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See detailConsensus statement on viscosupplementation with hyaluronic acid for the management of osteoarthritis
Henrotin, Yves ULg; Raman, R.; Richette, P. et al

in Semin Arthritis Rheum (2015), 45(2), 140-9

Viscosupplementation (VS) with hyaluronic acid is currently used by physicians to treat osteoarthritis. However, many aspects of this treatment remain questionable and subject of controversy. A group of 8 ... [more ▼]

Viscosupplementation (VS) with hyaluronic acid is currently used by physicians to treat osteoarthritis. However, many aspects of this treatment remain questionable and subject of controversy. A group of 8 experts in this field, from European countries, met to debate on 24 statements previously listed by the group members. Based on an extensive research of the literature and expert opinion, a consensus position has been proposed for each statement. Agreement was achieved on some recommendations. In particular, the expert achieved unanimous agreement in favor of the following statements: VS is an effective treatment for mild to moderate knee OA; VS is not an alternative to surgery in advanced hip OA; VS is a well-tolerated treatment of knee and other joints OA; VS should not be used only in patients who have failed to respond adequately to analgesics and NSAIDs; VS is a "positive" indication but not a "lack of anything better" indication; the dosing regimen must be supported by evidence-based medicine; cross-linking is a proven means for prolonging IA residence time of HA; the best approach to inject accurately knee joint is the lateral mid-patellar one; when VS is performed under fluoroscopy, the amount of radiopaque contrast agent must be as low as possible to avoid viscosupplement dilution. These clear recommendations have been established to help practitioners in the use of viscosupplementation. [less ▲]

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See detailHyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias
Richette, P.; Chevalier, X.; Ea, H. K. et al

in RMD Open (2015), 1(1), 000071

BACKGROUND: The effectiveness of intra-articular hyaluronic acid (IAHA) injection for knee osteoarthritis (KOA) is debated. OBJECTIVES: To evaluate the effect of IAHA for patients with KOA by analysing ... [more ▼]

BACKGROUND: The effectiveness of intra-articular hyaluronic acid (IAHA) injection for knee osteoarthritis (KOA) is debated. OBJECTIVES: To evaluate the effect of IAHA for patients with KOA by analysing data from trials of IAHA versus placebo with low risk of bias, to provide the highest level of evidence. METHODS: A systematic review and meta-analysis was conducted. Randomised controlled trials (RCTs) with a low risk of bias (adequate randomisation and concealment and double-blind design) that investigated IAHA versus placebo (saline solution) injection were eligible. The primary efficacy measure was pain intensity and secondary outcome function at 3 months. The treatment effect was summarised with the standardised mean difference (SMD) calculated from differences in means of pain and function measures between treatment and control groups at 3 months. Trials were pooled by a random-effects model with DerSimonian and Laird weights. Statistical heterogeneity was explored by a visual exploration of forest plots and the I(2) statistic. RESULTS: A total of eight RCTs (2 199 randomised patients) met our inclusion criteria. IAHA significantly reduced the pain intensity (SMD=-0.21, 95% CI (95% CI) -0.32 to -0.10) and improved function (SMD=-0.12, 95% CI -0.22 to -0.02). Trials showed no heterogeneity. CONCLUSIONS: This meta-analysis of high-quality trials of IAHA versus placebo shows that IAHA provides a moderate but real benefit for patients with KOA. [less ▲]

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See detailDiabetes is a risk factor for knee osteoarthritis progression
Eymard, F; Parsons, C; Edwards, M et al

in Osteoarthritis and Cartilage (2015), 23

Purpose Recent studies have suggested that metabolic factors (obesity, diabetes, hypertension and dyslipidemia) and their clustering in metabolic syndrome (MetS) might be involved in the pathophysiology ... [more ▼]

