Optimizing the effectiveness of viscosupplementation in non-knee osteoarthritis

Conrozier, Thierry

doi:10.1016/j.jbspin.2015.08.009

Cited by 3 publications

(7 citation statements)

References 19 publications

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“…The required number of injections depends on HA structure (linear or cross-linked) but not on the joint to be treated. 29,30 It has never been demonstrated that linear HAs can be effective through a single injection regimen. 13,[29][30][31] This is due to the very short half-life 32 of the linear HA molecule, which needs repeated injections.…”

Section: Safety and Predictive Factors Of Short-term Efficacy Of A Simentioning

confidence: 99%

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Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial)

Dauvissat

Rizzo²,

Lellouche

et al. 2018

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Purpose:To assess safety and search predictive factors of efficacy of a single intra-articular injection of a mannitol-modified hyaluronic acid (HA) viscosupplement, in patients having trapeziometacarpal (TMC) osteoarthritis (OA).Methods:Patients with symptomatic TMC OA, not adequately relieved by analgesic therapy and/or by the use of a thumb splint, were included in a 3-month prospective multicentre open-label trial. All underwent plain radiographs with the Kapandji incidences allowing the Dell radiological grade assessment (1-4). Primary end point was the variation between injection (D0) and day 90 (D90) of the thumb pain (11-point Likert scale). Treatment consisted in a single injection of 0.6 to 1 mL of a viscosupplement made of a cross-linked HA combined with mannitol. All injections were performed under imaging guidance. Predictive factors of pain decrease were studied in univariate and multivariate analysis.Results:A total of 122 patients (76% women, mean age 60, mean disease duration 36 months) were included and 120 (98%) were assessed at 3 months. The TMC OA was of Dell’s grade 1, 2, 3, and 4 in 23%, 36.8%, 36.8%, and 3.5% of cases, respectively. At D0, the average (SD) pain level was 6.5 ± 1.6 without significant difference between Dell groups (P = .21). At day 90, pain decreased from 6.5 ± 1.6 to 3.9 ± 2.5 (difference −2.7 ± 2.5; −42%; P < .0001) without significant difference between Dell grade (P = .055), despite a seemingly smaller number of responders in stage 2 patients. The average analgesic consumption decreased in more than 1 out of 2 patients. In multivariate analysis, no predictor of response was identified. There was no safety issue. All adverse events (11%) were transient increase in pain during or following HA administration and resolved without sequel within 1 to 7 days.Conclusions:This study suggests that a single course of HANOX-M-XL injection is effective in relieving pain in patients with TMC OA, without safety concern. Patients with advanced stage of OA benefit the treatment as much as those with mild or moderate OA.

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Section: Safety and Predictive Factors Of Short-term Efficacy Of A Simentioning

confidence: 99%

“…29,30 It has never been demonstrated that linear HAs can be effective through a single injection regimen. 13,29–31 This is due to the very short half-life 32 of the linear HA molecule, which needs repeated injections. 33,34 Cross-linked HA, whose IA residence time is much longer 35 can require only one injection.…”

Section: Introductionmentioning

confidence: 99%

Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial)

Dauvissat

Rizzo²,

Lellouche

et al. 2018

Clin Med�Insights�Arthritis�Musculoskelet Disord

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“…40 For example, a recent systematic review of hyaluronic acid injections for ankle OA found that although it is safe and effective, it was no more effective than other conservative treatments. 41 Although a recent meeting of 8 European experts on OA led to a unanimous vote in favor of the effectiveness of viscosupplementation for mild to moderate knee OA, there was only moderate consensus in favor for hip and ankle, and weak consensus in favor for shoulder OA.…”

Section: Poddar and Widstrommentioning

confidence: 99%

Nonoperative Options for Management of Articular Cartilage Disease

Poddar

Widstrom

2017

Clinics in Sports Medicine

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“…Acids having a linear structure possess a shorter halflife than acids with a large number of crosslinks. One of the hypotheses explaining the mechanism of HA activity assumes that its effectiveness depends on the duration of the contact of the specimen with structures within the joint (especially the cartilage and the synovium) [29].…”

Section: General Remarks Regarding Hyaluronic Acidmentioning

confidence: 99%

“…Despite the lack of substantial evidence, there are attempts to treat OA of different joints, in particular: hip, ankle, shoulder, and metacarpophalangeal joints (MCP) [56].…”

Section: The Role Of Hyaluronic Acid In Degenerative Arthritis Treatmentmentioning

confidence: 99%

Viscosupplementation in prevention and treatment of the degenerative joint disease

Kotela¹,

Sarzyńska²,

Woźniak³

et al. 2015

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Osteoarthritis (OA) is one of the most common musculoskeletal disorders. It limits patients' functionality and life satisfaction significantly. Although there are numerous types of therapy, the success rate of conservative treatment is limited, and it is often necessary to introduce surgical treatment. Therefore, new effective methods of therapy for OA are being tested and submitted. Endogenous hyaluronic acid (HA) is a natural ingredient of many tissues in the human organism, including synovial fluid. Viscosupplementation with the usage of HA is a relatively new method for treating degenerative joint changes. By virtue of its good safety profile and simplicity of application, it is increasingly used as an alternative or addition to classic conservative treatment. In this work, we attempted to summarise the current state of knowledge of HA usage in OA treatment based on literature. StreszczenieChoroba zwyrodnieniowa stawów jest częstym schorzeniem układu mięśniowo-szkieletowego. Niestety skuteczność leczenia zachowawczego zmian zwyrodnieniowych stawów jest ograniczona i często konieczne bywa leczenie chirurgiczne. W związku z tym podejmowane są próby wprowadzenia nowych metod terapii choroby zwyrodnieniowej stawów. Endogenny kwas hialuronowy jest naturalnym składnikiem wielu tkanek w organizmie ludzkim, w tym płynu stawowego. Wiskosuplementacja z wykorzystaniem preparatów kwasu hialuronowego jest stosunkowo nową metodą miejscowego leczenia zmian zwyrodnieniowych. Ze względu na dobry profil bezpieczeństwa i łatwość aplikacji jest coraz częściej wykorzystywana jako alternatywa lub wzbogacenie klasycznych terapii zachowawczych. W pracy podjęto próbę podsumowania aktualnej wiedzy na temat stosowania kwasu hialuronowego w leczeniu zmian zwyrodnieniowych stawów na podstawie aktualnego piśmiennictwa.

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Optimizing the effectiveness of viscosupplementation in non-knee osteoarthritis

Cited by 3 publications

References 19 publications

Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial)

Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial)

Nonoperative Options for Management of Articular Cartilage Disease

Viscosupplementation in prevention and treatment of the degenerative joint disease

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