RT Journal Article
SR Electronic
T1 Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias
JF RMD Open
JO RMD Open
FD EULAR
SP e000071
DO 10.1136/rmdopen-2015-000071
VO 1
IS 1
A1 Pascal Richette
A1 Xavier Chevalier
A1 Hang Korng Ea
A1 Florent Eymard
A1 Yves Henrotin
A1 Paul Ornetti
A1 Jérémie Sellam
A1 Michel Cucherat
A1 Marc Marty
YR 2015
UL http://rmdopen.bmj.com/content/1/1/e000071.abstract
AB Background The effectiveness of intra-articular hyaluronic acid (IAHA) injection for knee osteoarthritis (KOA) is debated.Objectives To evaluate the effect of IAHA for patients with KOA by analysing data from trials of IAHA versus placebo with low risk of bias, to provide the highest level of evidence.Methods A systematic review and meta-analysis was conducted. Randomised controlled trials (RCTs) with a low risk of bias (adequate randomisation and concealment and double-blind design) that investigated IAHA versus placebo (saline solution) injection were eligible. The primary efficacy measure was pain intensity and secondary outcome function at 3 months. The treatment effect was summarised with the standardised mean difference (SMD) calculated from differences in means of pain and function measures between treatment and control groups at 3 months. Trials were pooled by a random-effects model with DerSimonian and Laird weights. Statistical heterogeneity was explored by a visual exploration of forest plots and the I2 statistic.Results A total of eight RCTs (2 199 randomised patients) met our inclusion criteria. IAHA significantly reduced the pain intensity (SMD=−0.21, 95% CI (95% CI) −0.32 to −0.10) and improved function (SMD=−0.12, 95% CI −0.22 to −0.02). Trials showed no heterogeneity.Conclusions This meta-analysis of high-quality trials of IAHA versus placebo shows that IAHA provides a moderate but real benefit for patients with KOA.