HA derivatives have an established track record of efficacy and safety in knee OA. With the exception of Hylan GF-20, a drawback to these injections compared to corticosteroids is the need for multiple weekly injections over 3 to 5 weeks. Preliminary studies of the use of HAs in combination with corticosteroids or injected NSAIDs for knee OA show encouraging results. There appears to be a rapid onset of symptomatic relief with the same durability of response as HA alone with no apparent increase in toxicity with the combination approach. Future studies should examine if HA preparations (except for hylan G-F 20) can provide equal efficacy with compressed dosing schedules compared to traditional multi-week dosing. Additional research will also better define the role combination anti-inflammatory and HA injections for the treatment of OA at the knee and other sites.
Author's Disclosure Statement. The author reports no actual or potential conflict of interest in relation to this article.
The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Army, Department of Defense, or the US Government.
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