Knee Arthritis Treatment (hyaluronic acid injections) Value Questioned

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Knee Arthritis Treatment Value Questioned

December 17, 2003

http://www.intelihealth.com/

CHICAGO (AP) -- Government-approved treatments for knee arthritis in

which the joint is injected with fluid often made from rooster combs

offer little if any relief, researchers say.

Doctors should think twice about recommending hyaluronic acid

treatments, which cost at least $100 per injection, said Dr. Grace Lo of

Boston University, who led the analysis of 22 published studies.

The analysis found that the injections performed only slightly better

than dummy treatments.

Lo said even those results may be overstated, since studies with

positive results are more likely to be published than those with

negative ones, and the researchers found at least two unpublished

studies showing that hyaluronic acid performed no better than dummy

treatments.

The analysis appears in Wednesday's Journal of the American Medical

Association.

Dr. Jack Klippel, president of the Arthritis Foundation, said that even

if the treatments have only a slight effect on pain, that is beneficial

since arthritis pain is so common and sometimes difficult to treat.

The foundation and the American College of Rheumatology have supported

the use of such products for certain patients, and Klippel said the

study does not change his opinion.

The treatment, sometimes called joint fluid therapy, generally involves

three to five weekly injections in a doctor's office. The injections are

intended to replace the natural fluid that helps lubricate the knee joint.

The analysis included studies of three products approved for knee

arthritis by the Food and Drug Administration: Hyalgan, Synvisc and

Supartz. They are generally recommended for patients who have not

responded well to aspirin or ibuprofen.

About 500,000 U.S. patients use such products annually, said Dr.

Polisson, senior vice president of clinical research at Genzyme Corp.,

which makes Synvisc.

Polisson said the researchers excluded some studies that showed Synvisc

has significant benefits. And Daley, U.S. medical director of

Sanofi-Synthelabo Inc., which makes Hyalgan, complained the analysis

included hyaluronic acid products not approved for use in this country.