Orthopedics. 2022 Jan-Feb;45(1):13-18. doi: 10.3928/01477447-20211229-01. Epub 2022 Jan 1.
In Japan, hyaluronic acid (HA) is often used to treat patients with relatively mild knee osteoarthritis (OA). The use of HA in and the physique and lifestyle of the Japanese population differ from those of other populations. Therefore, clinical reports of HA from around the world must be interpreted with caution for application in Japan. We compared the clinical efficacy of two HA products, with average molecular weights of 900,000 (HA90) and 1.9 million (HA190), for Japanese patients with knee OA. There were 49 patients and 54 knees (27 patients received both HA90 and HA190 injections). We used a disease-specific/patient standing-type knee OA function evaluation scale that was developed earlier and later improved considering the uniqueness of the Japanese lifestyle. The assigned HA product was injected into the joints of patients with knee OA with Kellgren-Lawrence classification system grades I to III once a week, for 5 consecutive weeks. Effects were subjectively self-evaluated using the Japanese Knee Osteoarthritis Measure (JKOM) and a visual analog scale. The average age of the patients was 65.4 years (range, 42-88 years). Both HA products alleviated walking pain and improved JKOM scores, and symptoms continued to improve with continued injections for 6 months. The continued administration of HA90 improved general activity more than that of HA190. In contrast, HA190 improved initial pain more, but its continued administration did not contribute to improving general activity. These results suggest that it may be effective to use different HA products depending on the symptoms and conditions of patients with knee OA. [. 2022;45(1):13-18.].
在日本,常用于治疗膝关节骨关节炎(OA)相对较轻的患者的药物是透明质酸(HA)。HA 在日本人群中的使用情况、体质和生活方式与其他人群不同。因此,世界各地关于 HA 的临床报告在日本应用时必须谨慎解读。我们比较了两种 HA 产品(平均分子量分别为 900,000(HA90)和 1.9 百万(HA190))对日本膝 OA 患者的临床疗效。共有 49 例患者和 54 个膝关节(27 例患者同时接受 HA90 和 HA190 注射)。我们使用了一种较早开发的、后来又根据日本生活方式的独特性进行了改进的膝关节 OA 功能评估量表,该量表具有疾病特异性/患者站立型。将 HA 产品按照关节内注射方案注入膝关节 OA 患者的膝关节内(Kellgren-Lawrence 分级系统 I 至 III 级),每周一次,连续 5 周。使用日本膝关节骨关节炎量表(JKOM)和视觉模拟评分法对患者的治疗效果进行主观自评。患者的平均年龄为 65.4 岁(范围,42-88 岁)。两种 HA 产品均能减轻患者的行走疼痛,改善 JKOM 评分,且持续注射 6 个月后症状持续改善。HA90 的持续给药比 HA190 更能改善一般活动能力。相反,HA190 能更迅速地改善初始疼痛,但持续给药对改善一般活动能力并无帮助。这些结果表明,根据膝 OA 患者的症状和病情,使用不同的 HA 产品可能会更有效。[。2022;45(1):13-18。]。