Reduktion von Analgetika-Verschreibungen durch intraartikuläre Hyaluronsäure bei Kniegelenksarthrose

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Introduction: Intra-articular hyaluronic acid (HA) injections are widely used to treat pain and functional impairment in patients with knee osteoarthritis (KOA). However, evidence on their effectiveness in routine clinical practice and on their impact on analgesic prescribing remains limited. This study examined changes in analgesic prescriptions following HA injections in a large real-world outpatient cohort. Methods: This retrospective cohort study used data from the IQVIA™ Disease Analyzer database in Germany. Patients with KOA (ICD-10: M17) who received a first HA injection between 2011 and 2024 and had at least three months of observation time before and after treatment were included. Endpoints were (1) the proportion of patients with at least one analgesic prescription (EPHMRA-ATC codes M01A, N02A, N02B) and (2) the change in the number of prescribed analgesic tablets in the three months before versus after the injection. Multivariable logistic regression models were used to analyze factors associated with analgesic prescriptions after treatment and with reductions in tablet counts. Results: A total of 4,696 patients were included (mean age 64.5 years; 53.9% female), including 524 patients treated with Recosyn 20 mg and 4,172 patients who received other HA products. The proportion of patients with analgesic prescriptions decreased from 28.6% before the injection to 26.2% afterward (p = 0.004). Among patients treated with Recosyn, the proportion declined from 25.0% to 20.0% (p = 0.028). Overall, 70.8% of patients with baseline analgesic prescriptions showed a ≥10% reduction in tablet count, and 70.0% showed a ≥20% reduction. In multivariable analyses, treatment with Recosyn was associated with a lower likelihood of receiving an analgesic prescription after the injection (OR 0.67; 95% CI 0.53–0.85) and with a higher likelihood of achieving a ≥10% reduction in analgesic tablet count (OR 1.64; 95% CI 1.05–2.58). Discussion: In routine outpatient practice, HA injections were associated with moderate reductions in analgesic prescribing among patients with KOA. Larger reductions were observed in patients treated with Recosyn compared with those receiving other HA products.

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