Key result
Intra-articular hyaluronic acid improved knee osteoarthritis symptoms at 6 months, with 61% of patients receiving 20 mg and 66% receiving 40 mg achieving a 50% or greater clinical response.
Why the study?
Intra-articular hyaluronic acid is frequently used for knee osteoarthrosis in Argentina with varying regimens, prompting a need for real-world data on its use and effectiveness.
Does intra-articular hyaluronic acid improve symptoms in patients with knee osteoarthritis in routine clinical practice?
Cohort (n=1,227)
Yes
Does intra-articular hyaluronic acid improve symptoms in patients with knee osteoarthritis in routine clinical practice?
Absolute Event Rate: 61% vs 66%
p-value: p=0.159
In routine clinical practice, intra-articular hyaluronic acid provides significant symptomatic relief for knee osteoarthritis at 6 months, regardless of whether a 20mg or 40mg dose is used.
May support hyaluronic acid for knee osteoarthritis symptoms; leaves open need for randomized confirmation.
Background: Intra-articular treatment of knee osteoarthrosis (OA) with hyaluronic acid (IA-HA) is frequently used in Argentina, with different dosing forms and injection regimens. Our main objective was to provide real world data on the use and effectiveness of IA-HAMethods: In this observational retrospective cohort study we studied 1227 patients with knee osteoarthrosis treated with IA-HA 20mg/2ml weekly (76%-20mg group) and 40mg/2ml (24%-40mg group) according to usual practice intervals. Follow up was at 6 months and efficacy assessed by 5 point Likert scale and 50% or more response rate.Results: Median number of applications was 5 (20mg) and 3 (40mg). Both groups had a significant improvement in the Likert scale from baseline to 6 month. Median score improved from 4 (mean 3.77 ±0.69) at baseline to median of 2 (mean 1.99 ±0.76) at 6 months (20mg group, p <0.001) and from median of 4 (mean 3.65 ±0.65) to median 2 (mean 1.86 ±0.72) in the 40mg group, p <0.001. Proportion of patients with 50% or more 6 month response were 61% and 66% respectively. In the multivariate analysis, 50% response rate was associated with higher baseline score, younger age and shorter duration of disease. Only 1 patient in the 20mg group (0.1%) experienced a serious treatment related adverse event (septic arthritis) following injection.Conclusion: Our study in common clinical practice supports the effectiveness of IA-HA in step management of knee OA with clinical benefit observed at 6 month follow up.
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Berenstein et al. (2019) conducted a cohort in Knee osteoarthritis (n=1,227). Intra-articular hyaluronic acid 20 mg vs. Intra-articular hyaluronic acid 40 mg was evaluated on Proportion of patients with a response of ≥50% on the 5-point Likert scale at 6 months (p=0.159). Intra-articular hyaluronic acid improved knee osteoarthritis symptoms at 6 months, with 61% of patients receiving 20 mg and 66% receiving 40 mg achieving a 50% or greater clinical response.
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