Efficacy Study of Intra-articular Hyaluronic Acid in the Knee Osteoarthritis

NCT ID: NCT00556608

Last Updated: 2012-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

381 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-11-30

Study Completion Date

2010-05-31

Brief Summary

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The purpose of this study is to prove the non-inferiority of the intra-articular injection of hyaluronic acid (Sinovial®) in the symptomatic treatment of knee OA in comparison to Synvisc®.

Detailed Description

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Conditions

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Osteoarthritis, Knee

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Sinovial

3 intra-articular injections of Sinovial®

Group Type EXPERIMENTAL

Sinovial® (syringe containing sodium hyaluronate solution)

Intervention Type DEVICE

2 mL 0.8% sodium hyaluronate (16 mg) solution. 3 intra-articular injections once-a-week.

Sinvisc

Group Type ACTIVE_COMPARATOR

Synvisc® ( syringe containing Hylan G-F 20 solution)

Intervention Type DEVICE

2 mL 0.8% Hylan G-F 20 (16 mg) solution. 3 intra-articular injections once-a-week.

Interventions

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Sinovial® (syringe containing sodium hyaluronate solution)

2 mL 0.8% sodium hyaluronate (16 mg) solution. 3 intra-articular injections once-a-week.

Intervention Type DEVICE

Synvisc® ( syringe containing Hylan G-F 20 solution)

2 mL 0.8% Hylan G-F 20 (16 mg) solution. 3 intra-articular injections once-a-week.

Intervention Type DEVICE

Other Intervention Names

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Sinovial®: Class III medical device(CE mark n° 0499) Synvisc®: class III medical device (CE mark n° 0088)

Eligibility Criteria

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Inclusion Criteria

* Age between 40 and 80 years
* Primary knee OA of the medial or lateral femoro-tibial compartment
* Symptoms for at least 3 months
* Diagnosis according to ACR criteria
* Kellgren \& Lawrence radiological grade 2-3
* Patients who failed to respond sufficiently (not responders) to analgesics and/or NSAIDs taken regularly or responders intolerant to the regular use of analgesics and/or NSAIDs.
* Mean WOMAC pain subscore at the target knee \>= 40 mm and \< 80 mm on a VAS at baseline after wash-out from analgesics/NSAIDs· If bilateral knee OA: definition of the most symptomatic joint at screening based on patient's evaluation and Investigator's clinical judgment and mean WOMAC pain subscore at baseline in the contra-lateral knee \< 30 mm
* Written informed consent
* Subject able to understand, co-operative and reliable

Exclusion Criteria

* BMI \>= 32 kg/m2
* Secondary (post-traumatic) knee OA
* Predominantly patello-femoral pain/syndrome
* No remaining joint space width
* Symptomatic hip OA or other interfering health condition
* Severe varus/valgus deformity (\>15°)
* History/present evidence of (target knee): inflammatory, infective or metabolic joint diseases; recurrent clinical chondrocalcinosis; crystal arthropaties; osteo-articular pathologies differing from arthrosis; articular fracture; ochronosis; acromegaly; haemochromatosis; Wilson's disease; primary osteochondromatosis; heritable disorders; collagen gene mutations.
* Concomitant rheumatic disease
* Significant injury to the target knee in the last 6 months
* Previous joint replacement/arthroplasty (target knee)
* Arthroscopy/osteotomy/surgery in the past 1 year (target knee)
* Any surgery scheduled in the next 6 months
* Venous or lymphatic stasis in the relevant limb
* Skin infection/disease/trauma at the injection site
* Systemic or i.a. (target knee) corticosteroids in the past 3 months
* I.a. corticosteroids (non-target joint) in the past 4 weeks
* Viscosupplementation (target knee) in the past year
* Recently started (in the last 3 months) physical therapy (target knee)
* Recently (in the last 3 months) started therapy or change in dosage of SYSADOAs
* Ongoing anticoagulant therapy
* Chronic or recurrent use of NSAIDs/analgesics/narcotics because of diseases different from OA of the target knee
* History of allergy or hypersensitivity to hyaluronic acid or paracetamol or avian proteins
* Participation in a clinical study in the last 3 months
* Pregnant or lactating women, and women of childbearing potential not willing to use adequate contraception
* Patients unable to stay in the study for 6 months, non-cooperating, not able to understand
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IBSA Institut Biochimique SA

