Registro de ácido hialurónico intraarticular en el tratamiento de la osteoartritis de rodilla, en la Argentina. [Registry of intra-articular hyaluronic acid in the treatment of knee osteoarthritis in Argentina]

Mario Berenstein, Leonardo Tacus, Pablo Kobrinsky, Daniel Vaineras

Resumen


Introducción: El ácido hialurónico intrarticular se suele utilizar para tratar la artrosis de rodilla. Nuestro objetivo fue analizar la efectividad y el uso del ácido hialurónico intrarticular en la práctica habitual.

Materiales y Métodos: Cohorte retrospectiva observacional. Se evaluó a 1227 pacientes con artrosis de rodilla tratados con ácido hialurónico intrarticular 20 mg/2 ml/semana (76% 20 mg) y 40 mg/2 ml (24% 40 mg) según la práctica habitual. Seguimiento de 6 meses. Se evaluó la eficacia con la escala de Likert de 5 puntos y la proporción de respuesta ≥50%.

Resultados: La mediana de aplicaciones fue de 5 (20 mg) y 3 (40 mg). El puntaje de Likert mejoró significativamente en ambos grupos a los 6 meses. La mediana del puntaje mejoró de 4 (media 3,77 ± 0,69) al inicio a 2 (media 1,99 ± 0,76) a los 6 meses con 20 mg (p <0,001) y de 4 (media 3,65 ± 0,65) a 2 (media 1,86 ± 0,72) con 40 mg (p <0,001). La proporción de respuesta ≥50% a los 6 meses fue del 61% y 66%, respectivamente. En el análisis multivariado, la tasa de respuesta ≥50% se asoció con un mayor puntaje inicial, edad más joven y menor duración de la enfermedad. Solo un paciente con 20 mg (0,1%) tuvo un episodio adverso severo (artritis séptica).

Conclusión: Nuestro estudio en la práctica clínica común respalda la efectividad del ácido hialurónico intrarticular para tratar la artrosis de rodilla, con un beneficio clínico a los 6 meses de seguimiento.

 

Abstract

 

Background: Intra-articular treatment of knee osteoarthrosis (OA) with hyaluronic acid (IA-HA) is frequently used in Argentina, with different dosing forms and injection regimens. Our main objective was to provide real world data on the use and effectiveness of IA-HA

Methods: In this observational retrospective cohort study we studied 1227 patients with knee osteoarthrosis treated with IA-HA 20mg/2ml weekly (76%-20mg group) and 40mg/2ml (24%-40mg group) according to usual practice intervals. Follow up was at 6 months and efficacy assessed by 5 point Likert scale and 50% or more response rate.

Results: Median number of applications was 5 (20mg) and 3 (40mg). Both groups had a significant improvement in the Likert scale from baseline to 6 month. Median score improved from 4 (mean 3.77 ±0.69) at baseline to median of 2 (mean 1.99 ±0.76) at 6 months (20mg group, p <0.001) and from median of 4 (mean 3.65 ±0.65) to median 2 (mean 1.86 ±0.72) in the 40mg group, p <0.001. Proportion of patients with 50% or more 6 month response were 61% and 66% respectively. In the multivariate analysis, 50% response rate was associated with higher baseline score, younger age and shorter duration of disease. Only 1 patient in the 20mg group (0.1%) experienced a serious treatment related adverse event (septic arthritis) following injection.

Conclusion: Our study in common clinical practice supports the effectiveness of IA-HA in step management of knee OA with clinical benefit observed at 6 month follow up.  Key words: Intra-articular; hyaluronic acid; knee; arthrosis; osteoarthritis.


Palabras clave


Intraarticular; ácido hialurónico; rodilla; osteoartritis; intra-articular; hyaluronic acid; knee; arthrosis; osteoarthritis

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DOI: http://dx.doi.org/10.15417/issn.1852-7434.2019.84.2.846

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Registro de la Propiedad Intelectual Nº 22171081 (en línea).

ISSN 1852-7434 (en línea).

Esta Revista está bajo una Licencia Creative Commons Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional. (CC-BY-NC-SA 4.0)