CONTEXT: Although there are many nonsurgical therapies available for the treatment of pain associated with osteoarthritis (OA), their long-term use and safety have not been systematically followed. Intra-articular hyaluronan therapy has been used in the treatment of symptoms associated with OA of the knee with a very favorable safety profile. Five intra-articular hyaluronan products are approved in the US. No systematic review of the safety and efficacy of their chronic use has been reported. OBJECTIVE: To evaluate the literature on the efficacy and safety of repeat courses of hyaluronan therapy in patients with OA of the knee. DATA SOURCES: MEDLINE, EMBASE, searched through October 2004. STUDY SELECTION: Databases were searched using the terms hyaluronan, sodium hyaluronate, hyaluronic acid, hylan, hylan G-F 20, osteoarthritis, adverse events, repeat treatment, and multiple courses. DATA SYNTHESIS: There are some data that support the benefit and safety of repeat treatment for all products. Data also indicate that one formulation of sodium hyaluronate (molecular weight [MW] 500-730 kDa) is well tolerated and as effective after multiple courses of treatment as it is after a single course. There is also clinical evidence that prolonged use of sodium hyaluronate (MW 500-730 kDa) may significantly decrease the rate of deterioration of joint structure. Localized severe acute inflammatory reactions reported with repeated treatment in some patients are not a class effect but may be linked to physicochemical characteristics of hylan-based treatment. CONCLUSIONS: Repeat courses of the hyaluronans are safe and effective in the treatment of pain associated with OA of the knee.
CONTEXT: Although there are many nonsurgical therapies available for the treatment of pain associated with osteoarthritis (OA), their long-term use and safety have not been systematically followed. Intra-articular hyaluronan therapy has been used in the treatment of symptoms associated with OA of the knee with a very favorable safety profile. Five intra-articular hyaluronan products are approved in the US. No systematic review of the safety and efficacy of their chronic use has been reported. OBJECTIVE: To evaluate the literature on the efficacy and safety of repeat courses of hyaluronan therapy in patients with OA of the knee. DATA SOURCES: MEDLINE, EMBASE, searched through October 2004. STUDY SELECTION: Databases were searched using the terms hyaluronan, sodium hyaluronate, hyaluronic acid, hylan, hylan G-F 20, osteoarthritis, adverse events, repeat treatment, and multiple courses. DATA SYNTHESIS: There are some data that support the benefit and safety of repeat treatment for all products. Data also indicate that one formulation of sodium hyaluronate (molecular weight [MW] 500-730 kDa) is well tolerated and as effective after multiple courses of treatment as it is after a single course. There is also clinical evidence that prolonged use of sodium hyaluronate (MW 500-730 kDa) may significantly decrease the rate of deterioration of joint structure. Localized severe acute inflammatory reactions reported with repeated treatment in some patients are not a class effect but may be linked to physicochemical characteristics of hylan-based treatment. CONCLUSIONS: Repeat courses of the hyaluronans are safe and effective in the treatment of pain associated with OA of the knee.
Authors: Sascha Colen; Michel P J van den Bekerom; Johan Bellemans; Michiel Mulier Journal: BMC Musculoskelet Disord Date: 2010-11-16 Impact factor: 2.362
Authors: W Zhang; M Doherty; B F Leeb; L Alekseeva; N K Arden; J W Bijlsma; F Dinçer; K Dziedzic; H J Häuselmann; G Herrero-Beaumont; P Kaklamanis; S Lohmander; E Maheu; E Martín-Mola; K Pavelka; L Punzi; S Reiter; J Sautner; J Smolen; G Verbruggen; I Zimmermann-Górska Journal: Ann Rheum Dis Date: 2006-10-17 Impact factor: 19.103