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Published in: Journal of Orthopaedic Surgery and Research 1/2024

Open Access 01-12-2024 | Osteoarthrosis | Research article

Effectiveness and safety of polyacrylamide hydrogel injection for knee osteoarthritis: results from a 12-month follow up of an open-label study

Authors: Henning Bliddal, Jannie Beier, Andreas Hartkopp, Philip G. Conaghan, Marius Henriksen

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

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Abstract

Objective

There are few effective osteoarthritis (OA) therapies. A novel injectable polyacrylamide hydrogel (iPAAG) previously demonstrated efficacy and safety up to week 26 in an open-label study of knee OA. Here we report longer-term effectiveness and safety data.

Methods

This multi-centre, open-label study included patients with symptomatic and radiographic knee OA. Primary outcome was WOMAC pain (0–100 scale) at 13 weeks, and patients continued to 26 weeks before entering a further 26-week extension phase. Secondary efficacy outcomes included WOMAC stiffness and function subscales, Patient Global Assessment (PGA) and proportion of OMERACT-OARSI responders. Safety outcomes were adverse events (AEs).

Results

49 participants (31 women, mean age 70) received an ultrasound-guided, intra-articular injection of 6 ml iPAAG; 46 completed the extension phase to 52 weeks. There was a significant reduction in the WOMAC pain score from baseline to 52 weeks (− 17.7 points (95% CI − 23.1; − 12.4); p < 0.0001). Similar sustained improvements were observed for WOMAC stiffness (11.0 points; 95% CI − 17.0; − 4.9), physical function (18.0 points; 95% CI − 19.1; − 10.6), and PGA (16.3 points; 95% CI − 23.1; − 9.4). At 52 weeks 62.2% of patients were OMERACT-OARSI responders. From 26 to 52 weeks, 8 adverse effects (AE), including 1 serious AE (cerebrovascular accident) were reported in 5 subjects. None of the new adverse events were thought to be device related.

Conclusion

This open-label study suggests persistent benefits and safety of iPAAG through 52 weeks after a single injection.
Trial registration: Clinicaltrials.gov NCT04179552.
Literature
1.
go back to reference Sen R, Hurley JA. Osteoarthritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Sen R, Hurley JA. Osteoarthritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
2.
go back to reference Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American college of rheumatology/arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72:220–33.CrossRefPubMedPubMedCentral Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American college of rheumatology/arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72:220–33.CrossRefPubMedPubMedCentral
3.
go back to reference Deyle GD, Allen CS, Allison SC, Gill NW, Hando BR, Petersen EJ, et al. Physical therapy versus glucocorticoid injection for osteoarthritis of the knee. N Engl J Med. 2020;382:1420–9.CrossRefPubMed Deyle GD, Allen CS, Allison SC, Gill NW, Hando BR, Petersen EJ, et al. Physical therapy versus glucocorticoid injection for osteoarthritis of the knee. N Engl J Med. 2020;382:1420–9.CrossRefPubMed
4.
go back to reference Matzkin EG, Curry EJ, Kong Q, Rogers MJ, Henry M, Smith EL. Efficacy and treatment response of intra-articular corticosteroid injections in patients with symptomatic knee osteoarthritis. J Am Acad Orthop Surg. 2017;25:703–14.CrossRefPubMed Matzkin EG, Curry EJ, Kong Q, Rogers MJ, Henry M, Smith EL. Efficacy and treatment response of intra-articular corticosteroid injections in patients with symptomatic knee osteoarthritis. J Am Acad Orthop Surg. 2017;25:703–14.CrossRefPubMed
5.
go back to reference Jüni P, Hari R, Rutjes AW, Fischer R, Silletta MG, Reichenbach S, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev. 2015;2015:Cd005328.PubMedPubMedCentral Jüni P, Hari R, Rutjes AW, Fischer R, Silletta MG, Reichenbach S, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev. 2015;2015:Cd005328.PubMedPubMedCentral
6.
go back to reference Henriksen M, Overgaard A, Hartkopp A, Bliddal H. Intra-articular 2.5% polyacrylamide hydrogel for the treatment of knee osteoarthritis: an observational proof-of-concept cohort study. Clin Exp Rheumatol. 2018;36:1082–5.PubMed Henriksen M, Overgaard A, Hartkopp A, Bliddal H. Intra-articular 2.5% polyacrylamide hydrogel for the treatment of knee osteoarthritis: an observational proof-of-concept cohort study. Clin Exp Rheumatol. 2018;36:1082–5.PubMed
7.
go back to reference Bliddal H, Overgaard A, Hartkopp A, Beier J, Conaghan PG, Henriksen M. Polyacrylamide hydrogel injection for knee osteoarthritis: a 6 months prospective study. J Orthop Res Ther. 2021;6:1188. Bliddal H, Overgaard A, Hartkopp A, Beier J, Conaghan PG, Henriksen M. Polyacrylamide hydrogel injection for knee osteoarthritis: a 6 months prospective study. J Orthop Res Ther. 2021;6:1188.
8.
go back to reference Christensen L, Daugaard S. Histological appearance of the synovial membrane after treatment of knee osteoarthritis with polyacrylamide gel injections: a case report. J Arthritis. 2016;5:217.CrossRef Christensen L, Daugaard S. Histological appearance of the synovial membrane after treatment of knee osteoarthritis with polyacrylamide gel injections: a case report. J Arthritis. 2016;5:217.CrossRef
9.
go back to reference Christensen L, Camitz L, Illigen KE, Hansen M, Sarvaa R, Conaghan PG. Synovial incorporation of polyacrylamide hydrogel after injection into normal and osteoarthritic animal joints. Osteoarthr Cartil. 2016;24:1999–2002.CrossRef Christensen L, Camitz L, Illigen KE, Hansen M, Sarvaa R, Conaghan PG. Synovial incorporation of polyacrylamide hydrogel after injection into normal and osteoarthritic animal joints. Osteoarthr Cartil. 2016;24:1999–2002.CrossRef
10.
go back to reference Yu SP, van Middelkoop M, Deveza LA, Ferreira ML, Bierma-Zeinstra S, Zhang W, Atchia I, Birrell F, Bhagavath V, Hunter DJ. Predictors of placebo response to local (intra-articular) therapy in osteoarthritis: an individual participant data meta-analysis. Arthritis Care Res (Hoboken). 2024;76(2):208–24.CrossRefPubMed Yu SP, van Middelkoop M, Deveza LA, Ferreira ML, Bierma-Zeinstra S, Zhang W, Atchia I, Birrell F, Bhagavath V, Hunter DJ. Predictors of placebo response to local (intra-articular) therapy in osteoarthritis: an individual participant data meta-analysis. Arthritis Care Res (Hoboken). 2024;76(2):208–24.CrossRefPubMed
Metadata
Title
Effectiveness and safety of polyacrylamide hydrogel injection for knee osteoarthritis: results from a 12-month follow up of an open-label study
Authors
Henning Bliddal
Jannie Beier
Andreas Hartkopp
Philip G. Conaghan
Marius Henriksen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-024-04756-2

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