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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar la eficacia y seguridad del &#225;cido hialur&#243;nico &#40;AH&#41; intraarticular en pacientes con artrosis de rodilla&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo&#44; multic&#233;ntrico&#44; no controlado con 6 meses de seguimiento&#46; Se incluy&#243; a 111 pacientes ambulatorios diagnosticados de artrosis de rodilla seg&#250;n criterios cl&#237;nicos y radiol&#243;gicos &#40;excepto grado IV de Kellgren&#41;&#46; A los pacientes se les administraron 5 inyecciones intraarticulares de AH &#40;Adant<span class="elsevierStyleSup">&#174;</span>&#44; Tedec-Meiji Farma S&#46;A&#46;&#41; con cadencia semanal&#46; La eficacia se evalu&#243; a las 2&#44; 12 y 24 postratamiento respecto del dolor global &#40;EVA&#41;&#44; &#237;ndice Lequesne&#44; &#237;ndice WOMAC&#44; valoraci&#243;n global por el paciente y el investigador &#40;escala tipo Likert&#41;&#44; rango de movimiento de flexi&#243;n y extensi&#243;n&#44; y consumo de analg&#233;sicos&#46; Se realiz&#243; ecograf&#237;a de rodilla al inicio y al final del estudio&#46; La seguridad se valor&#243; mediante registro sistem&#225;tico de acontecimientos adversos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Los pacientes mostraron mejor&#237;a estad&#237;sticamente significativa en todos los par&#225;metros respecto a los valores basales &#40;p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; A los 6 meses&#44; el 68&#37; de los pacientes valor&#243; su situaci&#243;n como mejor o mucho mejor&#46; La presencia y cantidad de derrame sinovial en la articulaci&#243;n de la rodilla disminuy&#243; de forma considerable tras el tratamiento&#46; Los acontecimientos adversos fueron&#44; sobre todo&#44; locales y debidos mayoritariamente a la t&#233;cnica de administraci&#243;n&#44; y aparecieron reacciones por inyecci&#243;n en el 2&#44;4&#37; de los casos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">La administraci&#243;n de AH intraarticular es una alternativa eficaz y bien tolerada para el tratamiento de la artrosis de rodilla leve a moderada&#44; con mejor&#237;a sintom&#225;tica de hasta 6 meses&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To evaluate the efficacy and safety of hyaluronic acid &#40;HA&#41; therapy in patients with osteoarthritis of the knee&#46;</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a prospective&#44; multicenter&#44; noncontrolled study with a 6-month followup&#46; One hundred eleven outpatients with a diagnosis of knee osteoarthritis based on clinical and radiological criteria &#40;except for Kellgren grade IV&#41; were enrolled in the four participating centers&#46; Five sequential intraarticular injections of HA &#40;Adant<span class="elsevierStyleSup">&#174;</span>&#44; Tedec-Meiji Farma&#44; S&#46;A&#46;&#41; were administered over a 4-week period&#46; Efficacy was evaluated at the follow-up visits &#40;2&#44; 12 and 24 weeks after the final injection&#41; by comparing posttreatment with baseline scores for the following variables&#58; overall knee pain on a visual analog scale&#44; Lequesne Index&#44; WOMAC Index&#44; patient and investigator overall assessment of efficacy on a 5-point Likert scale&#44; knee range of movement&#44; and analgesic consumption&#46; Knee ultrasonography was performed at baseline and at the end of the study&#46; Safety was evaluated by systematic recording of adverse events &#40;AE&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A statistically significant improvement in all the efficacy variables analyzed &#40;p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; compared with baseline values was found at each of the follow-up visits&#46; At 24 weeks&#44; more than 68&#37; of the patients rated their status as better or much better&#46; The presence and amount of intraarticular fluid in the knee joint&#44; assessed by ultrasonography&#44; diminished dramatically after HA treatment&#46; Most of the adverse events were local and were mainly due to the administration technique&#59; the incidence of AEs due to injection was 2&#46;4&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">Intraarticular administration of HA is an effective&#44; safe and well-tolerated alternative in the treatment of mild-to-moderate osteoarthritis with symptomatic improvement lasting up to 6 months&#46;</p>"
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Vol. 2. Núm. 1.
Páginas 15-22 (enero - febrero 2006)
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Vol. 2. Núm. 1.
Páginas 15-22 (enero - febrero 2006)
Originales
Acceso a texto completo
Eficacia y seguridad de las inyecciones intraarticulares de ácido hialurónico en la artrosis de rodilla. Evaluación clínica y ecográfica
Efficacy and safety of intraarticular injections of hyaluronic acid in knee osteoarthritis: clinical and ultrasonographic evaluations
Visitas
42317
F. Navarroa,
Autor para correspondencia
federiconavarro@supercable.es

