Injectable hyaluronic acid drugs for the treatment of knee osteoarthritis in the context of evidence-based medicine

Abstract

To evaluate the efficacy and safety of intraarticular hyaluronic acid (HA) in osteoarthritis (OA), the authors have analyzed the scientific publications included in foreign databases (Medline/PubMed) on the relevant laboratory, experimental, and clinical studies conducted over the past 20 years. A few in vitro laboratory studies of individual HA drugs confirm their positive effect on articular cartilage. Analysis of the literature on their in vivo use has shown that a variety of intraarticular HA drugs permitted for use in Russia have not been studied in clinical trials, which raises doubts about their efficacy. At the same time, the published works suggest that a significant clinical effect is achieved with HA therapy mainly in early OA and that this therapy for end-stage knee OA yields poor results. The data regarding the clinical efficacy of different HA drugs are very contradictory. Thus, there is a need for additional comparative postmarketing research of HA drugs permitted for use in the Russian Federation, by stratifying patients according to the characteristics of the clinical phenotype of the disease, available risk factors for OA progression, and the magnitude of morphological changes in joint tissues, as verified by magnetic resonance imaging and/or arthroscopy.