Efficacy and Safety of Hylan G-F 20 Versus Intra-Articular Corticosteroids in People with Knee Osteoarthritis: A Systematic Review and Network Meta-Analysis.

Autor: Chevalier X; Department of Rheumatology, Hôpital Henri-Mondor, Paris University XII (UPEC), Créteil, France., Sheehan B; Division of Orthopaedic Surgery, Department of Medicine, Dalhousie University, Halifax, NS, Canada., Whittington C; Doctor Evidence, Santa Monica, CA, USA.; Sanofi, Global Medical, Bridgewater, NJ, USA., Pourrahmat MM; Evidinno Outcomes Research Inc., Vancouver, BC, Canada., Duarte L; Doctor Evidence, Santa Monica, CA, USA., Ngai W; Sanofi, Global Medical, Bridgewater, NJ, USA., de Campos GC; Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Jazyk: angličtina
Zdroj: Clinical medicine insights. Arthritis and musculoskeletal disorders [Clin Med Insights Arthritis Musculoskelet Disord] 2020 Nov 23; Vol. 13, pp. 1179544120967370. Date of Electronic Publication: 2020 Nov 23 (Print Publication: 2020).
DOI: 10.1177/1179544120967370
Abstrakt: Background: Direct injection of corticosteroids into the joint is a standard treatment for knee osteoarthritis (OA). However, the treatment is somewhat controversial with regard to the benefit of both single and repeated injections; evidence that they are beneficial comes from small studies that show only modest improvements. The aim of this study was to estimate the short- and long-term clinical efficacy and safety of hylan G-F 20 versus intra-articular corticosteroids (IACS) for the treatment of pain in knee OA using Bayesian network meta-analysis.
Methods: Based on a pre-specified protocol, MEDLINE, Embase, and CENTRAL were searched from inception to June 2018 to identify randomized controlled trials. The Cochrane Collaboration's tool for assessing risk of bias in randomized trials was used to assess the included studies. Hylan G-F 20 and IACS were compared using Bayesian network meta-analysis. Efficacy was evaluated at 1, 3, and 6 months, and at the final follow-up for safety outcomes. A pain hierarchy was used to select 1 pain outcome per study.
Results: Forty-two trials were included for analysis. The network meta-analysis of pain showed that hylan G-F 20 may be equivalent to IACS in the short-term, but by 6 months the benefit relative to IACS was statistically significant, standardized mean difference (95% credible interval): -0.13 (-0.26, -0.01). There were no statistical differences in adverse events.
Conclusions: Hylan G-F 20 may perform better in relieving pain at 6 months post-injection compared to IACS. Both agents were relatively well tolerated, with no clear differences in safety.
Competing Interests: Declaration of conflicting interests:The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: XC reports speaker/honoraria for Sanofi and IBSA Institut Biochimique, and consulting for Pfizer, IBSA Institut Biochimique, and LAB Pharma. BS reports speaker/honoraria and consulting for Sanofi. CW is currently employed by Sanofi, and is a former employee of Doctor Evidence, LLC. MP is currently employed by Evidinno Outcomes Research Inc., which reports contract by Doctor Evidence, LLC. LD is currently employed by Doctor Evidence, LLC, who were contracted by Sanofi to conduct this study. WN is currently employed by Sanofi. GCC reports speaker/honoraria and consulting for Sanofi.
(© The Author(s) 2020.)
Databáze: MEDLINE
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