P147 - Risk of Severe Acute Localized Reactions for Different Intra-articular Hyaluronic Acid Kee Injections in a Real World Setting
- A. Gudeman (Indianapolis, US)
- K. Ong (Philadelphia, US)
- J. Farr (Greenwood, US)
- L. McIntyre (Sleepy Hollow, US)
- I. Murray (Redwood City, US)
- C. Hummer (Glen Mills, PA,, US)
- W. Ngai (Bridgewater, NJ, US)
- H. Good (Bridgewater, NJ, US)
- S. Sherman (Redwood City, US)
- E. Lau (Menlo Park, CA, US)
- R. Altman (Los Angeles, CA, US)
Abstract
Purpose
To compare surrogate SALR measures between knee OA patients using hylanG-F 20 and specific non-hylanG-F 20 HA products.
Methods and Materials
Knee OA patients were identified from the Optum Clinformaticsdataset, stratified into hylan G-F 20 and non-hylan G-F 20 HA users, matched by single or multiple injection products.
Surrogate SALR measures within three days of HA use (with ICD/CPT codes): inflammation/infection, intra-articular corticosteroid (CS) injections, arthrocentesis/aspiration, arthrotomy/incision and drainage, arthroscopy, and office visits.
A logistic regression model was used to compare the risk of the surrogate SALR outcomes.
Results
•694,404 HA injections:(Hyalgan/Supartz (35.8%); Euflexxa (24.1%); Orthovisc (17.0%); Synvisc (15.6%); Synvisc-One (6.8%); Gel-One (0.5%); Monovisc (0.2%)).
Multiple injection products:
•Any SALR outcome: similar between hylan G-F 20 (3-injection) and Euflexxa cohorts (p=0.062), except when limited to those with corresponding knee OA diagnoses (AHR=1.24 for hylan G-F 20; p<0.001). Risk lower for hylan G-F 20 (3-injection) than Hyalgan/Supartz (p<0.001) or Orthovisc (p<0.001) patients.
Figure 1. Multiple injection products. * p<0.05; green and red for lower and greater adjusted risks in the hylan G-F 20 (3-injection) group, respectively.
Single injection products:
•Any SALR outcome: lower for hylan G-F 20 (1-injection) than Monovisc (p<=0.007) or Gel-One (p<=0.012).
Figure 2. Single injection products. * p<0.05; green and red for lower and greater adjusted risks in the hylan G-F 20 (1-injection) group, respectively
Conclusion
•Diagnoses of inflammation or infection diagnoses were extremely rare (0 to 0.03%) within three days of HA injections.
•Results consistent with a randomized controlled trial (Kirchner 2006), which reported a greater rate of local reactions in terms of effusions, in hylan G-F 20 (3-injection) than Euflexxa patients, the collective risk of any of the surrogate SALR outcomes was found to be significantly lower with hylan G-F 20 than non-hylan G-F 20 products.