Purpose Recent studies have suggested that metabolic factors (obesity, diabetes, hypertension and dyslipidemia) and their clustering in metabolic syndrome (MetS) might be involved in the pathophysiology of knee osteoarthritis (OA). We investigated their impact on radiographic progression by an annualised measure of the joint space narrowing (JSN) of the medial tibiofemoral compartment. Methods 559 patients older than 50 years with symptomatic knee OA were recruited for the placebo arm of the SEKOIA trial. The presence of diabetes, hypertension and dyslipidemia was determined at baseline interview. BMI was calculated, obesity was considered >30 kg/m2. MetS was defined by the sum of metabolic factors ≥3. Minimal medial tibiofemoral joint space on plain radiographs was measured by an automated method at baseline and then annually for up to 3 years. Results The mean age of patients was 62.8 [62.2-63.4] years; 392 were women. A total of 43.8% was obese, 6.6% had type 2 diabetes, 45.1% hypertension, 27.6% dyslipidemia and 13.6% MetS. Mean annualised JSN was greater for patients with type 2 diabetes than without diabetes (0.26 [-0.35 - -0.17] vs. 0.14 [-0.16 - -0.12] mm; p=0.001). This association remained significant after adjustment for sex, age, BMI, hypertension and dyslipidemia (p=0.018). In subgroup analysis, type 2 diabetes was a significant predictor of JSN in males but not females. The other metabolic factors and MetS were not associated with annualised JSN. Conclusion Type 2 diabetes was a predictor of joint space reduction in men with established knee OA. No relationships were found between MetS or other metabolic factors and radiographic progression. [less ▲]

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See detailImplication des troubles métaboliques dans la progression radiologique de la gonarthrose : analyse post-hoc issue de l'essai randomisé SEKOIA
Eymard, F; Parsons, C; Edwards, M et al

in Revue du Rhumatisme (2014), 81(Suppl. 1), 92

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See detailStrontium ranelate decreases the number of rapid radiological progressors from the first year in SEKOIA study
Chevalier, X; Richette, P; Bruyère, Olivier ULg et al

in Osteoarthritis and Cartilage (2014), 22(1), 461

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See detailImpact of components of the metabolic syndrome on knee osteoarthritis progression in the SEKOIA study
Eymard, F; Edwards, M; Parsons, C et al

in Osteoarthritis and Cartilage (2014), 22(1), 376

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See detailImpact of components of the metabolic syndrome on progression of knee osteoarthritis in the Sekoia study
Parsons, C; Edwards, MH; Eymard, F et al

in Osteoporosis International (2014), 25(2), 230

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See detailStrontium ranelate improves osteoarthritis symptoms compared to placebo in patients with knee OA: The SEKOIA study
Bruyère, Olivier ULg; Richette, P; Bellamy, N et al

in Osteoporosis International (2013, April), 24(Suppl.1), 49-51

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See detailEarly decrease of serum biomarkers of type II collagen degradation (Coll2-1) and joint inflammation (Coll2-1 NO(2) ) by hyaluronic acid intra-articular injections in patients with knee osteoarthritis: a research study part of the Biovisco study.
Henrotin, Yves ULg; Chevalier, X.; DEBERG, Michelle ULg et al

in Journal of orthopaedic research : official publication of the Orthopaedic Research Society (2013), 31(6), 901-7

To measure the evolution of the serum levels of specific Osteoarthritis (OA) biomarker, Coll2-1 and Coll2-1 NO(2) in knee osteoarthritic patients after viscosupplementation (VS). Fifty-one patients with ... [more ▼]

To measure the evolution of the serum levels of specific Osteoarthritis (OA) biomarker, Coll2-1 and Coll2-1 NO(2) in knee osteoarthritic patients after viscosupplementation (VS). Fifty-one patients with unilateral symptomatic knee were recruited for this prospective open label study. They received three intra-articular injections of 2 ml of hyaluronic acid (Hylan GF-20) and were followed for 3 months. Walking pain was evaluated and serum samples were taken at each visit. Coll2-1 and Coll2-1 NO(2) were measured in the serum using specific immunoassays. Variations over time of each parameter and predictive factor of response were studied. Forty-five patients were analyzed. The serum concentrations of Coll2-1 and Coll2-1 NO(2) were significantly higher in KL III/IV patients compared to KL I/II patients at baseline and decreased systematically over time after VS. Its effect was ever more pronounced in patients with KL III/IV. The serum concentration of Coll2-1 was significantly lower at baseline in responders than in non-responders. This study suggests a rapid slowdown of type II collagen degradation and joint inflammation after VS with Hylan G-20 and gives additional information for the validation of accurate biomarkers for OA. The serum level of Coll2-1 appeared to be a predictive factor for response to treatment. [less ▲]

