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透明质酸钠凝胶(Hylan G-F 20)治疗有症状的膝关节骨关节炎患者初始及重复治疗周期的开放标签研究。

Open-label Study of Initial and Repeat Treatment Cycles of Hylan G-F 20 in Patients with Symptomatic Knee Osteoarthritis.

作者信息

Heger Robert, Paulsen Günther, Fickert Ulrich, Kresmann Michael

机构信息

Praxis für Orthopädie, Eltinger Straße 56 71229 Leonberg, Germany.

Chirurgische Gemeinschaftspraxis, Katharinenstr 34, 75031 Eppingen, Germany.

出版信息

Open Rheumatol J. 2016 Oct 31;10:88-100. doi: 10.2174/1874312901610010088. eCollection 2016.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of initial and repeat treatment with hylan G-F 20 in patients with symptomatic osteoarthritis (OA) of the knee.

METHODS

A prospective, multicenter, open-label study in adult patients with symptomatic knee OA (Kellgren-Lawrence grades I-III) undergoing repeat (SC group) or initial (IC group) treatment courses (3 x 2 mL of hylan G-F 20 at weekly intervals) was conducted with a maximum follow-up of 26 weeks. Reduction of pain using the Verbal Pain Questionnaire (VPQ) and Patient Global Assessment (PTGA) scores, concomitant pain medications use, and adverse events (AEs) were evaluated.

RESULTS

A total of 842 patients were included (SC group, n=314; IC group, n=528), of whom 616 formed the intent-to-treat (ITT) population (SC group, n=235; IC group, n=381). Of the 462 patients with follow-up at week 26, 311 (67.3%) were defined as responders. In the ITT population, VPQ scores decreased significantly at 26 weeks (p<0.001) compared with baseline. VPQ and PTGA scores decreased significantly (p<0.001) from baseline at all time points, without any significant changes in concomitant medication use. Twenty-four treatment-related AEs (TEAEs) were reported in 2.9% of patients, with most being mild or moderate in intensity and resolving without sequelae.

CONCLUSION

Initial and repeat courses of hylan G-F 20 were effective with a favorable safety profile for knee OA. The large patient population and the study's pragmatic design suggest that these results could be replicated in routine clinical practice.

摘要

目的

评估透明质酸钠G-F 20初始治疗和重复治疗对症状性膝关节骨关节炎(OA)患者的疗效及安全性。

方法

对有症状的膝关节OA(Kellgren-Lawrence分级I-III级)成年患者进行一项前瞻性、多中心、开放标签研究,这些患者接受重复(SC组)或初始(IC组)治疗疗程(每周一次,每次3×2 mL透明质酸钠G-F 20),最长随访26周。使用言语疼痛问卷(VPQ)和患者整体评估(PTGA)评分评估疼痛减轻情况、伴随的止痛药物使用情况以及不良事件(AE)。

结果

共纳入842例患者(SC组,n = 314;IC组,n = 528),其中616例构成意向性治疗(ITT)人群(SC组,n = 235;IC组,n = 381)。在第26周有随访的462例患者中,311例(67.3%)被定义为有反应者。在ITT人群中,与基线相比,第26周时VPQ评分显著降低(p < 0.001)。在所有时间点,VPQ和PTGA评分与基线相比均显著降低(p < 0.001),伴随药物使用无任何显著变化。2.9%的患者报告了24例与治疗相关的不良事件(TEAE),大多数为轻度或中度,且无后遗症地缓解。

结论

透明质酸钠G-F 20的初始和重复疗程对膝关节OA有效且安全性良好。大量的患者人群和该研究的实用设计表明,这些结果可在常规临床实践中复制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dcd/5101633/3ef16cce0ac1/TORJ-10-88_F1.jpg

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