COMPARATIVE EFFICACY OF INTRAARTICULAR THERAPY OF GONARTHROSIS WITH HYALURONIC ACID OF DIFFERENT MOLECULAR WEIGHT (A DOUBLE-BLIND RANDOMI7ED STUDY)

Abstract

Objectives. To study the comparative efficacy and safety of intra-articular treatment of knee osteoarthritis (OA) with hyaluronic acid (HA) of different molecular weights (MW). Material and methods. Randomized double-blind controlled study included 50 patients with osteoarthritis of the knee stage II-III, weight-bearing pain more 40 mm on VAS and Lequesne index score > 4 and < 12. 25 patients received HA with MW 3500 kDa (Rusvisk group) and 25 patients were treated with HA with MW 1200-1400 kDa (Ostenil group) injected at 3-weekly intervals. During the 22-week observation period we assessed dynamics of pain on VAS (weightbearing pain, pain at rest), index WOMAC, and recorded the overall assessment of the effectiveness of therapy by patient and physician, OMERACT-OARSI criteria and the need for NSAIDs. Results. One week after the last injection, a significant decrease in weight-bearing pain (in the group Rusvisk by 69% in the group Ostenil 55%) and the total index WOMAC (group Rusvisk by 63% in the group Ostenil 60%), continuing until the end of observation. A significant decrease in pain at rest observed in the group Rusvisk at all visits and in the group Ostenil only at 6 and 10 weeks of therapy. The overall evaluation of effectiveness of therapy by patient and physician yielded the benefits observed in high molecular HA group. A high percentage of responses to therapy using OMERACT-OARSI criteria and reduced need for NSAIDs were observed in both groups. Tolerability was satisfactory and did not differ significantly between the groups. Most common adverse reactions were mild pain at the injection site. Conclusion. Intra-articular therapy with HA of different molecular weight Rusvisk and Ostenil resulted in pain reduction and improved joint function in patients with knee OA with satisfactory tolerability.