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See detailEfficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial.
Reginster, Jean-Yves ULg; Badurski, J; Bellamy, N et al

in Annals of the Rheumatic Diseases (2013), 72(2), 179-86

BACKGROUND: Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its ... [more ▼]

BACKGROUND: Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis. METHODS: Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) 2.5-5 mm) were randomly allocated to strontium ranelate 1 g/day (n=558), 2 g/day (n=566) or placebo (n=559). The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment) over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee pain. The trial is registered (ISRCTN41323372). RESULTS: The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: -0.23 (SD 0.56) mm; 2 g/day: -0.27 (SD 0.63) mm; placebo: -0.37 (SD 0.59) mm); treatment-placebo differences were 0.14 (SE 0.04), 95% CI 0.05 to 0.23, p<0.001 for 1 g/day and 0.10 (SE 0.04), 95% CI 0.02 to 0.19, p=0.018 for 2 g/day. Fewer radiological progressors were observed with strontium ranelate (p<0.001 and p=0.012 for 1 and 2 g/day). There were greater reductions in total WOMAC score (p=0.045), pain subscore (p=0.028), physical function subscore (p=0.099) and knee pain (p=0.065) with strontium ranelate 2 g/day. Strontium ranelate was well tolerated. CONCLUSIONS: Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day. [less ▲]

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See detailLe ranélate de strontium diminue la proportion de patients progressant rapidement dès la première année : une analyse post hoc de l'étude SEKOIA
Chevalier, X; Richette, P; Bruyère, Olivier ULg et al

in Revue du Rhumatisme (2013), 80(S1), 59-60

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See detailStructure modifying effects of strontium ranelate in knee osteoarthritis
Reginster, Jean-Yves ULg; Chapurlat, R; Christiaensen, C et al

in Osteoporosis International (2012, March), 23(S2), 58-59

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See detailStrontium ranelate reduces the number of radiological or radioclinical progressors in patients with primary knee osteoarthritis
Reginster, Jean-Yves ULg; Chapurlat, R; Christiansen, C et al

in Osteoporosis International (2012, March), 23(S2), 366-367

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See detailEffet structuro-modulateur du ranélate de strontium dans la gonarthrose : l'étude SEKOIA
Chevalier, X; Chapurlat, R; Cooper, C et al

in Revue du Rhumatisme (2012), 79(S1), 271

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See detailLe ranélate de strontium diminue le nombre de progresseurs radiologiques ou radiocliniques chez les patients ayant une arthrose primaire du genou
Chevalier, X; Chapurlat, R; Cooper, C et al

in Revue du Rhumatisme (2012), 79(S1), 270

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See detailStrontium ranelate in knee osteoarthritis trial (SEKOIA) : a structural and symptomatic efficacy
Reginster, Jean-Yves ULg; Chapurlat, R; Christiansen, C et al

in Arthritis and Rheumatism (2012), 64(S10), 681

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See detailClinically meaningful effect of strontium ranelate on knee osteoarthritis symptoms
Bruyère, Olivier ULg; Bellamy, N; Brown, J et al

in Arthritis and Rheumatism (2012), 64(S10), 110

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See detailEfficacy and safety of strontium ranelate in the treatment of knee osteoarthritis : a randomized, double-blind, placebo-controlled international trial
Cooper, C; Chapurlat, R; Christiansen, C et al

in Annals of the Rheumatic Diseases (2012), 71(3), 693

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See detailEfficacy and safety of strontium ranelate in the treatment of knee ostoarthritis : a randomized, double-blind, placebo-controlled international trial
Reginster, Jean-Yves ULg; Chapurlat, R.; Christiansen, C. et al

in Osteoporosis International (2011), 22(S5), 742-743

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