2015 Volume 34 Issue 1 Pages 19-25
Objective: Synvisc® is expected to be more effective than conventional hyaluronic acid therapy for treating osteoarthritis of the knee. However, an increased incidence of local adverse effects with multiple courses of Synvisc® has been reported, and single-course treatment is generally recommended. The present study investigated the effectiveness and safety of multiple courses of Synvisc® treatment in patients with osteoarthritis of the knee.
Methods: Among 45 patients treated with Synvisc® for osteoarthritis of the knee, we investigated 18 who underwent a second course of synvisc 6 months after the initial treatment and seven who subsequently underwent a third course 6 months later. Visual analog scale (VAS) scores during movement were assessed prior to administration and 1 week, 2 weeks, 3 months and 6 months after the administration of Synvisc® for each course.
Results: In the 18 subjects who underwent two courses, the VAS average scores for the first course improved significantly at 3 months after the administration from 54.4 to 30.9; however, at 6 months, their pain had recurred with an average VAS score increasing from 30.9 to 40.7, respectively. A second administration of Synvisc® delivered a significant improvement in the average VAS scores at 1 week after the administration from 40.7 to 32.9, and this effect persisted at 6 months with scores from 32.9 to 30.3, respectively. However, three of the seven subjects who underwent a third course of treatment experienced local adverse effects.
Conclusion: Multiple courses of Synvisc® treatment may be effective for persistent pain relief in osteoarthritis of the knee; however, the incidence of local adverse effects was high with use of multiple courses. Physicians should inform their patients of the increased risk of local adverse effects when considering multiple course treatment.
