Evaluation of the symptomatic and structural efficacy of a new hyaluronic acid compound, NRD101, in comparison with diacerein and placebo in a 1 year randomised controlled study in symptomatic knee osteoarthritis.

Abstract

OBJECTIVE:

To evaluate long term efficacy of three iterative courses of three weekly intra-articular (IA) injections of NRD101 in the treatment of symptomatic knee osteoarthritis (OA).

PATIENTS AND METHODS:

A 1 year prospective, multicentre, randomised, double blind, placebo controlled study of 301 patients aged >50 years with painful and radiological medial knee OA. Patients were randomly assigned into three groups receiving: (1) three courses of three IA injections of hyaluronic acid (HA) + oral placebo; (2) IA injections of saline solution + diacerein 100 mg/day; (3) IA injections of saline solution + oral placebo. Demographic data and symptomatic criteria-pain, Lequesne's index, patient's global assessment of disease activity, percentage of painful days-were obtained during the study; primary structural criterion was JSW. Efficacy criteria were changes in pain VAS, joint space narrowing (JSN), and percentage of progressors (JSN >0.5 mm). An intention to treat analysis was used for symptomatic variables, and completer analysis for structural variables.

RESULTS:

Baseline characteristics were similar between the three groups. Mean (SD) improvement in pain VAS was clinically relevant (-33.9 (27.3), n = 301), but with no difference between the groups (p = 0.96). JSW deteriorated (-0.09 (0.55) mm, n = 277, p = 0.01), but with no difference between the groups (p = 0.82). Percentages of progressors were 17.7, 18.9, and 20.3% (p = 0.90), in groups 1, 2, and 3, respectively.

CONCLUSION:

A weak but statistically significant structural deterioration occurred over 1 year, together with clinically relevant symptomatic improvement in patients receiving oral drug and iterative IA injections. Symptomatic and/or structural effects for both this new HA compound and diacerein were not demonstrated.

• Authors: T Pham, A Le Henanff, Ph Ravaud, P Dieppe, L Paolozzi, M Dougados
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 63 Issue 12 Pg. 1611-7 (Dec 2004) ISSN: 0003-4967 [Print] England
• PMID: 15331394 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Anthraquinones
• Anti-Inflammatory Agents, Non-Steroidal
• NRD101
• diacerein
• Hyaluronic Acid

Topics

• Aged
• Anthraquinones (adverse effects, therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects, therapeutic use)
• Disease Progression
• Double-Blind Method
• Female
• Humans
• Hyaluronic Acid (adverse effects, analogs & derivatives, therapeutic use)
• Injections, Intra-Articular
• Male
• Middle Aged
• Osteoarthritis, Knee (drug therapy)
• Pain Measurement
• Prospective Studies
• Severity of Illness Index
• Treatment Outcome