Special report: intra-articular hyaluronan for osteoarthritis of the knee

BlueCross BlueShield Association
Record ID 32005000083
Authors' objectives:

The purpose of this Special Report is to review the evidence on hyaluronan from the perspective of the prior TEC Assessment (1998) and the 3 published meta-analyses regarding the effectiveness of hyaluronan, and to determine the quality and direction of evidence regarding the effectiveness of this therapy. Evidence regarding comparisons between hyaluronan and alternative treatments, and the effectiveness of repeated hyaluronan treatments will also be reviewed.

Authors' recommendations: Up to this point in time, there appear to have been 28 randomized placebo-controlled clinical trials of hyaluronan and 3 published systematic reviews of hyaluronan. Despite the observed flaws in the studies, all of the reviews conclude that there is an effect of hyaluronan on the symptoms of knee osteoarthritis. One review concludes that the effect is small and possibly biased by publication bias. The evidence base regarding the comparison between hyaluronan and alternative treatments has not been advanced significantly since the 1998 TEC Assessment, with only 1 study that confirms the prior conclusion that hyaluronan is about as roughly as effective as NSAIDs. However, this literature base remains small, and the quality of the evidence is not very good. There is no rigorous controlled evidence regarding the effectiveness of repeated treatments of hyaluronan. Case series showing improvement of symptoms after repeated treatments could be due to either placebo effects or selection bias. Overall, this review shows that the evidence is still consistent with that presented in the 1998 TEC Assessment. The evidence shows a statistically significant effect in almost all studies, although the magnitude and clinical significance of the effect may be small.
Authors' methods: Review
Project Status: Completed
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Costs and Cost Analysis
  • Hyaluronic Acid
  • Osteoarthritis, Knee
Organisation Name: BlueCross BlueShield Association
Contact Address: BlueCross BlueShield Association, Technology Evaluation Center, 225 North Michigan Ave, Chicago, Illinois, USA. Tel: 888 832 4321
Contact Name: tec@bcbsa.com
Contact Email: tec@bcbsa.com
Copyright: BlueCross BlueShield Association (BCBS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.