A Cochrane review (update 2004): Hylan G-F 20 vs placebo for knee OA

Bellamy, N., Campbell, J., Robinson, V., Wells, G. A. and Bourne, R. B. (2004). A Cochrane review (update 2004): Hylan G-F 20 vs placebo for knee OA. In: R. D. Altman, Osteoarthritis & Cartilage. 9th World Congress of Osteoarthritis Res. Soc. Int., Chicago, (S31-S31). 2-5 December, 2004.


Author Bellamy, N.
Campbell, J.
Robinson, V.
Wells, G. A.
Bourne, R. B.
Title of paper A Cochrane review (update 2004): Hylan G-F 20 vs placebo for knee OA
Conference Paper Type Published Abstract
Conference name 9th World Congress of Osteoarthritis Res. Soc. Int.
DOI 10.1016/j.joca.2004.09.004
Conference location Chicago
Conference dates 2-5 December, 2004
Proceedings title Osteoarthritis & Cartilage    (ERA 2010 Rank A)   Check publisher's open access policy
Journal name Osteoarthritis and Cartilage    (ERA 2010 Rank A)   Check publisher's open access policy
Editor R. D. Altman
Place published U.S.A.
Publisher Elsevier
Publication date 2004
Volume number 12
Issue number Supplement 2
ISSN 1063-4584
Start page S31
End page S31
Total pages 1
Collection year 2004
Language eng
Abstract/Summary Aim of study: As part of a Cochrane review of viscosupplementation in knee OA, randomised controlled trials (RCT) were reviewed to evaluate evidence for the efficacy of viscosupplementation with Hylan G-F 20 compared to placebo. Methods: Electronic searches were conducted of MEDLINE, EMBASE, Premedline, Current Contents, and CENTRAL. Human, RCT involving Hylan G-F 20 compared to placebo, published prior to 1Q2004, were included. Trials were selected and data extracted by two independent reviewers. Methodological quality was assessed with the Jadad criteria by two reviewers. Data on the OARSI and OMERACT core set clinical outcome measures were extracted where possible. Weighted mean difference (WMD), based on post-test scores, and 95% confidence intervals (CI) were calculated for continuous outcome measures and relative risk (RR) for dichotomous outcome measures. Results: Seven RCT met the inclusion criteria. Median methodological quality was 4 (range 1–5). A further two studies were only reported in abstract form (Jadad score Z 1) and contained insufficient extractable data for inclusion in the analysis. Nine RCT, which compared Hylan G-F 20 to other interventions such as intra-articular corticosteroid, physiotherapy, NSAID, appropriate care, intra-articular gaseous oxygen and other hyaluronan, are not reported here. Twenty-three studies failed to meet inclusion criteria and were excluded. Hylan G-F 20 was more efficacious than placebo at 1–4 weeks post-injection for pain on weight-bearing WMD (random effects [RE]) 13 mm on a 0–100 mm VAS (P Z 0.002) based on 6 RCT. This difference was even greater at 5–13 weeks post-injection, 22 m (RE) (P Z 0.001) based on 5 RCT, and at 14–6 weeks postinjection, 21 m (RE) (P Z 0.006) based on 4 RCT. Hylan G-F 20 was more efficacious than placebo at 1–4 weeks post-injection for pain at night, WMD 7 mm on a 0–100 mm VAS (P Z 0.003) based on 5 RCT. This difference was even greater at 5–13 weeks post-injection, 11 mm (P Z 0.008) based on 4 RCT, and at 14–26 weeks post-injection, 17 mm (P ! 0.00001) based on 3 RCT. There was no significant difference (WMD 8 mm) between Hylan G-F 20 C oral placebo and arthrocentesis C oral placebo at 5–13 weeks post-injection for WOMAC Pain, but Hylan G-F 20 C oral placebo was more efficacious than arthrocentesis C oral placebo for WOMAC Function, WMD 9 mm on a 0–100 mm VAS (P Z 0.01) (Dickson, 2001). Hylan G-F 20 was more effective than placebo at 1–4 weeks postinjection for the variable designed treatment efficacy, WMD 22 mm on a 0–100 mm VAS (P ! 0.00001) based on improvement in 4 RCT. This difference was even greater at 5–13 weeks post injection, 35 mm (P ! 0.00001). Conclusions: Evidence from this updated Cochrane review supports the superior efficacy of Hylan G-F 20 compared to placebo on weight-bearing pain, night pain, function and treatment efficacy in the treatment of knee OA.
Subjects EX
321202 Epidemiology
730306 Evaluation of health outcomes
Q-Index Code EX

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Sub-type: Published Abstract
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