Display options
Cite
Richette P, Chevalier X, Ea HK, et al. Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias. RMD Open. 2015;1(1):e000071doi: 10.1136/rmdopen-2015-000071.
Richette, P., Chevalier, X., Ea, H. K., Eymard, F., Henrotin, Y., Ornetti, P., Sellam, J., Cucherat, M., & Marty, M. (2015). Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias. RMD open, 1(1), e000071. https://doi.org/10.1136/rmdopen-2015-000071
Richette, Pascal, et al. "Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias." RMD open vol. 1,1 (2015): e000071. doi: https://doi.org/10.1136/rmdopen-2015-000071
Richette P, Chevalier X, Ea HK, Eymard F, Henrotin Y, Ornetti P, Sellam J, Cucherat M, Marty M. Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias. RMD Open. 2015 May 14;1(1):e000071. doi: 10.1136/rmdopen-2015-000071. eCollection 2015. PMID: 26509069; PMCID: PMC4613148.
Copy Download .nbib Format: NLM
Share it on

RMD Open. 2015 May 14;1(1):e000071. doi: 10.1136/rmdopen-2015-000071. eCollection 2015.

Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias.

RMD open

Pascal Richette, Xavier Chevalier, Hang Korng Ea, Florent Eymard, Yves Henrotin, Paul Ornetti, Jérémie Sellam, Michel Cucherat, Marc Marty

Affiliations

  1. Université Paris Diderot, UFR Médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie , Paris , France ; Inserm U1132, Hôpital Lariboisière , Paris , France.
  2. Department of Rheumatology , Henri Mondor Hospital , Creteil , France.
  3. Cartilage Bone and Cartilage Research Unit , Arthropôle Liège, University of Liège, Institute of Pathology , Liège , Belgium.
  4. INSERM U1093, Plateforme d'Investigation Technologique, CHU Dijon, Université de Bourgogne , Dijon , France.
  5. Rheumatology Department , Assistance Publique-Hôpitaux de Paris (AP-HP), DHU i2B, Inserm UMRS_938, UPMC Univ Paris 06 , Paris , France.
  6. UMR 5558; CNRS, 69622 Villeurbanne Cedex , Lyon , France.

PMID: 26509069 PMCID: PMC4613148 DOI: 10.1136/rmdopen-2015-000071

Abstract

BACKGROUND: The effectiveness of intra-articular hyaluronic acid (IAHA) injection for knee osteoarthritis (KOA) is debated.

OBJECTIVES: To evaluate the effect of IAHA for patients with KOA by analysing data from trials of IAHA versus placebo with low risk of bias, to provide the highest level of evidence.

METHODS: A systematic review and meta-analysis was conducted. Randomised controlled trials (RCTs) with a low risk of bias (adequate randomisation and concealment and double-blind design) that investigated IAHA versus placebo (saline solution) injection were eligible. The primary efficacy measure was pain intensity and secondary outcome function at 3 months. The treatment effect was summarised with the standardised mean difference (SMD) calculated from differences in means of pain and function measures between treatment and control groups at 3 months. Trials were pooled by a random-effects model with DerSimonian and Laird weights. Statistical heterogeneity was explored by a visual exploration of forest plots and the I(2) statistic.

RESULTS: A total of eight RCTs (2 199 randomised patients) met our inclusion criteria. IAHA significantly reduced the pain intensity (SMD=-0.21, 95% CI (95% CI) -0.32 to -0.10) and improved function (SMD=-0.12, 95% CI -0.22 to -0.02). Trials showed no heterogeneity.

CONCLUSIONS: This meta-analysis of high-quality trials of IAHA versus placebo shows that IAHA provides a moderate but real benefit for patients with KOA.

