osteoarthritis of the knee. Osteoarthritis Cartilage 2007 Dec; 15(12): 1424–36

    Article  PubMed  CAS  Google Scholar 

  105. Towheed TE, Hochberg MC. A systematic review of randomized controlled trials of pharmacological therapy in osteoarthritis of the knee, with an emphasis on trial methodology. Semin Arthritis Rheum 1997 Apr; 26(5): 755–70

    Article  PubMed  CAS  Google Scholar 

  106. Jørgensen A, Stengaard-Pedersen K, Simonsen O, et al. Intraarticular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year. Ann Rheum Dis 2010 Jun; 69(6): 1097–102

    Article  PubMed  Google Scholar 

  107. Brzusek D, Petron D. Treating knee osteoarthritis with intra-articular hyaluronans. Curr Med Res Opin 2008 Dec; 24(12): 3307–22

    Article  PubMed  CAS  Google Scholar 

  108. Torrance GW, Raynauld JP, Walker V, et al. A prospective, randomized, pragmatic, health outcomes trial evaluating the incorporation of hylan G-F 20 into the treatment paradigm for patients with knee osteoarthritis (Pt 2 of 2): economic results. Osteoarthritis Cartilage 2002 Jul; 10(7): 518–27

    Article  PubMed  CAS  Google Scholar 

  109. Kahan A, Lleu PL, Salin L. Prospective randomized study comparing the medicoeconomic benefits of Hylan GF-20 vs. conventional treatment in knee osteoarthritis. Joint Bone Spine 2003 Aug; 70(4): 276–81

    Article  PubMed  Google Scholar 

  110. Yen ZS, Lai MS, Wang CT, et al. Cost-effectiveness of treatment strategies for osteoarthritis of the knee in Taiwan. J Rheumatol 2004 Sep; 31(9): 1797–803

    PubMed  Google Scholar 

  111. Waddell DD, Bricker DC. Total knee replacement delayed with Hylan G-F 20 use in patients with grade IV osteoarthritis. J Manage Care Pharm 2007 Mar; 13(2): 113–21

    Google Scholar 

  112. Waddell D, Rein A, Panarites C, et al. Cost implications of introducing an alternative treatment for patients with osteoarthritis of the knee in a managed care setting. Am J Manag Care 2001 Oct; 7(10): 981–91

    PubMed  CAS  Google Scholar 

  113. Hammesfahr JF, Knopf AB, Stitik T. Safety of intra-articular hyaluronates for pain associated with osteoarthritis of the knee. Am J Orthop (Belle Mead NJ) 2003 Jun; 32(6): 277–83

    Google Scholar 

  114. Adams ME, Lussier AJ, Peyron JG. A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug Saf 2000 Aug; 23(2): 115–30

    Article  PubMed  CAS  Google Scholar 

  115. Goldberg VM, Coutts RD. Pseudoseptic reactions to hylan viscosupplementation: diagnosis and treatment. Clin Orthop Relat Res 2004 Feb; (419): 130–7

    Google Scholar 

  116. Adams ME, Atkinson MH, Lussier AJ, et al. The role of viscosupplementation with hylan G-F 20 (Synvisc) in the treatment of osteoarthritis of the knee: a Canadian multicenter trial comparing hylan G-F 20 alone, hylan G-F 20 with non-steroidal anti-inflammatory drugs (NSAIDs) and NSAIDs alone. Osteoarthritis Cartilage 1995 Dec; 3(4): 213–25

    Article  PubMed  CAS  Google Scholar 

  117. Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group [published erratum appears in J Rheumatol 1999 May; 26 (5): 1216]. J Rheumatol 1998 Nov; 25(11): 2203–12

    PubMed  CAS  Google Scholar 

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    Monique P. Curran

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Curran, M.P. Hyaluronic Acid (Supartz®). Drugs Aging 27, 925–941 (2010). https://doi.org/10.2165/11205920-000000000-00000

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