Pharmacologic Interventions for Knee Osteoarthritis
Authors: Donald M. Marcus
Journal: Annals of Internal Medicine (2015)

Letters5 May 2015Pharmacologic Interventions for Knee OsteoarthritisDonald M. Marcus, MDDonald M. Marcus, MDFrom Baylor College of Medicine, Houston, Texas.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5090 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their complex review of pharmacologic interventions for treatment of knee osteoarthritis, Bannuru and colleagues (1) reported that intra-articular (IA) hyaluronic acid had the highest effect size for relief of pain compared with oral placebo. That comparison is misleading, because the appropriate control for IA hyaluronic acid is IA placebo injection.Although the authors and the accompanying editorial (2) note that the apparent efficacy of hyaluronic acid may result from the stronger placebo effect of an injection, the comparison with oral placebo gives unwarranted credibility to the efficacy of hyaluronic acid and is subject to misinterpretation. For ...References1. Bannuru RR, Schmid CH, Kent DM, Vaysbrot EE, Wong JB, McAlindon TE. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann Intern Med. 2015;162:46-54. [PMID: 25560713] doi:10.7326/M14-1231 LinkGoogle Scholar2. Mandl LA, Losina E. Relative efficacy of knee osteoarthritis treatments: are all placebos created equal? [Editorial]. Ann Intern Med. 2015;162:71-2. [PMID: 25560716] doi:10.7326/M14-2636 LinkGoogle Scholar3. Altman R. Next round on hyaluronic acid: better even than acetaminophen? MedPageToday. 22 January 2015. Accessed at www.medpagetoday.com/Rheumatology/Arthritis/49672 on 26 March 2015. Google Scholar4. Norton A. Knee arthritis drugs beat placebos, but study finds no clear winner. HealthDay. 6 January 2015. Accessed at http://consumer.healthday.com/bone-and-joint-information-4/arthritis-drug-news-39/knee-arthritis-drugs-are-better-than-nothing-study-695188.html on 26 March 2015. Google Scholar5. Rutjes AW, Jüni P, da Costa BR, Trelle S, Nüesch E, Reichenbach S. Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Ann Intern Med. 2012;157:180-91. [PMID: 22868835] doi:10.7326/0003-4819-157-3-201208070-00473 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Baylor College of Medicine, Houston, Texas.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0098. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis Raveendhara R. Bannuru , Christopher H. Schmid , David M. Kent , Elizaveta E. Vaysbrot , John B. Wong , and Timothy E. McAlindon Comparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis Raveendhara R. Bannuru , Christopher H. Schmid , David M. Kent , Elizaveta E. Vaysbrot , John B. Wong , and Timothy E. McAlindon Pharmacologic Interventions for Knee Osteoarthritis Raveendhara R. Bannuru , David M. Kent , and Timothy E. McAlindon Pharmacologic Interventions for Knee Osteoarthritis Raveendhara R. Bannuru , David M. Kent , and Timothy E. McAlindon Metrics Cited ByThe protective role of microRNA-140-5p in synovial injury of rats with knee osteoarthritis via inactivating the TLR4/Myd88/NF-κB signaling pathway 5 May 2015Volume 162, Issue 9Page: 672KeywordsConflicts of interestDisclosureKneesOsteoarthritis ePublished: 5 May 2015 Issue Published: 5 May 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...