Skip to main content
Top
Published in: MUSCULOSKELETAL SURGERY 1/2017

01-04-2017 | Original Article

Clinical comparison of oral administration and viscosupplementation of hyaluronic acid (HA) in early knee osteoarthritis

Authors: M. Ricci, G. M. Micheloni, M. Berti, F. Perusi, E. Sambugaro, E. Vecchini, B. Magnan

Published in: MUSCULOSKELETAL SURGERY | Issue 1/2017

Login to get access

Abstract

Purpose

Osteoarthritis (OA) is a progressive, chronic and degenerative joint disease characterized by a loss of articular cartilage. Treatment of OA is largely palliative based on nonsteroidal anti-inflammatory drugs, opioids and injections of steroids. Regarding conservative treatment, intra-articular injections of hyaluronic acid (HA) can play a role in early symptomatic knee OA.

Materials and methods

Between August 2015 and September 2015, sixty patients (32 males and 28 females) between 40 and 70 years old were randomly allocated into two groups: Half were treated with three weekly intra-articular injections of hyaluronic acid 1.6 % (group A), while the others were treated with Syalox 300 Plus® (hyaluronic acid 300 mg + Boswellia serrata extract 100 mg) 1 tab/die for 20 days and afterward Syalox 150® (hyaluronic acid 150 mg) 1 tab/die for other 20 days (group B). All patients were evaluated clinically with American Knee Society Score (AKSS) and visual analogue scale (VAS) for the pain before the treatment and after 3 months.

Results

AKSS of the patients in both groups was significantly increased by the treatment, and VAS score was significantly reduced. In both groups, two subgroups were created with patients older than 60 years and patients younger than 60 years. Better results are reported in younger patients of group A and older subjects in group B.

