Article Text

PDF

SAT0053 Efficacy and safety of synvisc in severe knee osteoarthritis (oa): experience from a large cohort of patients followed in private rheumatological practice
  1. A Wulwik1,
  2. S Bertocci2,
  3. V Raude-Leroy3,
  4. PL Lleu3
  1. 1Rheumatology, Private Office, Paris, France
  2. 2Medical Department, Genzyme Biosurgery, Paris, France
  3. 3Medical Department, Boehringer-Ingelheim, Reims, France

Abstract

Objectives It is demonstrated that Synvisc® (S) (3 intra-articular injections at 1 week apart) improved algofunctional status of patients with knee OA. In this cohort study, the efficacy of S. was followed for up to 2 years in a specific population of patients with severe knee OA, confirmed clinically and radiologically. One half of those patients were candidates for a total knee replacement.

Methods In all patients treated with S. between June 1998 and September 1999, demographic data and medical history were recorded. Following S. course, a rheumatological evaluation was performed to assess improvement and local safety. Then, a long-term follow-up was performed in May 2000, all patients completing a questionnaire recording their clinical status, global satisfaction, tolerance of S. and concomitant therapies consumption. Due to methodology of this study, patients? long-term follow-up ranked from 9 to 24 (mean = 15.5) months.

Results Out of 117 patients treated, 81 (70%) completed the follow-up questionnaire.

Baseline characteristics of those 81 patients are as follow:

  • demographic data: mean age = 71 years; female = 57%; BMI = 27.5 kg/m²;

  • medical history: mean disease duration = 8 years; femoro-tibial knee OA: 97% (isolated: 33% or associated with femoro-patelar knee OA: 64%); chondrocalcinose: 19%

At baseline, 54% of patients had a ?severe? and 42% a ?very severe? knee OA according to physician. Nineteen patients (23%) were treated by S. in both knees and 15 (19%) received two courses of S. in the same knee (mean time between these two courses = 11 months).

A clinically significant improvement (moderate, important or very important) was observed by the physician after 77% of S. courses, while this treatment was followed by transient local adverse events (pain, swelling) after only 15% of S. courses (3 IA injections).

The analysis of patients? questionnaires showed that 49% reported a ?severe? pain and 22% a ?very severe? pain before treatment with S. The treatment was considered as globally satisfactory by 63% of patients, the main symptoms improved being pain on movement (56% of patients) and nocturnal pain (52%). Out of daily living? activities, ascending and descending stairs were improved in 51% and 46% of patients respectively. Most patients (53%) improved their maximum distance walked and 22% resumed their leisure activities. Moreover 90% of them reported a good tolerance of S. and 47% decreased their analgesics and NSAIDs consumption.

Conclusion This study demonstrates the interest of high molecular viscosupplementation with Synvisc® in the management of severe knee OA patients. Of special interest, 32 patients (82%) out of 39 candidates for total knee replacement at baseline, were able to delay this surgical treatment.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.