Managing joint pain in osteoarthritis: safety and efficacy of hylan G-F 20

Figures & data

Table 1 Commercially available viscosupplements

Product	Molecular weight (× 105 d)	Hyaluronic acid concentration (mg/mL)	Proven duration of action (weeks)	Dosing regimen	Approximate cost (1 course)
Synvisc	60 (cross-linked)	8	26	3-weekly injections	$589
Euflexxa	24–36	10	12	3-weekly injections	$437
Hyalgan	5.0–7.3	10	8.5 (3 injections) 26 (5 injections)	3- to 5-weekly injections	$524
Supartz	6.2–11.7	10	14 (3 injections) 26 (5 injections)	3- to 5-weekly injections	$533
Orthovisc	>10	15	22	3-weekly injections	$543

Table 2 Prospective, randomized, placebo-controlled trials of hylan G-F 20 for treatment of osteoarthritis of the knee

Study	N	Intervention	Duration of study	Outcome measures	Outcomes
Scale et al^Citation44	80	Study 1: hylan G-F 20, 2 injections vs placebo Study 2: hylan G-F 20, 3 injections vs placebo	12 weeks	VAS, activity level, physician global assessment	Significant improvement in VAS, activity level, most painful knee improvement, physician global assessment in the treatment group compared with placebo at 12 weeks
Wobig et al^Citation38	110	Hylan G-F 20, 3 injections vs placebo	26 weeks	VAS pain scale, VAS functional scale	Significant improvement in all parameters in treatment group; less use of “rescue therapy” in treatment group
Dickson et al^Citation45	165	Hylan G-F 20 vs diclofenac vs arthrocentesis plus oral placebo	12 weeks	WOMAC A pain	Significant improvement in WOMAC A pain categories
Karlsson et al^Citation40		Hylan G-F 20, 3 injections vs placebo	52 weeks	VAS, Kaplan-Meier Survival, SF-36, WOMAC, Lequesne algofunctional index	No difference in outcome between treatment group and placebo at 52 weeks

Abbreviations: VAS, visual analog scale; WOMAC, Western Ontario McMasters University Osteoarthritis Index.

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DicksonDJHosieGEnglishJRA double-blind, placebo-controlled comparison of hylan G-F 20 against diclofenac in knee osteoarthritisJ Clin Res200144152

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KarlssonJSjögrenSLohmanderLSComparison of two hyaluronan drugs and placebo in patients with knee osteoarthritis: a controlled, randomized, double-blind, parallel-design multicentre studyRheumatology (Oxford)200241111240124812421996

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