Conclusions

Despite several limitations, the results of the study have shown that HA injection and oral administration may have beneficial therapeutic effects on patients with early osteoarthritis. Different outcomes in younger and older subject suggested a combined therapy first with local infiltrations and then with oral composition.
Literature
1.
go back to reference Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G (2005) A metaanalysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthr Cartil 13(9):769–781CrossRefPubMed Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G (2005) A metaanalysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthr Cartil 13(9):769–781CrossRefPubMed
2.
go back to reference Loeser RF Jr (2000) Aging and the etiopathogenesis and treatment of osteoarthritis. Rheum Dis Clin N Am 26(3):547–567CrossRef Loeser RF Jr (2000) Aging and the etiopathogenesis and treatment of osteoarthritis. Rheum Dis Clin N Am 26(3):547–567CrossRef
4.
go back to reference Poulet B, Staines KA (2016) New developments in osteoarthritis and cartilage biology. Curr Opin Pharmacol 28:8–13CrossRefPubMed Poulet B, Staines KA (2016) New developments in osteoarthritis and cartilage biology. Curr Opin Pharmacol 28:8–13CrossRefPubMed
5.
go back to reference Mayer K, Palemer J (1934) The polysaccharide of the vitreoushumor. J Biol Chem 107:629–637 Mayer K, Palemer J (1934) The polysaccharide of the vitreoushumor. J Biol Chem 107:629–637
6.
go back to reference (2000) Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American college of rheumatology subcommittee on osteoarthritis guidelines. Arthritis Rheum 43(9):1905–1915 (2000) Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American college of rheumatology subcommittee on osteoarthritis guidelines. Arthritis Rheum 43(9):1905–1915
7.
go back to reference Sato T, Iwaso H (2008) An effectiveness study of hyaluronic acid (Hyabest J) in the treatment of osteoarthritis of the knee. J New Remedies Clin 57(2):260–269 (Japanese) Sato T, Iwaso H (2008) An effectiveness study of hyaluronic acid (Hyabest J) in the treatment of osteoarthritis of the knee. J New Remedies Clin 57(2):260–269 (Japanese)
8.
go back to reference Sato T, Iwaso H (2009) An effectiveness study of hyaluronic acid (Hyabest J) in the treatment of osteoarthritis of the knee on the patint in the United States. J New Remedies Clin 58(3):551–558 (Japanese) Sato T, Iwaso H (2009) An effectiveness study of hyaluronic acid (Hyabest J) in the treatment of osteoarthritis of the knee on the patint in the United States. J New Remedies Clin 58(3):551–558 (Japanese)
9.
go back to reference Iwaso H, Sato T (2009) Examination of the efficacy and safety of oral administration of Hyabest J, highly pure hyaluronic acid, for knee joint pain. J Jpn Soc Clin Sports Med 17(3):566–572 Iwaso H, Sato T (2009) Examination of the efficacy and safety of oral administration of Hyabest J, highly pure hyaluronic acid, for knee joint pain. J Jpn Soc Clin Sports Med 17(3):566–572
10.
go back to reference Nagaoka I, Nabeshima K, Murakami S et al (2010) Evaluation of the effects of a supplementary diet containing chicken comb extract on symptoms and cartilage metabolism in patients with knee osteoarthritis. Exp Ther Med 1(5):817–827PubMedPubMedCentral Nagaoka I, Nabeshima K, Murakami S et al (2010) Evaluation of the effects of a supplementary diet containing chicken comb extract on symptoms and cartilage metabolism in patients with knee osteoarthritis. Exp Ther Med 1(5):817–827PubMedPubMedCentral
11.
go back to reference Balazs EA, Denlinger JL (1993) Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl 39:3–9PubMed Balazs EA, Denlinger JL (1993) Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl 39:3–9PubMed
12.
go back to reference Ghosh P, Guidolin D (2002) Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular weight dependent? Semin Arthritis Rheum 32(1):10–37CrossRefPubMed Ghosh P, Guidolin D (2002) Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular weight dependent? Semin Arthritis Rheum 32(1):10–37CrossRefPubMed
13.
go back to reference Zhou PH, Liu SQ, Peng H (2008) The effect of hyaluronic acid on IL-1beta-induced chondrocyte apoptosis in a rat model of osteoarthritis. J Orthop Res 26(12):1643e8CrossRef Zhou PH, Liu SQ, Peng H (2008) The effect of hyaluronic acid on IL-1beta-induced chondrocyte apoptosis in a rat model of osteoarthritis. J Orthop Res 26(12):1643e8CrossRef
14.
go back to reference Lurati A, Laria A, Mazzocchi D, Re KA, Marrazza M, Scarpellini M (2015) Effects of hyaluronic acid (HA) viscosupplementation on peripheral Th cells in knee and hip osteoarthritis. Osteoarthr Cartil 23(1):88–93CrossRefPubMed Lurati A, Laria A, Mazzocchi D, Re KA, Marrazza M, Scarpellini M (2015) Effects of hyaluronic acid (HA) viscosupplementation on peripheral Th cells in knee and hip osteoarthritis. Osteoarthr Cartil 23(1):88–93CrossRefPubMed
15.