Keywords: Osteoarthritis; Outcomes research; Treatment

References

  1. J Fam Pract. 2005 Sep;54(9):758-67 - PubMed
  2. J Fam Pract. 2006 Aug;55(8):669-75 - PubMed
  3. JAMA. 2003 Aug 27;290(8):1062-70 - PubMed
  4. J Bone Joint Surg Am. 2013 Oct 16;95(20):1885-6 - PubMed
  5. Ann Rheum Dis. 2014 Jul;73(7):1323-30 - PubMed
  6. Osteoarthritis Cartilage. 1993 Oct;1(4):233-41 - PubMed
  7. BMJ. 2011 Jul 22;343:d4002 - PubMed
  8. Scand J Rheumatol. 2008 Mar-Apr;37(2):142-50 - PubMed
  9. Osteoarthritis Cartilage. 2008 Feb;16(2):137-62 - PubMed
  10. Ann Rheum Dis. 2011 Nov;70(11):1957-62 - PubMed
  11. Ann Rheum Dis. 2003 Dec;62(12):1145-55 - PubMed
  12. Osteoarthritis Cartilage. 2014 Mar;22(3):363-88 - PubMed
  13. CMAJ. 2005 Apr 12;172(8):1039-43 - PubMed
  14. JAMA. 2003 Dec 17;290(23):3115-21 - PubMed
  15. BMJ. 2009 Jul 21;339:b2535 - PubMed
  16. Semin Arthritis Rheum. 2014 Apr;43(5):593-9 - PubMed
  17. Lancet. 1999 May 15;353(9165):1680 - PubMed
  18. JAMA. 1995 Feb 1;273(5):408-12 - PubMed
  19. PLoS One. 2013 Jul 05;8(7):e66844 - PubMed
  20. Semin Arthritis Rheum. 2009 Aug;39(1):1-9 - PubMed
  21. PLoS One. 2013 Nov 27;8(11):e81823 - PubMed
  22. BMJ. 2003 Sep 6;327(7414):557-60 - PubMed
  23. J Rheumatol. 2006 May;33(5):951-6 - PubMed
  24. Clin Med Insights Arthritis Musculoskelet Disord. 2013 Sep 01;6:57-63 - PubMed
  25. Ryumachi. 1983 Aug;23(4):280-90 - PubMed
  26. Best Pract Res Clin Rheumatol. 2014 Feb;28(1):5-15 - PubMed
  27. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD004257 - PubMed
  28. Lancet. 2013 Aug 31;382(9894):769-79 - PubMed
  29. Osteoarthritis Cartilage. 2011 Jun;19(6):611-9 - PubMed
  30. Stat Med. 2000 Nov 30;19(22):3127-31 - PubMed
  31. BMJ. 2001 Jul 7;323(7303):42-6 - PubMed
  32. BMJ. 2011 Mar 08;342:d1165 - PubMed
  33. Joint Bone Spine. 2014 Jan;81(1):4-5 - PubMed
  34. Ann Intern Med. 2012 Aug 7;157(3):180-91 - PubMed
  35. J Pain. 2008 Feb;9(2):105-21 - PubMed
  36. Nat Rev Rheumatol. 2012 Nov;8(11):635-6 - PubMed
  37. J Bone Joint Surg Am. 2004 Mar;86-A(3):538-45 - PubMed
  38. Clin Exp Rheumatol. 2008 Sep-Oct;26(5 Suppl 51):S120-4 - PubMed
  39. Ann Rheum Dis. 2010 Jan;69(1):113-9 - PubMed
  40. JAMA. 1995 Nov 8;274(18):1456-8 - PubMed
  41. N Engl J Med. 1982 Jun 3;306(22):1332-7 - PubMed
  42. Arthritis Care Res (Hoboken). 2012 Apr;64(4):465-74 - PubMed
  43. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD005321 - PubMed
  44. Arthritis Rheum. 2000 Sep;43(9):1905-15 - PubMed
  45. Semin Arthritis Rheum. 2014 Dec;44(3):253-63 - PubMed
  46. Osteoarthritis Cartilage. 2004 Aug;12(8):642-9 - PubMed

Publication Types