Real-world impact of the high concentration non-avian high molecular weight hyaluronan on pain medication use among osteoarthritis patients

Abstract

Objective: A prior study found that hyaluronic acid (HA) treatment may help reduce pain medication use (such as steroids, non-steroidal anti-inflammatory drugs [NSAIDs] and opioids) among knee osteoarthritis (OA) patients in the real-world setting. This study aims to update the prior study results to include only the high concentration non-avian high molecular weight hyaluronan (HMW-HA) injectables using data from recent years.

Study design: This was a retrospective cohort study utilizing IBM MarketScan Commercial data from 2008 to 2015.

Methods: Commercially insured patients between 18 and 64 years of age who received high concentration non-avian HMW-HA (Orthovisc¹) between 1 January 2008 and 30 June 2015 were identified. Utilization of three prescription pharmacotherapies commonly used in the treatment for knee OA – NSAIDs, corticosteroid injections and opioids – in the 6 month pre and post periods was assessed. Utilization was measured as number of prescriptions and any prescription (yes/no). The independent variable was receiving the high concentration non-avian HMW-HA injection. Paired sample t-test and McNemar’s test were used to assess pre–post changes.

Results: The utilization of NSAIDs and steroids prescriptions was reduced significantly during the post period among the study cohort. The proportion of patients filling these prescriptions during the post period was also reduced (p < .001). In addition, the number of patients getting any opioid prescriptions was reduced significantly during the post period (p < .001).

Conclusions: Based on this retrospective cohort study, the high concentration non-avian HMW-HA may offer effective pain alleviation among knee OA patients while reducing prescription pain medications such as steroids, NSAIDs and opioids.

Keywords:

• High concentration non-avian high molecular weight hyaluronan
• osteoarthritis
• pain medication
• real-world data

Notes

Transparency

Author contributions

Concept and design (A.S.C., K.E., C.E.H., S.K.B.); acquisition of data (A.S.C., K.E.); analysis and interpretation of data (A.S.C., K.E., C.E.H., S.K.B., F.S.G., F.J.M., B.B.); drafting of the manuscript (A.S.C., K.E., C.E.H., S.K.B.); critical revision of the manuscript for important intellectual content (A.S.C., K.E., C.E.H., S.K.B., F.S.G., F.J.M., B.B.); statistical analysis (A.S.C., K.E.); obtaining funding (S.K.B.); and supervision (C.E.H., B.B., S.K.B.).

Declaration of financial/other relationships

A.S.C., C.E.H., K.E., B.B. and S.K.B. have disclosed that they are stockholders of Johnson and Johnson. F.S.G. and F.J.M. have disclosed that they have received lecture fees on Orthovisc. CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work but have no relevant financial or other relationships to disclose.

Acknowledgements

None reported

Notes

1 ORTHOVISC^® is registered to Anika Therapeutics, Inc.

Additional information

Funding

This study was funded by Johnson and Johnson, New Brunswick, NJ.