Roy D Altman1, Forough Farrokhyar2, Anke Fierlinger3, Faizan Niazi3, Jeffrey Rosen4. 1. Division of Rheumatology and Immunology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. 2. Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. 3. Ferring Pharmaceuticals Inc, Parsippany, NJ, USA. 4. Department of Orthopaedics & Rehabilitation, New York Presbyterian Queens, Flushing, NY, USA; Clinical Orthopaedic Surgery, Weill Medical College of Cornell University, New York, NY, USA.
Abstract
INTRODUCTION:Intra-articular hyaluronic acid (IA-HA) injections are a treatment for knee osteoarthritis (OA), although current literature provides mixed results with regard to their efficacy. We will review a randomized controlled trial (RCT) and subsequent extension trial in order to identify factors that are associated with outcomes in patients with knee OA who received IA-HA. METHODS: We used data recorded by the FLEXX trial and extension trial for secondary analysis of potential prognostic factors. Linear regression was used to examine the predictors of outcomes at 6- and 12-month follow-up visits. RESULTS: Sixty percent of all patients presented with a Kellgren Lawrence (K-L) grade 3. Patients with high baseline outcome scores and a K-L grade 3 demonstrated less response than individuals within an earlier stage of knee OA, although results for both K-L grade 2 and K-L grade 3 patients still showed benefit. Those with more severe radiographic change K-L grade 3 often had a better response with the second series of IA-HA injections. Significantly greater positive response in all outcomes was demonstrated for the patient subgroup classified as K-L grade 2, when compared with K-L grade 3 patients. CONCLUSIONS: The results demonstrate that IA-HA for knee OA was of greater benefit in those with less severe radiographic changes. However, those with more severe radiographic change often had a better response with the second course of IA-HA. Similar analyses are required in order to determine if these results are unique to Euflexxa, or if these results are consistent with other available IA-HA agents.
RCT Entities:
INTRODUCTION: Intra-articular hyaluronic acid (IA-HA) injections are a treatment for knee osteoarthritis (OA), although current literature provides mixed results with regard to their efficacy. We will review a randomized controlled trial (RCT) and subsequent extension trial in order to identify factors that are associated with outcomes in patients with knee OA who received IA-HA. METHODS: We used data recorded by the FLEXX trial and extension trial for secondary analysis of potential prognostic factors. Linear regression was used to examine the predictors of outcomes at 6- and 12-month follow-up visits. RESULTS: Sixty percent of all patients presented with a Kellgren Lawrence (K-L) grade 3. Patients with high baseline outcome scores and a K-L grade 3 demonstrated less response than individuals within an earlier stage of knee OA, although results for both K-L grade 2 and K-L grade 3 patients still showed benefit. Those with more severe radiographic change K-L grade 3 often had a better response with the second series of IA-HA injections. Significantly greater positive response in all outcomes was demonstrated for the patient subgroup classified as K-L grade 2, when compared with K-L grade 3 patients. CONCLUSIONS: The results demonstrate that IA-HA for knee OA was of greater benefit in those with less severe radiographic changes. However, those with more severe radiographic change often had a better response with the second course of IA-HA. Similar analyses are required in order to determine if these results are unique to Euflexxa, or if these results are consistent with other available IA-HA agents.
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