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Intra-articular hyaluronan treatment for osteoarthritis
  1. W PUHL,
  2. P SCHARF
  1. RKU, Oberer Eselsberg 45, 89081 Ulm, Germany

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    We wish to comment on the article by Stefan Lohmander in which the results of a placebo controlled study with intra-articular hyaluronan in osteoarthritis of the knee were presented.1It was suggested that aged patients with a high disease severity might be the best ‘responders’ to such a treatment. We felt that it was worthwhile to reanalyse the data of the patients of our German multicentre study with hyaluronan2 to see whether this somewhat unexpected but clinically extremely important hypothesis could be supported. The results of our subgroup analysis clearly seem to indicate again that the patient sample over the age of 60 years and with a high baseline score of >10 Lequesne points is the most likely subgroup to benefit from the treatment (table 1).

    Table 1

    Lequesne score (ISK) improvements (mean values)

    Stratified analyses of other methodologically comparable studies or preplanned trials in severe osteoarthritis could contribute to a validated identification of such patients who will probably respond best to an intra-articular treatment with hyaluronan in osteoarthritis of the knee.

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