Bellamy, N. and Campbell, J. and Gee, T. and Robinson, V. and Bourne, R. and Wells, G. (2005) Hylan G-F 20 (Synvisc) versus placebo: Cochrane Review 2005. In: Annual European Congress of Rheumatology - EULAR 2005 , 8-11 June 2005, Vienna.
PDF (Published Version - Abstract)
Background: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide, and is associated
with significant pain and disability. Intra-articular (IA) hyaluronan/hylan (HA) is an established local
therapeutic modality for the treatment of knee OA. The goal of therapy is to relieve the symptoms
associated 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 20
compared to placebo.
Methods: Electronic searches were conducted of EMBASE, MEDLINE, PREMEDLINE, Current Contents
and 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 GF
20 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 even
greater 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 1-4
weeks post-injection for pain at night, WMD -7 mm on a 0-100 mm VAS (p=0.003) based on 5 RCTs. This
difference was even greater at 5-13 weeks post-injection, -11 mm (RE) (p=0.008) based on 4 RCTs, and at
14-26 weeks post-injection, -17 mm (p<0.00001) based on 3 RCTs. Hylan G-F 20 was more efficacious
than placebo at 1-4 weeks post-injection for improvement in the most painful knee movement WMD 19 mm
on 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 Index
WMD -1.60 on a 0-24 scale (p=0.02)(Dickson 2001). Hylan G-F 20 was more effective than placebo at 1-4
weeks 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 compared
to placebo on weight- bearing pain, night pain, function and treatment efficacy in knee OA.
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|Item Type:||Conference or Workshop Item (Commonwealth Reporting Category E) (Paper)|
|Item Status:||Live Archive|
|Additional Information:||Published abstract deposited in accordance with the copyright policy of the publisher.|
|Depositing User:||Dr Travis Gee|
|Faculty / Department / School:||Historic - Faculty of Sciences - Department of Psychology|
|Date Deposited:||16 Nov 2010 04:26|
|Last Modified:||02 Jul 2013 23:51|
|Uncontrolled Keywords:||osteoarthritis; knee|
|Fields of Research :||11 Medical and Health Sciences > 1115 Pharmacology and Pharmaceutical Sciences > 111502 Clinical Pharmacology and Therapeutics|
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