Correspondencia: Dr. F. Navarro. Servicio de Reumatología. Hospital Universitario Virgen Macarena. Av. Dr. Fedriani, 3. 41071 Sevilla. España.
, G. Herrero-Beaumontb, E. Naredoc, J. Paulinod, J. Torneroe, I. Villanuevaa
a Servicio de Reumatología. Hospital Universitario Virgen Macarena. Sevilla. España
b Servicio de Reumatología. Fundación Jiménez Díaz. Madrid. España
c Servicio de Reumatología. Hospital Severo Ochoa. Leganés. Madrid. España
d Servicio de Reumatología. Hospital Nuestra Señora del Carmen. Ciudad Real. España
e Servicio de Reumatología. Hospital General Universitario. Guadalajara. España
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Resumen
Bibliografía
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Estadísticas
Objetivos

Evaluar la eficacia y seguridad del ácido hialurónico (AH) intraarticular en pacientes con artrosis de rodilla.

Pacientes y métodos

Estudio prospectivo, multicéntrico, no controlado con 6 meses de seguimiento. Se incluyó a 111 pacientes ambulatorios diagnosticados de artrosis de rodilla según criterios clínicos y radiológicos (excepto grado IV de Kellgren). A los pacientes se les administraron 5 inyecciones intraarticulares de AH (Adant®, Tedec-Meiji Farma S.A.) con cadencia semanal. La eficacia se evaluó a las 2, 12 y 24 postratamiento respecto del dolor global (EVA), índice Lequesne, índice WOMAC, valoración global por el paciente y el investigador (escala tipo Likert), rango de movimiento de flexión y extensión, y consumo de analgésicos. Se realizó ecografía de rodilla al inicio y al final del estudio. La seguridad se valoró mediante registro sistemático de acontecimientos adversos.

Resultados

Los pacientes mostraron mejoría estadísticamente significativa en todos los parámetros respecto a los valores basales (p0,01). A los 6 meses, el 68% de los pacientes valoró su situación como mejor o mucho mejor. La presencia y cantidad de derrame sinovial en la articulación de la rodilla disminuyó de forma considerable tras el tratamiento. Los acontecimientos adversos fueron, sobre todo, locales y debidos mayoritariamente a la técnica de administración, y aparecieron reacciones por inyección en el 2,4% de los casos.

Conclusión

La administración de AH intraarticular es una alternativa eficaz y bien tolerada para el tratamiento de la artrosis de rodilla leve a moderada, con mejoría sintomática de hasta 6 meses.

Palabras clave:
Ácido hialurónico
Artrosis de rodilla
Viscosuplementación
Objectives

To evaluate the efficacy and safety of hyaluronic acid (HA) therapy in patients with osteoarthritis of the knee.

Materials and methods

We performed a prospective, multicenter, noncontrolled study with a 6-month followup. One hundred eleven outpatients with a diagnosis of knee osteoarthritis based on clinical and radiological criteria (except for Kellgren grade IV) were enrolled in the four participating centers. Five sequential intraarticular injections of HA (Adant®, Tedec-Meiji Farma, S.A.) were administered over a 4-week period. Efficacy was evaluated at the follow-up visits (2, 12 and 24 weeks after the final injection) by comparing posttreatment with baseline scores for the following variables: overall knee pain on a visual analog scale, Lequesne Index, WOMAC Index, patient and investigator overall assessment of efficacy on a 5-point Likert scale, knee range of movement, and analgesic consumption. Knee ultrasonography was performed at baseline and at the end of the study. Safety was evaluated by systematic recording of adverse events (AE).

Results

A statistically significant improvement in all the efficacy variables analyzed (p0.01) compared with baseline values was found at each of the follow-up visits. At 24 weeks, more than 68% of the patients rated their status as better or much better. The presence and amount of intraarticular fluid in the knee joint, assessed by ultrasonography, diminished dramatically after HA treatment. Most of the adverse events were local and were mainly due to the administration technique; the incidence of AEs due to injection was 2.4%.

Conclusion

Intraarticular administration of HA is an effective, safe and well-tolerated alternative in the treatment of mild-to-moderate osteoarthritis with symptomatic improvement lasting up to 6 months.

Key words:
Hyaluronic acid
Osteoarthritis of the knee
Viscosupplementation
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Copyright © 2006. Elsevier España S.L. Barcelona
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