Hylan G-F 20 (Synvisc) versus placebo: Cochrane Review 2005

Paper


Bellamy, N., Campbell, J., Gee, T., Robinson, V., Bourne, R. and Wells, G.. 2005. "Hylan G-F 20 (Synvisc) versus placebo: Cochrane Review 2005." van de Putte, L. (ed.) Annual European Congress of Rheumatology - EULAR 2005 . Vienna 08 - 11 Jun 2005 Netherlands.
Paper/Presentation Title

Hylan G-F 20 (Synvisc) versus placebo: Cochrane Review 2005

Presentation TypePaper
AuthorsBellamy, N. (Author), Campbell, J. (Author), Gee, T. (Author), Robinson, V. (Author), Bourne, R. (Author) and Wells, G. (Author)
Editorsvan de Putte, L.
Journal or Proceedings TitleAnnals of the Rheumatic Diseases, vol. 64, Suppl. 3
Annals of the Rheumatic Diseases
Journal Citation64 (Supplement 3), pp. 492-492
Number of Pages1
Year2005
Place of PublicationNetherlands
ISSN0003-4967
1468-2060
Conference/EventAnnual European Congress of Rheumatology - EULAR 2005
Event Details
Annual European Congress of Rheumatology - EULAR 2005
Event Date
08 to end of 11 Jun 2005
Event Location
Vienna
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.

Keywordsosteoarthritis; knee
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020321402. Clinical pharmacology and therapeutics
Public Notes

File reproduced in accordance with the copyright policy of the publisher/author.

Byline AffiliationsUniversity of Queensland
University of Western Ontario, Canada
Griffith University
No affiliation
University of Ottawa, Canada
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