Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 6/2009

Open Access 01-12-2009 | Research article

Comparative, double-blind, controlled study of intra-articular hyaluronic acid (Hyalubrix®) injections versus local anesthetic in osteoarthritis of the hip

Authors: Alberto Migliore, Umberto Massafra, Emanuele Bizzi, Francesca Vacca, Severino Martin-Martin, Mauro Granata, Andrea Alimonti, Sandro Tormenta

Published in: Arthritis Research & Therapy | Issue 6/2009

Login to get access

Abstract

Introduction

Comparison of intra-articular bacterial-derived hyaluronic acid (Hyalubrix®) (HA) with local analgesia (mepivacaine) for osteoarthritis (OA) of the hip.

Methods

A pilot prospective, double-blind, 6-month randomized trial of 42 patients with hip OA. HA or mepivacaine was administered twice (once a month) under ultrasound guidance. Efficacy measurements included the Lequesne's algofunctional index, a visual analog scale for pain, concomitant use of analgesia, patient and physician global measurement, and safety.

Results

Patients in the HA group exhibited a significantly reduced Lequesne's algofunctional index 3 and 6 months after treatment (P < 0.001) and significantly reduced visual analog scale pain scores 3 and 6 months after treatment (P < 0.05) compared with the local anesthetic group. All primary and secondary measures were significantly improved versus baseline, but other than the above were not different from each other at 3 or 6 months. Adverse effects were minimal.

Conclusions

This comparative study suggests a beneficial effect and safety of intra-articular HA in the management of hip OA.

