The effectiveness of three weekly injections compared to five weekly injections of intra-articular sodium hyaluronate on pain relief of knee osteoarthritis or three weekly injections of other hyaluronan products: A Systematic Review and Meta-Analysis

Publication date: Available online 21 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Todd P. Stitik, Sony M. Issac, Simple Modi, Saad Nasir, Irina Kulinets
ObjectiveTo investigate whether the number of hyaluronic acid (HA) injections in a Hyalgan^® course of therapy alters effectiveness in reducing knee osteoarthritis (OA) pain.Data SourcesElectronic databases, including PubMed and EMBase, were searched from January 1980 until November 2015.Study SelectionWe included clinical studies that evaluated the effectiveness of a course of three or five weekly intra-articular injections of Hyalgan to treat knee OA pain. We also included clinical studies evaluating the effectiveness of a three-week course of other FDA-approved HA treatments of knee OA pain. Twenty-four studies were identified, comprising 2,168 study participants in 30 treated cohorts.Data ExtractionWe determined effect sizes for selected studies by extracting knee OA pain scores before and after HA or control treatments. Meta-regressions were implemented to determine whether the number of weekly injections in a course of Hyalgan therapy modified outcomes.Data SynthesisThe pooled estimate for relief from baseline pain was –31.4 (5.46 SE; 95% confidence interval [CI], –45.5, –17.4) with a three-week course of Hyalgan and –32.2 (5.25; CI, –45.6, –18.7) with a five-week course of Hyalgan. Findings from the meta-analysis indicate relief of knee OA pain with a three-week course of Hyalgan is similar to that with a five-week course of Hyalgan (P = .916). The pooled estimate for relief from baseline pain with a three-week course of other HA products was –29.4 (4.98; CI, –42.2, –16.6), also indicating pain relief with a three-week course of Hyalgan is similar to that with a three-week course of other HA products (P = .696).ConclusionsThere was no statistical difference between reduction in knee OA pain with a three-week course of Hyalgan compared to reduction in knee OA pain with a five-week course of Hyalgan or a three-week course of other HA products. These findings demonstrate that comparable knee OA pain relief is achieved with a three-week course of Hyalgan and the two control groups.



http://ift.tt/2m9sgR0