go back to reference Jevsevar D, Donnelly P, Brown GA, Cummins DS (2015) Viscosupplementation for osteoarthritis of the knee: a systematic review of the evidence. J Bone Joint Surg Am 97(24):2047–2060CrossRefPubMed Jevsevar D, Donnelly P, Brown GA, Cummins DS (2015) Viscosupplementation for osteoarthritis of the knee: a systematic review of the evidence. J Bone Joint Surg Am 97(24):2047–2060CrossRefPubMed
16.
go back to reference Kajimoto O, Odanaka Y, Sakamoto W, Yoshida K, Takahashi T (2001) Clinical effects of dietary hyaluronic acid on dry skin. J New Remedies Clin 50(4):548–560 Kajimoto O, Odanaka Y, Sakamoto W, Yoshida K, Takahashi T (2001) Clinical effects of dietary hyaluronic acid on dry skin. J New Remedies Clin 50(4):548–560
17.
go back to reference Sato T, Sakamoto W, Odanaka W, Yoshida K, Urushibara O (2002) Clinical effects of dietary hyaluronic acid on dry, rough skin. Aesthet Dermatol 12:109–120 Sato T, Sakamoto W, Odanaka W, Yoshida K, Urushibara O (2002) Clinical effects of dietary hyaluronic acid on dry, rough skin. Aesthet Dermatol 12:109–120
18.
go back to reference Balogh L, Polyak A, Mathe D, Kiraly R, Thuroczy J, Therez M et al (2008) Absorption, uptake and tissue affinity of high-molecular-weight hyaluronan after oral administration in rats and dogs. J Agric Food Chem 56(22):10582–10593CrossRefPubMed Balogh L, Polyak A, Mathe D, Kiraly R, Thuroczy J, Therez M et al (2008) Absorption, uptake and tissue affinity of high-molecular-weight hyaluronan after oral administration in rats and dogs. J Agric Food Chem 56(22):10582–10593CrossRefPubMed
19.
go back to reference Nelson FR, Zyrbulis RA, Zonca B, Li KW, Turner SM, Pasierb M et al (2015) The effects of an oral preparation containing hyaluronic acid (Oralvisc®) on obese knee osteoarthritis patients determined by pain, function, bradykinin, leptin, infiammatory cytokines, and heavy water analyses. Rheumatol Int 35(1):43–52CrossRefPubMed Nelson FR, Zyrbulis RA, Zonca B, Li KW, Turner SM, Pasierb M et al (2015) The effects of an oral preparation containing hyaluronic acid (Oralvisc®) on obese knee osteoarthritis patients determined by pain, function, bradykinin, leptin, infiammatory cytokines, and heavy water analyses. Rheumatol Int 35(1):43–52CrossRefPubMed
20.
go back to reference Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N (2012) Oral administartion of plymer hyaluronic acid alleviates symptoms of knee osteartritis: a double-blind, placebo-controlled study over a 12-month period. Sci World J 167928 Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N (2012) Oral administartion of plymer hyaluronic acid alleviates symptoms of knee osteartritis: a double-blind, placebo-controlled study over a 12-month period. Sci World J 167928
21.
go back to reference Kimmatkar N, Thawani V, Hingorani L, Khiyani R (2003) Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee: a randomized double blind placebo controlled trial. Phytomedicine 10:3–7CrossRefPubMed Kimmatkar N, Thawani V, Hingorani L, Khiyani R (2003) Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee: a randomized double blind placebo controlled trial. Phytomedicine 10:3–7CrossRefPubMed
23.
go back to reference Sengupta K, Alluri KV, Satish AR, Mishra S, Golakoti T, Sarma KV et al (2008) A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther 10:R85CrossRefPubMedPubMedCentral Sengupta K, Alluri KV, Satish AR, Mishra S, Golakoti T, Sarma KV et al (2008) A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther 10:R85CrossRefPubMedPubMedCentral
24.
go back to reference Sengupta K, Krishnaraju AV, Vishal AA, Mishra A, Trimurtulu G, Sarma KV et al (2010) Comparative efficacy and tolerability of 5-Loxin and Aflapin Against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 7:366–377CrossRefPubMedPubMedCentral Sengupta K, Krishnaraju AV, Vishal AA, Mishra A, Trimurtulu G, Sarma KV et al (2010) Comparative efficacy and tolerability of 5-Loxin and Aflapin Against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 7:366–377CrossRefPubMedPubMedCentral
25.
go back to reference Sengupta K, Kolla JN, Krishnaraju AV, Yalamanchili N, Rao CV, Golakoti T et al (2011) Cellular and molecular mechanisms of anti-inflammatory effect of Aflapin: a novel Boswellia serrata extract. Mol Cell Biochem 354:189–197CrossRefPubMed Sengupta K, Kolla JN, Krishnaraju AV, Yalamanchili N, Rao CV, Golakoti T et al (2011) Cellular and molecular mechanisms of anti-inflammatory effect of Aflapin: a novel Boswellia serrata extract. Mol Cell Biochem 354:189–197CrossRefPubMed
26.
go back to reference Vishal AA, Mishra A, Raychaudhuri SP (2011) A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. Int J Med Sci 8:615–622CrossRefPubMedPubMedCentral Vishal AA, Mishra A, Raychaudhuri SP (2011) A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. Int J Med Sci 8:615–622CrossRefPubMedPubMedCentral
Metadata
Title
Clinical comparison of oral administration and viscosupplementation of hyaluronic acid (HA) in early knee osteoarthritis
Authors
M. Ricci
G. M. Micheloni
M. Berti
F. Perusi
E. Sambugaro
E. Vecchini
B. Magnan
Publication date
01-04-2017
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 1/2017
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-016-0428-x

Other articles of this Issue 1/2017

MUSCULOSKELETAL SURGERY 1/2017 Go to the issue