Trial registration number

ISRCTN39397064.
Appendix
Available only for authorised users
Literature
1.
Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998, 41: 778-799. 10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V.CrossRefPubMed
2.
National Center for Health Statistics: Prevalence of osteoarthritis in adults by age, sex, race and geographic area: United States 1960-62. Vital and Health Statistics no. 15, series 11. 1966, Washington, DC: Government Printing Office
3.
American College of Rheumatology Subcommittee on Osteoarthritis Guidelines: Recommendation for the medical management of osteoarthritis of hip and knee: 2000 update. Arthritis Rheum. 2000, 43: 1905-1915. 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-P.CrossRef
4.
Helin-Salmivaara A, Saarelainen S, Grönroos JM, Vesalainen R, Klaukka T, Huupponen R: Risk of upper gastrointestinal events with the use of various NSAIDs: a case-control study in a general population. Scand J Gastroenterol. 2007, 42: 923-932. 10.1080/00365520701192326.CrossRefPubMed
5.
Meagher EA: Cardiovascular and renovascular implications of COX-2 inhibition [review]. Curr Pharm Des. 2004, 10: 603-611. 10.2174/1381612043453153.CrossRefPubMed
6.
Joshi GP, Gertler R, Fricker R: Cardiovascular thromboembolic adverse effects associated with cyclooxygenase-2 selective inhibitors and nonselective antiinflammatory drugs [review]. Anesth Analg. 2007, 105: 1793-1804. 10.1213/01.ane.0000286229.05723.50. table of contentsCrossRefPubMed
7.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P: OARSI recommendations for the management of hip and knee osteoarthritis. Part II: OARSI evidence-based, expert consensus guidelines [review]. Osteoarthritis Cartilage. 2008, 16: 137-162. 10.1016/j.joca.2007.12.013.CrossRefPubMed
8.
Bekerom van der M, Lamme B, Sermon A, Mulier M: What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature. Arch Orthop Trauma Surg. 2008, 128: 815-823. 10.1007/s00402-007-0447-z.CrossRefPubMed
9.
Adams ME, Atkinson MH, Lussier AJ, Schulz JI, Siminovitch KA, Wade JP, Zummer M: The role of viscosupplementation with Hylan G-F 20 (Synvisc) in the treatment of osteoarthritis of the knee: a Canadian multicenter trial comparing Hylan G-F 20 alone, Hylan G-F 20 with non-steroidal anti-inflammatory drugs (NSAIDs) and NSAIDs alone. Osteoarthritis Cartilage. 1995, 3: 213-226. 10.1016/S1063-4584(05)80013-5.CrossRefPubMed
10.
Altman RD, Moskowitz R: Intra-articular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomised clinical trial. J Rheumatol. 1998, 25: 2203-2212.PubMed
11.
Qvistgaard E, Kristoffersen H, Terslev L, Danneskiold-Samsoe B, Torppedersen S, Bliddal H: Guidance by ultrasound of intra-articular injections in the knee and hip joints. Osteoarthritis Cartilage. 2001, 9: 512-517. 10.1053/joca.2001.0433.CrossRefPubMed
12.
Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G: Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006, CD005328-2
13.
Aggarwal A, Sempowski IP: Hyaluronic acid injections for knee osteoarthritis. Systematic review of the literature. Can Fam Physician. 2004, 50: 249-256.PubMedCentralPubMed
14.
HYAP15 (Hyalubrix®) Clinical Investigator's Brochure; Fidia S.p.A, Padova, Italy. 2004
15.
Zuniga JR, Ibanez C, Kozacko M: The analgesic efficacy and safety of intra-articular morphine and mepivicaine following temporomandibular joint arthroplasty. J Oral Maxillofac Surg. 2007, 65: 1477-1485. 10.1016/j.joms.2007.04.001.CrossRefPubMed
16.
Crawford RW, Gie GA, Ling RS, Murray DW: Diagnostic value of intra-articular anaesthetic in primary osteoarthritis of the hip. J Bone Joint Surg Br. 1998, 80: 279-281. 10.1302/0301-620X.80B2.8299.CrossRefPubMed
17.
Kleiner JB, Thorne RP, Curd JG: The value of bupivicaine hip injection in the differentiation of coxarthrosis from lower extremity neuropathy. J Rheumatol. 1991, 18: 422-427.PubMed
18.
Migliore A, Martin LS, Alimonti A, Valente C, Tormenta S: Efficacy and safety of viscosupplementation by ultrasound-guided intra-articular injection in osteoarthritis of the hip. Osteoarthritis Cartilage. 2003, 11: 305-306. 10.1016/S1063-4584(03)00008-6.CrossRefPubMed
19.
Migliore A, Tormenta S, Martin Martin LS, Valente C, Massafra U, Latini A, Alimonti A: Safety profile of 185 ultrasound-guided intra-articular injections for treatment of rheumatic diseases of the hip. Reumatismo. 2004, 56: 104-109. [in Italian]PubMed
20.
Pham T, Heijde van der D, Altman RD, Anderson JJ, Bellamy N, Hochberg M, Simon L, Strand V, Woodworth T, Dougados M: OMERACT-OARSI initiative: Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials revisited. Osteoarthritis Cartilage. 2004, 12: 389-399. 10.1016/j.joca.2004.02.001.CrossRefPubMed
