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Study shows Synvisc reduces OA knee pain faster and for longer duration
Significant improvement, higher patient compliance with Synvisc compared to Hyalgan.
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Results from a clinical trial comparing the effectiveness of hylan G-F 20 (Synvisc; Genzyme) and Hyalgan (Sanofi Aventis) show that although both treatments significantly reduced patient pain, Synvisc reduced pain earlier and the effects persisted longer.
"Synvisc delivers a greater magnitude and duration of pain relief and function than Hyalgan, although both equally reduced pain on a short-term basis," Raghu Raman, FRCS, the study's lead investigator, told Orthopedics Today.
The independent, controlled, prospective study, presented at the European League Against Rheumatism meeting in Amsterdam, consisted of 348 patients with osteoarthritis (OA) of the knee who failed to respond to conservative, nonpharmacologic therapy and simple analgesics.
Researchers randomized participants to receive Synvisc or Hyalgan injections and then given the recommended doses by the same physician: three injections 7 days apart of Synvisc or five weekly injections of Hyalgan.
Independent assessors were blinded and reviewed patients at pre-injection, 6 weeks, 3 months, 6 months and then yearly.
Determining OA severity
Prior to treatment, researchers reviewed weight-bearing radiographs to determine each patient's degree of OA using the Kellgren-Lawrence system. The investigators recorded knee pain on the Visual Analog Scale (VAS), as well as range of motion, in all patients.
They also assessed functional outcome using Tegner, UCLA, Oxford knee score and EuroQol-5D scores, said Raman, an orthopedic surgeon at the Hull Royal Infirmary in Hull, England.
The mean age of the participants was 66.7 years, and there were no significant differences in the degree of OA, age and sex between the two treatment groups.
Patients treated with Synvisc had initial knee pain of 6.7 on the VAS; it improved to 3.2 by 6 weeks and was constant until 12 months.
In Hyalgan-treated patients, pain improved from 6.6 to 5.7 at 6 weeks and to 4.1 at 3 months; however, the improvement lasted only 6 months.
The Tegner, UCLA and Oxford knee scores were also significantly better in the Synvisc group at 6 weeks, 6 months and 12 months postinjection.
Patient compliance
According to researchers, patient compliance with Synvisc was 99.2%, compared to 92.2% with Hyalgan. They attributed the difference in compliance rates to the number of recommended injections (ie, more injections required for Hyalgan). According to Raman, patient satisfaction in regards to knee pain reduction was greater with Synvisc than Hyalgan.
Although the cost of the two drugs is the same, the total treatment cost for patients treated with Hyalgan was 23% more due to the two additional visits needed to complete treatment, they wrote.
Synvisc is currently marketed in more than 60 countries.
For more information:
- Raman R, Dutta A, Day N, et al. A prospective randomized controlled clinical trial comparing the efficacy of Hylan G-F 20 and sodium hyaluronate in the treatment of osteoarthritis of the knee. #0391. Presented at the European League Against Rheumatism 2006 Congress. June 21-24, 2006. Amsterdam.