Abstract
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.
Original language | English (US) |
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Pages (from-to) | 751-761 |
Number of pages | 11 |
Journal | Osteoarthritis and Cartilage |
Volume | 13 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2005 |
Keywords
- Hyaluronan
- Hyaluronic acid
- Hylan G-F 20
- Osteoarthritis
- Repeat treatment
- Sodium hyaluronan
- Sodium hyaluronate
ASJC Scopus subject areas
- Rheumatology
- Biomedical Engineering
- Orthopedics and Sports Medicine