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Data show hyaluronic acid more effective than betamethasone as OA treatment
Patients with osteoarthritis who received injections of hyaluronic acid or betamethasone improved, but those who received hyaluronic acid showed greater improvement and less pain, according to recently published clinical trial data.
Researchers evaluated 89 patients with osteoarthritis (OA) randomly assigned to treatment with intra-articular injections of hyaluronic acid (HA) and 91 who were randomly assigned to treatment with betamethasone (BM) in a parallel, prospective 12-month study.
Exclusion criteria included BMI over 35, age younger than 40 years or older than 85 years, history of trauma or surgery in the target knee, inflammatory arthritis, microcrystalline arthropies, knee infection, angular deformities and other relevant confounding criteria.
Baseline demographics, medical histories and laboratory tests were performed at baseline and knee X-rays were performed using anteroposterior projection with support at 30° flexion and 45° Merchant views and one bipodalic mechanical axis digitized in a single plane.
Weekly injections were performed for 5 weeks for HA or one injection of BM on day 0 and at week 4. Follow-up was scheduled at 3, 6 and 9 months.
At baseline and follow-up, patient outcomes were measured by comparing the Western Ontario McMaster University Osteoarthritis (WOMAC) subscale scores and a 0 to 10 cm Visual Analog Scale (VAS) was used for global pain measurement. Primary outcome analysis was adjusted by age, sex, BMI, radiographic damage and use of acetaminophen.
Although global pain was significantly reduced in both groups at the 3-month follow-up, pain was found to be lower overall in patients treated with BM compared with those treated with HA; however, the effect diminished in following visits, according to the researchers. Mean pain reduction at 12 months in the HA group was 33.6% compared with 8.2% in patients treated with BM.
Both groups achieved the Minimal Clinically Important Improvement (MCII) for both pain and function at up to 6 months. However, at 9 and 12 months, the researchers found MCII figures were higher in the HA group than in the BM group.
Overall, adverse reactions were found to be rare and related to the administration procedure. – by Shirley Pulawski
Disclosures: The authors report no relevant financial disclosures.