Combining two hyaluronic acids in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial

• Published in: Clinical rheumatology 2008-08, Vol.27 (8), p.975-981
• Main Authors: Petrella, Robert J., Cogliano, Anthony, Decaria, Joseph
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthritis; Dietary supplements; Double-Blind Method; Female; Humans; Hyaluronic Acid - chemistry; Hyaluronic Acid - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Molecular weight; Original Article; Osteoarthritis, Knee - drug therapy; Pain; Pain - drug therapy; Pain Measurement; Prospective Studies; Rheumatology; Viscosupplements - chemistry; Viscosupplements - therapeutic use
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-007-0834-4

Synovial fluid in patients may differ in molecular weight depending on the presence and degree of osteoarthritis. Treatment is not directed at this relationship. Patients with osteoarthritis of the knee with resting visual analogue scale (VAS) pain of >45 mm were included in a randomized, prospective, double-blind cohort followed for 16 weeks. Patients were randomized at baseline to receive a three intra-articular injection series with one of: dual molecular weight (DMW; 580–780 kDa + 1.2 to 2.0 million Da); low molecular weight (LMW; 500–730 kDa); high molecular weight (HMW; 6 million Da); or saline placebo over 3 weeks. Patients completed baseline assessment of rest and walking VAS pain (primary efficacy variable), collection of a 5-point categorical global satisfaction score, and record of adverse events. Two-hundred and twenty-five patients (age 68 ± 8 y) were screened and 200 were randomized to one of the four groups. There were no differences at baseline between groups. At 4, 12 and 16 weeks, respectively, walking VAS pain was significantly improved in all treatment groups vs. placebo: DMW (79.6%, p