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• W4379651065 abstract "Background Knee osteoarthritis (OA) is a progressive degenerative condition resulting in functional loss, pain and discomfort. [1] The current aim of treatment is alleviation of symptoms, improvement of function and joint preservation. Viscosupplementation (VS) with Intra-articular hyaluronic acid (IAHA) injection has been shown to have protective physiochemical functions and may confer disease-modifying, long term effects in OA. [2][3] However, conflicting guidelines, pooling of results for different molecular weight products, and a paucity of long-term clinical studies has resulted in lack of confidence in the results of IAHA. Objectives To determine the primary and sustained response to VS with different types if IAHA in Bilateral Knee OA. To identify whether the response is different for subgroups which are: Type of IAHA, Gender - Males (M) or Females (F), and Grade of OA treated. Methods We did a retrospective analysis of a 15-year cohort from a single Indian centre. The inclusion criteria were adults with bilateral knee OA with functional reduction and radiological KL Grade of III and IV, treated with Non-Animal Stabilized Hyaluronic Acid (NASHA) origin IAHA injections. Subjects were stratified into two groups based on the molecular weight of the hyaluronic acid used: High Molecular Weight - 6-8 mg/ml – 6ml single injections (HMW-HA), or Very high Molecular weight – 20 mg/ml – 3 ml injections (VHMW-HA). The primary outcome measure was responder rates determined by those with improvement in total WOMAC scores of > 30% from baseline versus non-responders. Responders with sustained response of at least 12 months or more were determined. Results A total of 2037 (F 1467 (72%) & M 570 (28%)) patients were treated. The overall responder rate was 1496 (73.4%) (F 1099 (74.9%) & M 397 (69.6%)). The Primary responder rate was similar for VHMW-HA (73.5% in Gr III OA & 77.0% in Gr IV OA) and HMW-HA (71.0% in Gr III OA & 68.6% in Gr IV OA). The Sustained response in VHMW-HA was greater (60.5% in Gr III OA & 68.5% in Gr IV OA) versus HMW-HA (47.3% in Gr III OA & 46.7% in Gr IV OA). Table 1. The results are summarized in Table -1: - INTERVENTION TYPE VHMW-HA VHMW-HA HMW-HA HMW-HA TOTAL RATE GRADE OF OA Grade III OA Grade IV OA Grade III OA Grade IV OA N % TOTAL PATIENTS TREATED Total (%) 684 (33.6%) 631 (31.0%) 480 (23.6%) 242 (11.9%) 2037 Females 509 418 352 188 1467 72.0% Males 175 213 128 54 570 28.0% PRIMARY RESPONDERS Total (%) 503 (73.5%) 486 (77.0%) 341 (71.0%) 166 (68.6%) 1496 73.4% Females 394 330 251 124 1099 74.9% Males 109 156 90 42 397 69.6% SUSTAINED RESPONDERS Total (%) 414 (60.5%) 432 (68.5%) 227 (47.3%) 113 (46.7%) 1186 58.2% Females 311 286 166 84 847 77.1% Males 103 146 61 29 339 85.4% NON RESPONDERS Total (%) 181 (26.5%) 145 (23.0%) 139 (29.0%) 76 (31.4%) 541 26.6% Females 115 88 101 64 368 25.1% Males 66 57 38 12 173 30.4% Primary responders – Total WOMAC scores improvement of > 30% from baseline, Sustained responders - Sustained WOMAC improvement for >=12 mts., Non-responders - WOMAC change < 30% or Lost to follow up. OA-Osteoarthritis Knees, Grade III and IV OA - radiological KL Grade, VHMW-HA - Very high Molecular weight hyaluronic acid, HMW-HA -High molecular weight hyaluronic acid. Conclusion The responders to treatment of 73.4% justify treatment outcome. The primary response to treatment was similar in all the subgroups – Type of IAHA, Grade of OA and Gender. However, the sustained response for 12 months or more was far greater in VHMW-HA versus HMW-HA. References [1]Mathers CD, Bernard C, Iburg KM, et al. Global programme on evidence for health policy. Discussion paper no. 54. 2003. http://www.who.int/healthinfo/paper54.pdf . Accessed 06 June 2019 [2]Henrotin Y, Raman R, Richette P, et al. Consensus statement on Viscosupplementation with hyaluronic acid for the management of osteoarthritis. Semin Arthritis Rheum. 2015;45(2):140–149. [PubMed] [Google Scholar] [3]du Souich P. Absorption, distribution and mechanism of action of SYSADOAS. Pharmacol Ther. 2014;142(3):362–374. [PubMed] [Google Scholar] Acknowledgements: NIL. Disclosure of Interests Anish Kumar Aggarwal Speakers bureau: Novartis Healthcare, Pfizer Ltd., Johnson & Johnson, Cipla Ltd., Zydus Lifesciences Ltd., Emcure Pharma Ltd., Lupin Ltd, Intas Pharmaceuticals Ltd., Torrent Pharmaceuticals Ltd. and RPG lifesciences Ltd., JANE FITZPATRICK Consultant of: Bioventus Inc., NAKUL AGGARWAL: None declared." @default.
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• W4379651065 date "2023-05-30" @default.
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• W4379651065 title "AB1192 RESPONSE TO VISCOSUPPLEMENTATION WITH DIFFERENT TYPES OF INTRA-ARTICULAR HYALURONIC ACIDS IN OSTEOARTHRITIS OF THE KNEE – A RETROGRADE INDIAN COHORT STUDY OF MORE THAN 15 YEARS LONGITUDINAL DATA" @default.
• W4379651065 doi "https://doi.org/10.1136/annrheumdis-2023-eular.2660" @default.
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