Effect of ultrasound-detected synovitis on therapeutic efficacy of hyaluronic acid injection for symptomatic knee osteoarthritis

Wang, Chien-Chih; Wang, Chin-Tien; Tsai, Kun Ling; Chou, Chung Tei; Chao, Jian-Kang; Huang, Hsin-Yi; Kao, Chung-Lan

doi:10.1093/rheumatology/keab020

Cited by 6 publications

(5 citation statements)

References 38 publications

(43 reference statements)

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“…Wang и соавт. [37], изучавшие действие ЛИТ ГлК в зависимости от выраженности суставного выпота у 137 пациентов с ОА, продемонстрировали однозначно негативное влияние синовита на динамику боли и индекса WOMAC. [41].…”

Section: глк: механизм действияunclassified

Local injection therapy with hyaluronic acid preparations: in focus of rheumatologists and orthopedic traumatologists

Karateev

2024

Sovremennaâ revmatologiâ

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Hyaluronic acid (HA) is an effective and safe medication for local injection therapy (LIT) widely used in the treatment of osteoarthritis (OA) of large joints. The therapeutic effect of HA is determined both by the replacement of the lubricating function of natural hyaluronate (viscosupplementation), which leads to an improvement in the biomechanical parameters of the joint, and by the biological effects that unfold when interacting with cellular receptors (CD44, RHAMM, etc.), resulting in an anti-inflammatory, anti-nociceptive and anabolic effect of HA. HA therapy has a reliable evidence base. According to a number of clinical studies and meta-analyses, LIT with HA – reduces pain intensity by 28–54 % and improves the function of the affected joint by 9–32 % compared to baseline over a 12-24 week observation period. Repeated administration of HA can delay the need for orthopedic surgery. HA extremely rarely causes serious adverse events and can also be prescribed to patients with concomitant diseases. The use of HA for the treatment of OA is included in Russian and several foreign clinical guidelines (in particular OARSI and ESCEO). A new direction in LIT for OA is therapy with combined (hybrid) HA preparations containing high molecular weight (HMW) and low molecular weight (LMW) fractions. A new HA preparation has appeared in our country, which is a stabilized, highly purified hydrogel containing 80 % HMW HA (molecular weight – 30,000 kDa) with transverse "crosslinking" BDDE (innovative ECHATM technology) and 20 % "uncluttered" linear HA (molecular weight – 1500 kDa). This product is characterized by favorable rheological parameters, which guarantee a long-term improvement in the biomechanics of the affected joint and a rapid onset of biological effects, reduction in pain and inflammation and activation of the synthesis of natural hyaluronate.

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Section: глк: механизм действияunclassified

Local injection therapy with hyaluronic acid preparations: in focus of rheumatologists and orthopedic traumatologists

Karateev

2024

Sovremennaâ revmatologiâ

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“…Wang и соавт. [73], анализировавшие эффективность ЛИТ ГлК при ОА в зависимости от выраженности суставного выпота (n=137), указали на однозначно негативное влияние этого фактора на результат терапии -динамику боли и индекса WOMAC.…”

Section: комментарииunclassified

Local injection therapy in the complex treatment of musculoskeletal disorders: principles of application, evidence base, safety

Lila,

Zagorodniy,

Karateev

et al. 2023

Sovremennaâ revmatologiâ

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Local injection therapy (LIT) is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT. LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.

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“…To identify the patient population in the early to mid-stages of the disease is also important. Some studies have proposed using MRI or US for the test of disease-modifying approaches and recruiting patients with early diseases as defined on MRI or US in clinical trials (Eckstein and Le Graverand, 2015;Wang et al, 2021). There is an unmet need for DMOADs.…”

Section: Expert Opinionmentioning

confidence: 99%

New Trends in Pharmacological Treatments for Osteoarthritis

et al. 2021

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Osteoarthritis (OA) is the leading cause of function loss and disability among the elderly, with significant burden on the individual and society. It is a severe disease for its high disability rates, morbidity, costs, and increased mortality. Multifactorial etiologies contribute to the occurrence and development of OA. The heterogeneous condition poses a challenge for the development of effective treatment for OA; however, emerging treatments are promising to bring benefits for OA management in the future. This narrative review will discuss recent developments of agents for the treatment of OA, including potential disease-modifying osteoarthritis drugs (DMOADs) and novel therapeutics for pain relief. This review will focus more on drugs that have been in clinical trials, as well as attractive drugs with potential applications in preclinical research. In the past few years, it has been realized that a complex interaction of multifactorial mechanisms is involved in the pathophysiology of OA. The authors believe there is no miracle therapeutic strategy fitting for all patients. OA phenotyping would be helpful for therapy selection. A variety of potential therapeutics targeting inflammation mechanisms, cellular senescence, cartilage metabolism, subchondral bone remodeling, and the peripheral nociceptive pathways are expected to reshape the landscape of OA treatment over the next few years. Precise randomized controlled trials (RCTs) are expected to identify the safety and efficacy of novel therapies targeting specific mechanisms in OA patients with specific phenotypes.

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Effect of ultrasound-detected synovitis on therapeutic efficacy of hyaluronic acid injection for symptomatic knee osteoarthritis

Cited by 6 publications

References 38 publications

Local injection therapy with hyaluronic acid preparations: in focus of rheumatologists and orthopedic traumatologists

Local injection therapy with hyaluronic acid preparations: in focus of rheumatologists and orthopedic traumatologists

Local injection therapy in the complex treatment of musculoskeletal disorders: principles of application, evidence base, safety

New Trends in Pharmacological Treatments for Osteoarthritis

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