Retrospective Comparative Analysis of Opioid Use and Intra-Articular Corticosteroid Injections Before and After Initial Treatment of Knee Osteoarthritis with Hylan G-F 20
Authors Khangulov V, Zhang X, Munson SH, Peyerl F, Rey F
Received 13 January 2020
Accepted for publication 14 May 2020
Published 3 June 2020 Volume 2020:12 Pages 79—85
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Chuan-Ju Liu
Victor Khangulov,1 Xuan Zhang,1 Sibyl H Munson,1 Fred Peyerl,1 Francoise Rey2
1Department of Health Economics and Outcomes Research, Boston Strategic Partners, Inc., Boston, MA, USA; 2Sanofi, Paris, France
Correspondence: Victor Khangulov 15 Graham Street #2, Jersey City, NJ 07307, USA
Background: Knee osteoarthritis (OA) is a painful condition affecting > 250 million people worldwide and is a leading cause of disability. Intra-articular (IA) corticosteroids and/or oral opioids are often recommended for the management of knee OA pain. There are, however, concerns regarding their safety and tolerability.
Study Question: Do patients diagnosed with knee OA show a decrease in opioids or IA corticosteroid injections prescribed/administered in hospitals following hylan G-F 20 treatment?
Study Design: This case-crossover, retrospective study using Health Facts®, a de-identified electronic health records database, enrolled patients ≥ 18 years with knee OA treated with hylan G-F 20 between January 1, 2000 and March 31, 2016, with data within 6 months before/after treatment.
Measures and Outcomes: Primary endpoints compared days on opioids, amounts of opioids, and number of IA corticosteroid injections before/after hylan G-F 20 treatment via paired t-tests.
Results: A total of 513 patients were qualified for analysis. In the opioid cohort, the average total number of days on opioids (N = 50; 5.0 vs 13.5 days; P = 0.007) and average total amount of opioids (N = 44; 165.4 morphine mg equivalents [MME] vs 493.7 MME; P = 0.013) were lower 6 months after hylan G-F 20 treatment than 6 months before treatment. In the IA corticosteroid cohort, the average number of IA corticosteroid injections decreased after hylan G-F 20 treatment (N = 36; 0.56 in the 6-month follow-up vs 1.39 before treatment; P < 0.0001). Additional time frames of 1– 5 months before and after treatment were examined; similar conclusions were drawn for patients with > 2 months of data.
Conclusion: Patients with knee OA previously treated with opioids or IA corticosteroid injections who received hylan G-F 20 demonstrated statistically significant decreases in these medications > 2 months following hylan G-F 20 treatment versus > 2 months before treatment.
Keywords: corticosteroids, opioids, osteoarthritis, viscosupplementation, hyaluronic acid, hylan G-F 20
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]