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Karel PAVELKA, MD

Role: PRINCIPAL_INVESTIGATOR

Institute of Rheumatology-Na Slupi 4 - 12850 Praha 2 (Czech Republic)

Locations

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Interni hemato-onkologická klinika, Fakultní nemocnice

Brno - Bohunice, , Czechia

Site Status

ARTHROMED s.r.o.

Pardubice, , Czechia

Site Status

Institute of Rheumatology

Prague, , Czechia

Site Status

Centrum léčby pohybového aparátu spol. s.r.o.

Prague, , Czechia

Site Status

University Hospital Centre Bois-Guillaume

Bois-Guillaume, , France

Site Status

University Hospital Centre of Limoges - Rheumatology Service

Limoges, , France

Site Status

Orthopädische Universitätsklinik und Poliklinik der RWTH Aachen

Aachen, , Germany

Site Status

Nova clinic

Biberach an der Riss, , Germany

Site Status

Orthopädische Praxis

Stockach, , Germany

Site Status

Sezione Dipartimentale a valenza provinciale di Reumatologia - AzUSL 8

Arezzo, , Italy

Site Status

Ospedale Privato Accreditato Nigrisoli

Bologna, , Italy

Site Status

Medicina e Traumatologia dello Sport - AzUSL 2 Lucca

Lucca, , Italy

Site Status

Unità Operativa di Reumatologia - Istituto Ortopedico Gaetano Pini

Milan, , Italy

Site Status

Rheumatology Unit Santa Chiara Hospital

Pisa, , Italy

Site Status

Unità Operativa di Reumatologia - Az. Ospedaliera Universitaria Senese - Policlinico "Le Scotte"

Siena, , Italy

Site Status

F.D. Roosevelt's University Hospital

Banská Bystrica, , Slovakia

Site Status

Romjan s.r.o.

Bratislava, , Slovakia

Site Status

National Institute of Rheumatic Diseases

Piešťany, , Slovakia

Site Status

Rheumatology Clinic, Reumaglobal s.r.o

Trnava, , Slovakia

Site Status

Department of Rheumatology and Institute of Physical Medicine - Zurich University

Zurich, , Switzerland

Site Status

Countries

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Czechia France Germany Italy Slovakia Switzerland

References

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Theiler R, Bruhlmann P. Overall tolerability and analgesic activity of intra-articular sodium hyaluronate in the treatment of knee osteoarthritis. Curr Med Res Opin. 2005 Nov;21(11):1727-33. doi: 10.1185/030079905X65547.

Reference Type BACKGROUND
PMID: 16307692 (View on PubMed)

Castellacci E, Polieri T. Antalgic effect and clinical tolerability of hyaluronic acid in patients with degenerative diseases of knee cartilage: an outpatient treatment survey. Drugs Exp Clin Res. 2004;30(2):67-73.

Reference Type BACKGROUND
PMID: 15272644 (View on PubMed)

Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, Gunther K, Hauselmann H, Herrero-Beaumont G, Kaklamanis P, Lohmander S, Leeb B, Lequesne M, Mazieres B, Martin-Mola E, Pavelka K, Pendleton A, Punzi L, Serni U, Swoboda B, Verbruggen G, Zimmerman-Gorska I, Dougados M; Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003 Dec;62(12):1145-55. doi: 10.1136/ard.2003.011742.

Reference Type BACKGROUND
PMID: 14644851 (View on PubMed)

Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum. 2000 Sep;43(9):1905-15. doi: 10.1002/1529-0131(200009)43:93.0.CO;2-P. No abstract available.

Reference Type BACKGROUND
PMID: 11014340 (View on PubMed)

Altman RD. Status of hyaluronan supplementation therapy in osteoarthritis. Curr Rheumatol Rep. 2003 Feb;5(1):7-14. doi: 10.1007/s11926-003-0077-6.

