A new meta-analysis published in the journal Cartilage has shown the use of intra-articular hyaluronic acid (IAHA) to be safe in patients with symptomatic knee osteoarthritis (OA). Although non-serious local reactions were more common with IAHA than with intra-articular (IA) saline, no additional safety risks were identified for IAHA.
Researchers performed a meta-analysis of 35 randomised controlled trials (RCTs; n=8078) identified through a literature search on Medline, Embase, Cochrane library and the Directory of Open Access Journals. Primary outcomes included adverse events (AEs), serious adverse events (SAEs), local AEs, study withdrawals and AE-related withdrawals in the IAHA and IA saline groups.
When IAHA and IA saline groups were compared for a follow-up period of six months, no differences were observed in the risk for AEs (42.4% vs 39.7%; risk ratio [RR], 1.01; 95% CI, 0.96-1.07; P=.61) and SAEs (1.8% vs 1.2%; RR, 1.44; 95% CI, 0.91-2.26; P=.12). Similarly, no differences were observed between the two groups for study withdrawals (12.3% vs 12.7%; RR, 0.99; 95% CI, 0.87-1.12; P=.83) and AE-related study withdrawals (2.7% vs 2.1%; RR, 1.37; 95% CI, 0.97-1.93; P=.08). Local AEs (all non-serious) such as injection site pain, arthralgia, joint swelling and joint effusion were slightly more common with IAHA group vs IA saline group (14.5% vs 11.7%; RR, 1.21; 95% CI, 1.07-1.36; P=.003), and their resolution typically occurred within two to three days.
The authors commented: "Given this evidence supporting the safety of IAHA in relation to IA saline, it would be interesting for future studies to compare the safety of IAHA to active therapies recommended for treatment of symptomatic knee OA."