21.
Conrozier T, Vignon E: Is there evidence to support the inclusion of viscosupplementation in the treatment paradigm for patients with hip osteoarthritis [review]. Clin Exp Rheumatol. 2005, 23: 711-716.PubMed
22.
Fernández López JC, Ruano-Ravina A: Efficacy and safety of intraarticular hyaluronic acid in the treatment of hip osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2006, 14: 1306-1311. 10.1016/j.joca.2006.08.003.CrossRefPubMed
23.
Qvistgaard E, Christensen R, Torp-Pedersen S, Bliddal H: Intra-articular treatment of hip osteoarthritis: a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage. 2006, 14: 163-170. 10.1016/j.joca.2005.09.007.CrossRefPubMed
24.
Tikiz C, Unlu Z, Sener A, Efe M: Comparison of the efficacy of lower and higher molecular weight viscosupplementation in the treatment of hip osteoarthritis. Clin Rheumatol. 2005, 24: 244-250. 10.1007/s10067-004-1013-5.CrossRefPubMed
25.
Conrozier T, Bertin P, Mathieu P, Charlot J, Bailleul F, Treves R, Vignon E, Chevalier X: Intra-articular injections of hylan G-F 20 in patients with symptomatic hip osteoarthritis: an open label, multicentre, pilot study. Clin Exp Rheumatol. 2003, 21: 605-610.PubMed
26.
Karson AS, Bates DW: Screening for adverse events. J Eval Clin Pract. 1999, 5: 23-32. 10.1046/j.1365-2753.1999.00158.x.CrossRefPubMed
27.
Moreland LW: Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: mechanisms of action [review]. Arthritis Res Ther. 2003, 5: 54-67. 10.1186/ar623.PubMedCentralCrossRefPubMed
28.
Migliore A, Tormenta S, Massafra U, Martin Martin LS, Carloni E, Padalino C, Alimonti A, Granata M: 18 month observation study on efficacy of intraarticular hyaluronic acid (Hylan G-F 20) injections under ultrasound guidance in hip osteoarthritis. Reumatismo. 2006, 58: 39-49.PubMed
29.
Migliore A, Tormenta S, Martin LSM, Valente C, Massafra U, Granata M, Alimonti A: Open pilot study of ultrasound-guided intra-articular injection of hylan G-F 20 (Synvisc) in the treatment of symptomatic hip osteoarthritis. Clin Rheumatol. 2005, 24: 285-289. 10.1007/s10067-004-1009-1.CrossRefPubMed
30.
Brocq O, Tran G, Breuil V, Grisot C, Flory P, Euller-Ziegler L: Hip osteoarthritis: short-term efficacy and safety of viscosupplementation by Hylan G-F 20. An open-label study in 22 patients. Joint Bone Spine. 2002, 69: 388-391. 10.1016/S1297-319X(02)00416-5.CrossRefPubMed
31.
Caglar-Yagci H, Unsal S, Yagci I, Dulgeroglu D, Ozel S: Safety and efficacy of ultrasound-guided intra-articular hylan G-F 20 injection in osteoarthritis of the hip: a pilot study. Rheumatol Int. 2005, 25: 341-344. 10.1007/s00296-004-0441-5.CrossRefPubMed
32.
Vad VB, Sakalkale D, Sculco TP, Wickiewicz TL: Role of hylan G-F 20 in treatment of osteoarthritis of the hip joint. Arch Phys Med Rehabil. 2003, 84: 1224-1226. 10.1016/S0003-9993(03)00140-0.CrossRefPubMed
33.
Pourbagher MA, Ozalay M, Pourbagher A: Accuracy and outcome of sonographically guided intra-articular sodium hyaluronate injection in patients with osteoarthritis of the hip. J Ultrasound Med. 2005, 24: 1391-1395.PubMed
Metadata
Title
Comparative, double-blind, controlled study of intra-articular hyaluronic acid (Hyalubrix®) injections versus local anesthetic in osteoarthritis of the hip
Authors
Alberto Migliore
Umberto Massafra
Emanuele Bizzi
Francesca Vacca
Severino Martin-Martin
Mauro Granata
Andrea Alimonti
Sandro Tormenta
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 6/2009
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2875

Other articles of this Issue 6/2009

Arthritis Research & Therapy 6/2009 Go to the issue

Meeting report

Kitasato Symposium 2009: New Prospects for Cytokine Inhibition

Research article

A combination of methotrexate and zoledronic acid prevents bone erosions and systemic bone mass loss in collagen induced arthritis

Research article

Effect of small interference RNA (siRNA) for ADAMTS5on intervertebral disc degeneration in the rabbit anular needle-puncture model

Research article

Interleukin-23 is critical for full-blown expression of a non-autoimmune destructive arthritis and regulates interleukin-17A and RORγt in γδ T cells

Review

Utility of synovial biopsy

Research article

Adiponectin may contribute to synovitis and joint destruction in rheumatoid arthritis by stimulating vascular endothelial growth factor, matrix metalloproteinase-1, and matrix metalloproteinase-13 expression in fibroblast-like synoviocytes more than proinflammatory mediators
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits