Long-Term (1-Year) Safety and Efficacy of a Single 6-mL Injection of Hylan G-F 20 in Indian Patients with Symptomatic Knee Osteoarthritis

Sarvajeet Pal, Sreedhar Thuppal, K J Reddy, Sachin Avasthi, Anish Aggarwal, Himanshu Bansal, Senthilnathan Mohanasundaram, Francois Bailleul, Sarvajeet Pal, Sreedhar Thuppal, K J Reddy, Sachin Avasthi, Anish Aggarwal, Himanshu Bansal, Senthilnathan Mohanasundaram, Francois Bailleul

Abstract

Introduction: The prevalence of symptomatic knee osteoarthritis (OA) among Asians ≥65 years is estimated to double by 2040. This study was designed to evaluate the safety and efficacy of a single, 6-mL intra-articular injection of hylan G-F 20 in Indian patients with knee OA at 26 weeks through to 52 weeks.

Methods: This study was an open-label, multicentre, phase 4 clinical trial. Enrolled patients (N=394) were ≥30 years old with Kellgren-Lawrence grade 1-3 OA; all patients received hylan G-F 20. WOMAC, SF-12, PTGA, and COGA scores, and OA medication use were evaluated at weeks 1, 4, 12, 26, 39, and 52 (initial treatment phase). At 26, 39, or 52 weeks, eligible patients could participate in a repeat treatment phase. McNemar-Bowkers, paired t-tests and ANOVA analyses were performed (alpha=0.05).

Results: At 26 weeks, statistically significant changes from baseline were observed in all efficacy parameters, including the primary efficacy endpoint of WOMAC A1 (p<0.0001). Improvements continued for 52 weeks. No significant changes occurred in concomitant medication use. Eleven patients (2.8%) were re-injected at week 26 or 52. After repeat injection, statistically significant decreases were observed in WOMAC A1, WOMAC C and PTGA scores (p≤0.028). Twenty-three (5.8%) patients reported 26 local target knee AEs.

Conclusion: Among Indian patients within this study, a 6-mL hylan G-F 20 injection was well tolerated and effective in treating symptomatic knee OA with significant long-term (1 year) improvement of outcomes. When needed, repeat treatment was safe and efficacious for 4 weeks.

Trial registration: Clinical Trial Registry of India (CTRI/2010/091/000052) www.ctri.nic.in/Clinicaltrials/login.php.

Keywords: Hyaluronan; Western Ontario and McMaster Universities Osteoarthritis Index.; hylan G-F 20; osteoarthritis.

Figures

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Fig. (1)
Study design.
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Fig. (2)
Patient disposition.
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Fig. (3)
Mean Scores for the WOMAC A1 (A) and the WOMAC A, B, and C scores (B) with hylan G-F 20 over time. *p

Fig. (4)

The proportion of patients within…

Fig. (4)

The proportion of patients within each rating for PTGA (A) and COGA (B)…

Fig. (4)
The proportion of patients within each rating for PTGA (A) and COGA (B) scores with hylan G-F 20 over 52 weeks. *p

Fig. (5)

Responder rates at weeks 1,…

Fig. (5)

Responder rates at weeks 1, 4, 12, 26, and 52 following hylan G-F…

Fig. (5)
Responder rates at weeks 1, 4, 12, 26, and 52 following hylan G-F 20. Responders were patients with ≥10 mm WOMAC A1 score reduction from baseline.
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References
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Fig. (4)
Fig. (4)
The proportion of patients within each rating for PTGA (A) and COGA (B) scores with hylan G-F 20 over 52 weeks. *p

Fig. (5)

Responder rates at weeks 1,…

Fig. (5)

Responder rates at weeks 1, 4, 12, 26, and 52 following hylan G-F…

Fig. (5)
Responder rates at weeks 1, 4, 12, 26, and 52 following hylan G-F 20. Responders were patients with ≥10 mm WOMAC A1 score reduction from baseline.
Fig. (5)
Fig. (5)
Responder rates at weeks 1, 4, 12, 26, and 52 following hylan G-F 20. Responders were patients with ≥10 mm WOMAC A1 score reduction from baseline.

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