Southcoast Health Systems, New Bedford, MA, USA.
Premier Orthopaedics and Sports Medicine, Media, PA, USA.
Cartilage. 2021 Dec;13(1_suppl):1586S-1597S. doi: 10.1177/1947603520967076. Epub 2020 Oct 23.
Assess how treatment with the viscosupplement hylan G-F 20 relates to opioid prescriptions and intraarticular corticosteroid injections (IACS) in patients with osteoarthritis of the knee (OAK).
Case-crossover; adult patients with OAK identified in a claims database were treated with hylan G-F 20 from July 1, 2007, to June 29, 2017. Opioid or IACS prescriptions in the 6 months before treatment were compared to the 6 months after. Patients with comorbid conditions requiring pain medications were excluded, resulting in a 29,395-patient cohort. Four subgroups were investigated: patients with (1) opioids before hylan G-F 20 (OB; = 6,609); (2) opioids before and after hylan G-F 20 (OBF; = 3,320); (3) IACS before hylan G-F 20 (CB; = 11,162); and (4) IACS before and after hylan G-F 20 (CBF; = 2,810). All opioids were converted to morphine milligram equivalents (MME).
OB subgroup patients had a significant decrease ( < 0.01) in total MME (-14.0%), MME per day (-14.2%) and opioid prescription days (-12.6%) after treatment versus before. Only 50.2% of patients prescribed opioids before hylan G-F 20 were prescribed an opioid after treatment. OBF subgroup patients had a significant increase ( < 0.01) in opioid prescription days (7.8%) before versus after treatment. There was a significant decrease ( < 0.01) in the number of IACS after versus before treatment for the Total Cohort (-56.1%), and subgroups CB (-72.6%) and CBF (-4.1%). A total of 74.8% of patients receiving an IACS before treatment did not receive an IACS after treatment.
Hylan G-F 20 is associated with a reduction in opioid prescriptions and IACS in OAK patients.
评估膝关节骨关节炎（OAK）患者使用透明质酸 G-F 20 治疗与阿片类药物处方和关节内皮质类固醇注射（IACS）的关系。
病例交叉；从 2007 年 7 月 1 日至 2017 年 6 月 29 日，在索赔数据库中确定患有 OAK 的成年患者接受透明质酸 G-F 20 治疗。治疗前 6 个月和治疗后 6 个月的阿片类药物或 IACS 处方进行比较。排除有需要疼痛药物治疗的合并症的患者，最终得到 29395 例患者队列。研究了四个亚组：（1）在接受透明质酸 G-F 20 治疗前使用阿片类药物的患者（OB；n=6609）；（2）在接受透明质酸 G-F 20 治疗前后均使用阿片类药物的患者（OBF；n=3320）；（3）在接受透明质酸 G-F 20 治疗前使用 IACS 的患者（CB；n=11162）；（4）在接受透明质酸 G-F 20 治疗前后均使用 IACS 的患者（CBF；n=2810）。所有阿片类药物均转换为吗啡毫克当量（MME）。
OB 亚组患者在治疗后与治疗前相比，总 MME（-14.0%）、每日 MME（-14.2%）和阿片类药物处方天数（-12.6%）显著减少（<0.01）。仅 50.2%在接受透明质酸 G-F 20 治疗前开具阿片类药物处方的患者在治疗后开具阿片类药物处方。OBF 亚组患者在治疗前与治疗后相比，阿片类药物处方天数（7.8%）显著增加（<0.01）。总队列（-56.1%）和亚组 CB（-72.6%）和 CBF（-4.1%）在接受治疗后 IACS 的数量与接受治疗前相比显著减少。在治疗前接受 IACS 的患者中，有 74.8%的患者在治疗后未接受 IACS。
透明质酸 G-F 20 与 OAK 患者阿片类药物处方和 IACS 的减少相关。
