PMID- 27492466
OWN - NLM
STAT- MEDLINE
DCOM- 20180426
LR  - 20220409
IS  - 1522-9653 (Electronic)
IS  - 1063-4584 (Linking)
VI  - 24
IP  - 12
DP  - 2016 Dec
TI  - Comparative safety profile of hyaluronic acid products for knee osteoarthritis: a 
      systematic review and network meta-analysis.
PG  - 2022-2041
LID - S1063-4584(16)30196-0 [pii]
LID - 10.1016/j.joca.2016.07.010 [doi]
AB  - PURPOSE: Intra-articular (IA) hyaluronic acid (HA) is considered a safer 
      alternative to oral Non-Steroidal Antiinflammatory Drugs (NSAIDs) and opioids for 
      knee osteoarthritis (OA). A recent review raised potential safety concerns about 
      HA, warranting further review of safety outcomes. We examined the risks of HA 
      compared with IA placebo and investigated whether the risks vary among individual 
      HA preparations. METHODS: We searched all relevant databases from inception to 
      October 2015 and sought unpublished data. We included all knee OA trials which 
      compared any of the 18 HA products and reported on adverse events (AEs) and 
      withdrawals. We calculated odds ratios for safety data reported at the longest 
      follow-up. Network meta-analysis was performed using a Bayesian hierarchical 
      random effects model for mixed multiple treatment comparisons. RESULTS: We 
      identified 74 studies involving 13,032 participants aged between 45 and 75 years. 
      The proportion of women ranged from 28% to 100%. The overall incidence of local 
      reactions reported across all products was 8.5%. Commonly reported AEs were 
      transient local reactions, such as pain, swelling and arthralgia, which subsided 
      rapidly. None of the HA products were statistically significantly different from 
      IA placebo or from each other with regard to incidence of AEs. Three 
      treatment-related serious adverse events (SAEs) were reported among 9214 
      participants. CONCLUSIONS: Given the very low incidence of any particular AEs, we 
      conclude that HA products are relatively well tolerated. These products have a 
      similar safety profile compared to each other. This information along with the 
      comparative effectiveness profile and relative cost would be helpful for 
      clinicians in delivering individualized patient care.
CI  - Copyright (c) 2016 Osteoarthritis Research Society International. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Bannuru, R R
AU  - Bannuru RR
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, Boston, MA, USA. Electronic address: 
      rbannuru@tuftsmedicalcenter.org.
FAU - Osani, M
AU  - Osani M
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, Boston, MA, USA.
FAU - Vaysbrot, E E
AU  - Vaysbrot EE
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, Boston, MA, USA.
FAU - McAlindon, T E
AU  - McAlindon TE
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, Boston, MA, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20160802
PL  - England
TA  - Osteoarthritis Cartilage
JT  - Osteoarthritis and cartilage
JID - 9305697
RN  - 9004-61-9 (Hyaluronic Acid)
SB  - IM
MH  - Aged
MH  - Bayes Theorem
MH  - Female
MH  - Humans
MH  - Hyaluronic Acid
MH  - Injections, Intra-Articular
MH  - Male
MH  - Middle Aged
MH  - Network Meta-Analysis
MH  - *Osteoarthritis, Knee
OTO - NOTNLM
OT  - Hyaluronic acid
OT  - Intra-articular therapy
OT  - Knee
OT  - Osteoarthritis
OT  - Safety
EDAT- 2016/08/06 06:00
MHDA- 2018/04/27 06:00
CRDT- 2016/08/06 06:00
PHST- 2016/01/07 00:00 [received]
PHST- 2016/07/08 00:00 [revised]
PHST- 2016/07/24 00:00 [accepted]
PHST- 2016/08/06 06:00 [pubmed]
PHST- 2018/04/27 06:00 [medline]
PHST- 2016/08/06 06:00 [entrez]
AID - S1063-4584(16)30196-0 [pii]
AID - 10.1016/j.joca.2016.07.010 [doi]
PST - ppublish
SO  - Osteoarthritis Cartilage. 2016 Dec;24(12):2022-2041. doi: 
      10.1016/j.joca.2016.07.010. Epub 2016 Aug 2.