Reference Type BACKGROUND
PMID: 12590879 (View on PubMed)

Lo GH, LaValley M, McAlindon T, Felson DT. Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. JAMA. 2003 Dec 17;290(23):3115-21. doi: 10.1001/jama.290.23.3115.

Reference Type BACKGROUND
PMID: 14679274 (View on PubMed)

Wang CT, Lin J, Chang CJ, Lin YT, Hou SM. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials. J Bone Joint Surg Am. 2004 Mar;86(3):538-45. doi: 10.2106/00004623-200403000-00012.

Reference Type BACKGROUND
PMID: 14996880 (View on PubMed)

Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006 Apr 19;2006(2):CD005321. doi: 10.1002/14651858.CD005321.pub2.

Reference Type BACKGROUND
PMID: 16625635 (View on PubMed)

Recommendations for the registration of drugs used in the treatment of osteoarthritis. Group for the respect of ethics and excellence in science (GREES): osteoarthritis section. Ann Rheum Dis. 1996 Aug;55(8):552-7. doi: 10.1136/ard.55.8.552. No abstract available.

Reference Type BACKGROUND
PMID: 8774185 (View on PubMed)

Altman R, Brandt K, Hochberg M, Moskowitz R, Bellamy N, Bloch DA, Buckwalter J, Dougados M, Ehrlich G, Lequesne M, Lohmander S, Murphy WA Jr, Rosario-Jansen T, Schwartz B, Trippel S. Design and conduct of clinical trials in patients with osteoarthritis: recommendations from a task force of the Osteoarthritis Research Society. Results from a workshop. Osteoarthritis Cartilage. 1996 Dec;4(4):217-43. doi: 10.1016/s1063-4584(05)80101-3. No abstract available.

Reference Type BACKGROUND
PMID: 11048620 (View on PubMed)

Strand V, Kelman A. Outcome measures in osteoarthritis: randomized controlled trials. Curr Rheumatol Rep. 2004 Feb;6(1):20-30. doi: 10.1007/s11926-004-0080-6.

Reference Type BACKGROUND
PMID: 14713399 (View on PubMed)

Kirchner M, Marshall D. A double-blind randomized controlled trial comparing alternate forms of high molecular weight hyaluronan for the treatment of osteoarthritis of the knee. Osteoarthritis Cartilage. 2006 Feb;14(2):154-62. doi: 10.1016/j.joca.2005.09.003. Epub 2005 Oct 19.

Reference Type BACKGROUND
PMID: 16242361 (View on PubMed)

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833-40.

Reference Type BACKGROUND
PMID: 3068365 (View on PubMed)

Bellamy N. WOMAC: a 20-year experiential review of a patient-centered self-reported health status questionnaire. J Rheumatol. 2002 Dec;29(12):2473-6. No abstract available.

Reference Type BACKGROUND
PMID: 12465137 (View on PubMed)

KELLGREN JH, LAWRENCE JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957 Dec;16(4):494-502. doi: 10.1136/ard.16.4.494. No abstract available.

Reference Type BACKGROUND
PMID: 13498604 (View on PubMed)

Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986 Aug;29(8):1039-49. doi: 10.1002/art.1780290816.

Reference Type BACKGROUND
PMID: 3741515 (View on PubMed)

Lockman LE. Practice tips. Knee joint injections and aspirations: the triangle technique. Can Fam Physician. 2006 Nov;52(11):1403-4. No abstract available.

Reference Type BACKGROUND
PMID: 17279197 (View on PubMed)

Lequesne MG, Mery C, Samson M, Gerard P. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests. Scand J Rheumatol Suppl. 1987;65:85-9. doi: 10.3109/03009748709102182.

Reference Type BACKGROUND
PMID: 3479839 (View on PubMed)

Lequesne M, Samson M, Gerard P, Mery C. [Pain-function indices for the follow-up of osteoarthritis of the hip and the knee]. Rev Rhum Mal Osteoartic. 1990 Oct 30;57(9 ( Pt 2)):32S-36S. French.

