Randomized Trial of Hymovis® versus Synvisc® on Matrix Metalloproteinases in Knee Osteoarthritis

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Background. This study aims to evaluate the effects of HYADD 4-G, a not chemically cross-linked HA (Hyaluronic Acid) derivative, and hylan G-F 20, a cross-linked HA product, on synovial matrix metalloproteinases and cytokines in patients suffering from knee osteoarthritis. Methods. 31 patients were randomized to receive HYADD 4-G or hylan G-F 20. Synovial fluid was collected before and one week after the first injection. Activity of MMP-3, MMP-2, MMP-13, IL-6 and other cytokines were measured. Changes in synovial fluid neutrophils and lymphocytes were analyzed. The VAS, the WOMAC questionnaire, and a Physician Global Assessment (PhGA VAS) were recorded. Results. A trend towards a greater decrease in MMP-3 activity was observed in the Hymovis® group. Active MMP-2 and MMP-13 decreased in both groups. IL-6 levels also decreased significantly in both groups. Median change in neutrophils from baseline was significantly different between the treatment groups. No differences between the treatment groups were observed for the WOMAC, VAS and PhGA VAS scores. No serious adverse events were reported. Conclusions. These findings demonstrate that intra-articular HA injections in patients with knee osteoarthritis tend to protect cartilage structural integrity reducing the activity of key proteolytic enzymes implicated in cartilage degradation as well as inflammatory mediators.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.