Heger Robert, Paulsen Günther, Fickert Ulrich, Kresmann Michael
Praxis für Orthopädie, Eltinger Straße 56 71229 Leonberg, Germany.
Chirurgische Gemeinschaftspraxis, Katharinenstr 34, 75031 Eppingen, Germany.
Open Rheumatol J. 2016 Oct 31;10:88-100. doi: 10.2174/1874312901610010088. eCollection 2016.
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.
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.
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.
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.
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。
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)。
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。
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。