Reference Type BACKGROUND
PMID: 2080414 (View on PubMed)

Ali Y, Weinstein M, Jokl P. Acute pseudogout following intra-articular injection of high molecular weight hyaluronic acid. Am J Med. 1999 Dec;107(6):641-2. doi: 10.1016/s0002-9343(99)00255-7. No abstract available.

Reference Type BACKGROUND
PMID: 10625037 (View on PubMed)

Luzar MJ, Altawil B. Pseudogout following intraarticular injection of sodium hyaluronate. Arthritis Rheum. 1998 May;41(5):939-40. doi: 10.1002/1529-0131(199805)41:53.0.CO;2-D. No abstract available.

Reference Type BACKGROUND
PMID: 9588748 (View on PubMed)

Maillefert JF, Hirschhorn P, Pascaud F, Piroth C, Tavernier C. Acute attack of chondrocalcinosis after an intraarticular injection of hyaluronan. Rev Rhum Engl Ed. 1997 Oct;64(10):593-4. No abstract available.

Reference Type BACKGROUND
PMID: 9385702 (View on PubMed)

Allen E, Krohn K. Adverse reaction to Hylan GF-20. J Rheumatol. 2000 Jun;27(6):1572. No abstract available.

Reference Type BACKGROUND
PMID: 10852302 (View on PubMed)

Chen AL, Desai P, Adler EM, Di Cesare PE. Granulomatous inflammation after Hylan G-F 20 viscosupplementation of the knee : a report of six cases. J Bone Joint Surg Am. 2002 Jul;84(7):1142-7.

Reference Type BACKGROUND
PMID: 12107313 (View on PubMed)

Zardawi IM, Chan I. Synvisc perisynovitis. Pathology. 2001 Nov;33(4):519-20. doi: 10.1080/00313020120083296.

Reference Type BACKGROUND
PMID: 11827424 (View on PubMed)

Hamburger MI, Lakhanpal S, Mooar PA, Oster D. Intra-articular hyaluronans: a review of product-specific safety profiles. Semin Arthritis Rheum. 2003 Apr;32(5):296-309. doi: 10.1053/sarh.2002.50008.

Reference Type BACKGROUND
PMID: 12701040 (View on PubMed)

Ehrich EW, Davies GM, Watson DJ, Bolognese JA, Seidenberg BC, Bellamy N. Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis. J Rheumatol. 2000 Nov;27(11):2635-41.

Reference Type BACKGROUND
PMID: 11093446 (View on PubMed)

Angst F, Aeschlimann A, Michel BA, Stucki G. Minimal clinically important rehabilitation effects in patients with osteoarthritis of the lower extremities. J Rheumatol. 2002 Jan;29(1):131-8.

Reference Type BACKGROUND
PMID: 11824949 (View on PubMed)

Bijlsma JW. Patient centred outcomes in osteoarthritis. Ann Rheum Dis. 2005 Jan;64(1):1-2. doi: 10.1136/ard.2004.025072. No abstract available.

Reference Type BACKGROUND
PMID: 15608297 (View on PubMed)

Tubach F, Ravaud P, Baron G, Falissard B, Logeart I, Bellamy N, Bombardier C, Felson D, Hochberg M, van der Heijde D, Dougados M. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement. Ann Rheum Dis. 2005 Jan;64(1):29-33. doi: 10.1136/ard.2004.022905. Epub 2004 Jun 18.

Reference Type BACKGROUND
PMID: 15208174 (View on PubMed)

Pavelka K, Uebelhart D. Efficacy evaluation of highly purified intra-articular hyaluronic acid (Sinovial((R))) vs hylan G-F20 (Synvisc((R))) in the treatment of symptomatic knee osteoarthritis. A double-blind, controlled, randomized, parallel-group non-inferiority study. Osteoarthritis Cartilage. 2011 Nov;19(11):1294-300. doi: 10.1016/j.joca.2011.07.016. Epub 2011 Aug 16.

Reference Type DERIVED
PMID: 21875678 (View on PubMed)

Other Identifiers

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06CZIFCH/Hai06

Identifier Type: -

Identifier Source: org_study_id