Intra-articular injections of hyaluronic acid as treatment for patients with knee osteoarthritis displayed similar effectiveness and a superior safety profile compared with nonsteroidal anti-inflammatory drug treatment, according to recent results.
Researchers in Japan studied 200 patients with knee osteoarthritis (OA) registered from 20 hospitals. The patients were randomly assigned treatment of nonsteroidal anti-inflammatory drugs (NSAIDs) as three daily 60 mg tablets per day for 5 weeks (n=100 patients) or intra-articular injections of hyaluronic acid (IA-HA) as an injection of high-molecular weight 2,700 kDa HA (25 mg) once a week for 5 weeks. The Japanese Knee Osteoarthritis Measure (JKOM) score determined percentage change in patient-oriented outcome measure for knee OA at 5 weeks, which was the primary endpoint.
Patients eligible to efficacy at the beginning of the trial included 99 in the IA-HA cohort (mean age, 68.2 years, 72 women) and 93 in the NSAID cohort (mean age, 68.5 years; 71 women). Ninety-eight patients in the IA-HA cohort and 86 patients in the NSAID group were included in analyses at primary endpoint. The IA-HA cohort had a percentage change from baseline in JKOM score of –34.7%, while the NSAID cohort had a change of –32.2% (P<.001, both), for a difference in percentage change of –2.5% (95% CI, –14% to 9.1%).
The IA-HA cohort had significantly lower frequencies of withdrawal (9.1%) and adverse events (AEs; 1%) compared with patients in the NSAID cohort (20.4% and 10.8%, respectively; P=.026, withdrawal; P=.004, AEs). Serious AEs were not reported in both groups. Gastrointestinal tract disorders (n=7) were AEs reported in the NSAID cohort but not the IA-HA cohort.
“The early efficacy of IA-HA is suggested to be not inferior to that of a NSAID, and the safety of the early phase of IA-HA is superior to that of a NSAID for patients with knee OA,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.