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• W1590065751 abstract "Background: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide, and is associatedwith significant pain and disability. Intra-articular (IA) hyaluronan/hylan (HA) is an established localtherapeutic modality for the treatment of knee OA. The goal of therapy is to relieve the symptomsassociated with inflammation and thereby reduce pain and disability.Objectives: As part of a Cochrane review of viscosupplementation in knee OA, randomised controlled trials (RCTs) were reviewed to evaluate evidence for the efficacy of viscosupplementation with Hylan G-F 20compared to placebo.Methods: Electronic searches were conducted of EMBASE, MEDLINE, PREMEDLINE, Current Contentsand CENTRAL. Human, RCTs involving Hylan G-F 20 compared to placebo, published prior to 1Q2004, were included. Trials were selected and data extracted by 2 independent reviewers. Methodological quality was assessed with the Jadad criteria by 2 reviewers. Data on OARSI core set measures were extracted. Weighted mean differences (WMD), based on unadjusted post-test scores, and 95% confidence intervals (CI) were calculated for continuous outcome measures.Results: Seven RCTs met the inclusion criteria. Median methodological quality was 4 (range 4-5). Hylan GF20 was more efficacious than placebo at 1-4 weeks post-injection for pain on weight-bearing WMD(random effects [RE]) -13 mm on a 0-100 mm VAS (p=0.002) based on 6 RCTs. This difference was evengreater at 5-13 weeks post-injection, -22 mm (RE) (p=0.0006) based on 5 RCTs, and at 14-26 weeks postinjection, -21 mm (RE) (p=0.006) based on 4 RCTs. Hylan G-F 20 was more efficacious than placebo at 1-4weeks post-injection for pain at night, WMD -7 mm on a 0-100 mm VAS (p=0.003) based on 5 RCTs. Thisdifference was even greater at 5-13 weeks post-injection, -11 mm (RE) (p=0.008) based on 4 RCTs, and at14-26 weeks post-injection, -17 mm (p<0.00001) based on 3 RCTs. Hylan G-F 20 was more efficaciousthan placebo at 1-4 weeks post-injection for improvement in the most painful knee movement WMD 19 mmon a 0-100 mm VAS (p<0.00001) based on 4 RCTs. This difference was even greater at 5-13 weeks postinjection,34 mm (RE) (p<0.00001). Hylan G-F 20 + oral placebo was more efficacious than arthrocentesis +oral placebo for WOMAC Function, WMD -9 mm on a 0-100 mm VAS (p=0.01)and for Lequesne IndexWMD -1.60 on a 0-24 scale (p=0.02)(Dickson 2001). Hylan G-F 20 was more effective than placebo at 1-4weeks post-injection for the variable designated treatment efficacy, WMD 22 mm on a 0-100 mm VAS(p<0.00001) based on improvement in 4 RCTs. This difference was even greater at 5-13 weeks postinjection,35 mm (p<0.00001).Conclusion: Evidence from this Cochrane review supports the superior efficacy of Hylan G-F 20 comparedto placebo on weight- bearing pain, night pain, function and treatment efficacy in knee OA." @default.
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• W1590065751 date "2005-01-01" @default.
• W1590065751 modified "2023-09-24" @default.
• W1590065751 title "Hylan G-F 20 (Synvisc) versus placebo: Cochrane Review 2005" @default.
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