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BackgroundIntra-articular hyaluronic acid IA-HA is a common therapy used to treat knee pain and suppress knee inflammation in knee osteoarthritis OA typically prescribed in regimens ranging from a single injection to 5 weekly injections given once weekly We conducted a systematic review to determine the efficacy of IA-HA with subgroup analyses to explore the differences in knee pain and adverse events AEs across different dosing regimens MethodsWe conducted a systematic search of the literature to identify studies evaluating IA-HA for the management of knee OA compared to IA-saline Primary outcome measure was the mean knee pain score at 13 Weeks 3 months or 26 weeks 6 months Secondary outcome was the number of treatment-related AEs and treatment-related serious adverse events SAEs We evaluated differences in levels of pain and AEs SAEs between dosing regimens compared to IA-Saline ResultsThirty articles were included Overall IA-HA injections were associated with less knee pain compared to IA-Saline injections for all dosing regimens 2 4 injections of IA-HA vs IA-Saline produced the largest effect size at both 3-months and 6-months Standard mean difference SMD 0 76 0 98 to 0 53 95 CI P 0 00001 and SMD 0 36 0 63 to 0 09 95 CI P 0 008 respectively Additionally single injection studies yielded a non-significant treatment effect at 3 and 6 months while 5 5 injections demonstrated a significant improvement in pain only at 6 months Five or more injections of IA-HA were associated with a higher risk of treatment-related AEs compared to IA-Saline Risk ratio RR 1 67 1 09 to 2 56 95 CI p 0 02 which was a result not seen within the 1 and 2 4 injection subgroups ConclusionOverall 2 4 and 5 injection regimens provided pain relief over IA-Saline while single injection did not Intra-articular injections of HA used in a 2 4 injection treatment regimen provided the greatest benefit when compared to IA-Saline with respect to pain improvement in patients with knee OA and was generally deemed safe with few to no treatment-related AEs reported across studies Future research is needed to directly compare these treatment regimens

Publication search with Intra-articular hyaluronic acid (IA-HA) as keyword

The efficacy of multiple versus single hyaluronic acid injections: a systematic review and meta-analysis

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with Intra-articular hyaluronic acid (IA-HA) as keyword