A meta-analysis of the therapeutic effect of treatment with hyaluronic acid in knees for Kashin-Beck disease
Evaluation of the therapeutic effect of treatment with intra-articular hyaluronic acid in knees for Kashin-Beck disease: A meta-analysis
Article specifications
This meta-analysis was published in 2014 in Journal of Osteoarthritis and Cartilage (IF 2014: 4.165) by chines orthopedics. The aim of the study was to assess the efficacy and safety of intra-articular hyaluronic acid (IAHA) injection in knee joints of patients with Kashin-Beck disease (KBD). They searched nine electronic databases as well as unpublished data from inception until November 30th 2013 using a combination of search terms for KBD and hyaluronic acid (HA). For dichotomous data, odds ratios (OR) and 95% confidence intervals (CI) were estimated. For continuous data, standard mean difference (SMD) was used for outcomes pooled on the difference scale using a “random-effects” or “fixed-effects” model. In this article also the mean and standard deviation of cytokine levels in post-treatment was compared.
Results
-IAHA efficacy vs pre-treatment:
However treatment effects for the index of the knee joint were slighter lower with SMD of 0.99 at 2 weeks (P = 0.124), there was no statistically significant difference compared to pre-injection.
-IAHA efficacy vs controls
They evaluated four comparisons including 745 intervention and 360 controls that showed significant effect of hyaluronic acid in reduction of the pain.
- Changes in cytokine levels
Three trials reported the changes in cytokines levels in the KBD group. The levels of
CD44 and KS in the serum of healthy control in KBD area were not acquired. There was significant reduction of HA, CD44, KS, TNF-a and NO in serum in post-treatment, healthy controls in KBD area and non-KBD area, and the significant reduction of IL-1b in pre-treatment compared with post-treatment and healthy controls in non-KBD. Meanwhile, no significant difference the levels of IL-1b were observed between pre-treatment and healthy controls in KBD area.
-Adverse events
The five RCTs with a total of 848 intervention patients reported 26 cases of joint pain and swelling after injection, in which the symptoms disappeared after 1 week without special treatment. One study mentioned two cases of joint effusion and one case of injection site bleeding. Overall the rate of adverse events in IAHA groups was 3.1%.
