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- W2149931581 abstract "Please allow me to clarify the terminology used to describe the intra-articular hyaluronan (IAHA) class of osteoarthritis (OA) treatments, in the excellent evidence update reported by Zhang et al. (OARSI recommendations for the management of hip and knee osteoarthritis part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis and Cartilage, February 17, 2010; 18(4); 473–99). In Table IV, the authors report a lower risk of local reactions for “IAHA” compared to “IA high molecular HA (hylan)”. This incorrectly suggests that the risk reported from the hylan G-F 20 trials is representative of all high molecular weight HA formulations. This is not the case, as HA and hylan are chemically distinct entities. Hylan is a generic term used to describe a class of HA derivatives chemically modified via their hydroxyl groups1Balazs E.A. Leshchiner E. Larsen N.E. Band P. Hyaluronan biomaterials: medical applications.in: Wise D.L. Handbook of Biomaterials and Applications. Marcel Dekker Inc., New York1995: 2719-2741Google Scholar. The hylan formulation tested in the reviewed trials, hylan G-F 20, contains both hylan A, a soluble high molecular weight derivative of HA, and hylan B, a crosslinked HA derivative that is a water insoluble hydrogel. This distinction between hylan and high molecular weight HA formulations is important, to avoid suggesting that the clinical profile described for hylan G-F 20 applies in a general way to all high molecular weight HA formulations. It is also worthwhile to note that all HA derivatives should not be expected to have the same clinical profile as hylan G-F 20. HA derivatives can be synthesized using different chemical methods, and formulated as different physical forms (e.g., solutions, solid hydrogels or gel–fluid mixtures). The safety and effectiveness of each derivative formulation should be evaluated for its intended use. The author was formerly an employee of Biomatrix, where the hylan G-F 20 formulation mentioned in the letter and publication was developed, and is currently a consultant to Smith-Nephew, a marketer and developer of IAHA products. Response from authors: ‘OARSI update on the evidence for osteoarthritis therapies’Osteoarthritis and CartilageVol. 18Issue 9PreviewWe appreciate Dr Philip Band’s letter in response to our recent publication OARSI recommendations for the management of hip and knee osteoarthritis Part III: changes in evidence following systematic cumulative update of research published through January 2009 (Osteoarthritis & Cartilage 2010; 18: 476–499). The meta-analysis (Reichenberg et al. Arthritis Rheum (Arthritis Care and Research) 2007; 57: 1410–1418) reported in Table IV showed that treatment with IA hylan G-F 20 (Synvisc) was associated with an increased relative risk of flares of joint pain (RR 2.04; 95% CI 1.18, 3.53; I2=0%) compared with IA avian hyaluronans (Hyalgan and Orthovisc), or the bacterial hyaluronan (Ostentil). Full-Text PDF Open Archive" @default.
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- W2149931581 date "2010-09-01" @default.
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- W2149931581 title "OARSI update on the evidence for osteoarthritis therapies: comment on the nomenclature used for intra-articular hyaluronan" @default.
- W2149931581 doi "https://doi.org/10.1016/j.joca.2010.03.019" @default.
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