Hylan versus Hyaluronic Acid for Osteoarthritis of the Knee: A Systematic Review and Meta-Analysis
This article was published in 2007 in journal of Arthritis & Rheumatism (IF 2007:7.764) by Swiss orthopedics. The researchers performed a systematic review and meta-analysis of randomized controlled trials comparing hylan (crosslinked) with a hyaluronic acid in patients with knee osteoarthritis. Trials were identified by systematic searches of Central, Medline, EMBase, Cinahl, the Food and Drug Administration, and Science Citation Index supplemented by hand searches of conference proceedings and reference lists (last update November 2006). Literature screening and data extraction were performed in duplicate. Effect sizes were calculated from differences in means of pain-related outcomes between treatment and control groups at the end of the trial, divided by the pooled standard deviation. Trials were combined using random-effects meta-analysis. Thirteen trials with a pooled total of 2,085 patients contributed to the meta-analysis.
The meta-analyses on safety revealed an increased risk associated with hylan for any local adverse events and for flares. In Conclusion given the likely lack of a superior effectiveness of hylan over hyaluronic acids and the increased risk of local adverse events associated with hylan, they discourage the use of intra-articular hylan in patients with knee osteoarthritis in clinical research or practice.