Literature DB >> 12127830

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.

J-P Raynauld1, G W Torrance, P A Band, C H Goldsmith, P Tugwell, V Walker, M Schultz, N Bellamy.   

Abstract

OBJECTIVE: First, to assess the clinical effectiveness of hylan G-F 20 in an appropriate care treatment regimen (as defined by the American College of Rheumatology (ACR) 1995 guidelines) as measured by validated disease-specific outcomes and health-related quality of life endpoints for patients with osteoarthritis (OA) of the knee. Second, to utilize the measures of effectiveness and costs in an economic evaluation (see accompanying manuscript).
DESIGN: A total of 255 patients with OA of the knee were enrolled by rheumatologists or orthopedic surgeons into a prospective, randomized, open-label, 1-year, multi-centred trial, conducted in Canada. Patients were randomized to 'Appropriate care with hylan G-F 20' (AC+H) or 'Appropriate care without hylan G-F 20' (AC). Data were collected at clinic visits (baseline, 12 months) and by telephone (1, 2, 4, 6, 8, 10, and 12 months).
RESULTS: The AC+H group was superior to the AC group for all primary (% reduction in mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale: 38% vs 13%,P =0.0001) and secondary effectiveness outcome measures. These differences were all statistically significant and exceeded the 20% difference between groups set a priori by the investigators as the minimum clinically important difference. Health-related quality of life improvements in the AC+H group were statistically superior for the WOMAC pain, stiffness and physical function (all P< 0.0001), the SF-36 aggregate physical component (P< 0.0001) and the Health Utilities Index Mark 3 (HUI3) overall health utility score (P< 0.0001). Safety (adverse events and patient global assessments of side effects) differences favoured the AC+H group.
CONCLUSION: The data presented here indicate that the provision to patients with knee OA of viscosupplementation with hylan G-F 20 within an appropriate care treatment regimen provides benefits in the knee, overall health and health related quality of life at reduced levels of co-therapy and systemic adverse reactions. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.

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Year:  2002        PMID: 12127830     DOI: 10.1053/joca.2002.0798

Source DB:  PubMed          Journal:  Osteoarthritis Cartilage        ISSN: 1063-4584            Impact factor:   6.576


  47 in total

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2.  Rheologic behavior of osteoarthritic synovial fluid after addition of hyaluronic acid: a pilot study.

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Review 3.  Viscosupplementation for osteoarthritis: a primer for primary care physicians.

Authors:  M Carrington Reid
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4.  Open pilot study of ultrasound-guided intra-articular injection of hylan G-F 20 (Synvisc) in the treatment of symptomatic hip osteoarthritis.

Authors:  Alberto Migliore; Sandro Tormenta; Luis Severino Martin Martin; Costanzo Valente; Umberto Massafra; Mauro Granata; Andrea Alimonti
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5.  Functional and perceived response to intra-articular hyaluronan injection in patients with knee osteoarthritis: persistence of treatment effects over 5 months.

Authors:  Kristin Briem; Michael J Axe; Lynn Snyder-Mackler
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2009-03-19       Impact factor: 4.342

Review 6.  A review of health-utility data for osteoarthritis: implications for clinical trial-based evaluation.

Authors:  Hirsch S Ruchlin; Ralph P Insinga
Journal:  Pharmacoeconomics       Date:  2008       Impact factor: 4.981

7.  Hylan g-f 20: review of its safety and efficacy in the management of joint pain in osteoarthritis.

Authors:  A Migliore; F Giovannangeli; M Granata; B Laganà
Journal:  Clin Med Insights Arthritis Musculoskelet Disord       Date:  2010-09-20

8.  Intra-articular viscosupplementation with hylan g-f 20 to treat osteoarthritis of the knee: an evidence-based analysis.

Authors: 
Journal:  Ont Health Technol Assess Ser       Date:  2005-06-01

9.  Comparing the performance of the EQ-5D and SF-6D when measuring the benefits of alleviating knee pain.

Authors:  Garry R Barton; Tracey H Sach; Anthony J Avery; Michael Doherty; Claire Jenkinson; Kenneth R Muir
Journal:  Cost Eff Resour Alloc       Date:  2009-07-17

10.  Single, intra-articular treatment with 6 ml hylan G-F 20 in patients with symptomatic primary osteoarthritis of the knee: a randomised, multicentre, double-blind, placebo controlled trial.

Authors:  X Chevalier; J Jerosch; P Goupille; N van Dijk; F P Luyten; D L Scott; F Bailleul; K Pavelka
Journal:  Ann Rheum Dis       Date:  2010-01       Impact factor: 19.103

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