Two Thumbs up for Sodium Hyaluronidate for Treating Osteoarthritis

June 14, 2005

By Matas A. Loewy

VIENNA (Reuters Health) Jun 13 - French investigators report that

intra-articular sodium hyaluronidate injections might benefit patients

with osteoarthritis of carpometacarpal joint (CMCJ) of the thumb, a

form of osteoarthritis that is " usually underestimated " and for which

there are currently no specific medical treatment guidelines.

Sodium hyaluronidate " should be used as a first choice therapy before

the surgery, " lead author Dr. Christian Roux told Reuters Health.

In an intention-to-treat analysis, researchers from the Academic

Hospital LArchet, in Nice, France, studied 31 subjects (mean age 65

years) with symptomatic osteoarthritis of the CMCJ of the thumb.

Patients were randomly allocated to receive, at weekly intervals, one,

two or three image-guided injections of 1 mL sodium hyaluronidate

(Sinovial).

After 3 months, authors observed " significant improvements " in scores

of pain and hand function. The mean pain score and function index were

reduced from 55.8 and 10.3 at baseline to 37.8 and 8.6, respectively.

Six subjects were lost to follow-up.

" Side effects were rare and limited to transient local pain, " the

researchers reported.

The number of injections had no statistically significant influence on

the result, but Dr. Roux thinks that this might be linked to the low

number of participants in each group. " One injection tended to have a

lower efficacy than two, and three injections appear to work better

than two, " he said.

Dr. Roux noted that their study is important because effects of

antiarthritic drugs in hip or knee might not apply to the thumbs. For

instance, it is widely considered that intra-articular steroids are

effective for knee, but a recent double-blind randomized trial failed

to find clinical benefits for steroid injections to the CMCJ in

patients with moderate to severe thumb osteoarthritis, he added.

The study findings were presented here last Saturday at the Annual

European Congress of Rheumatology.

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