AB1003 Strategies of use of hyaluronic acids (HA) in knee osteoarthritis by the french rheumatologists (stratalgan study)
Authors: R.-L. Dreiser, M. Guillaume
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Although the intra-articular injection of hyaluronic acids is henceforth very wide-spread in knee osteoarthritis, there is few data on practices of the rheumatologists, their exact indications, the modalities of their prescriptions and the profile of the patients to whom this treatment is administered. <h3>Objectives</h3> Specify the modalities of hyaluronic acids'injection in 2011 by the rheumatologists in knee osteoarthritis in France. <h3>Methods</h3> Descriptive epidemiological survey: 194 french rheumatologists, male for 2/3 of them, mean age 53 years old, practicing mainly in liberal mode (59%) answered a directed questionnaire consisted of closed questions. <h3>Results</h3> The monthly average number of patients affected by knee osteoarthritis is on average 35. 93% of the patients treated by HA's are above all patients refusing surgery or inoperable, or having already benefited from a treatment by HA. Other patients are the ones intolerant or having received NSAID's unsuccessfully, or refusing NSAID's. Criteria of choice of HA's are especially the good tolerance (78%) and the efficiency recognized by a scientific file (77%). The status of drug (57%), the price (56%) are less important. The molecular weight and the concentration are very important only for 17% and 11% of the practitioners. The possibility of making a unique injection is a criterion of very important choice only for 19% of the rheumatologists. Treatments associated with HA's are paracetamol or others level I analgesics (88%), level II analgesics (69%), and classic NSAID's (67%). In case of association with oral SYSADOA, 58% of the practioners prescribe them the same day as the injection of HA, 48% prescribe them after 15 days. Whatever is the type of SYSADOA, they are prescribed mostly in a continuous way (48%) or by cure of three months (37%). <h3>Conclusions</h3> French rheumatologists often use hyaluronic acids during chronic painful phase either subacute, in association with analgesics, NSAID's, or SYSADOA's. In 71% of the cases the rheumatologists associate SYSADOA and HA for landing a consumption of badly tolerated NSAID's or to decrease their consumption (70%) or during resistant knee osteoarthritis in treatments by analgesics and NSAID's (61%). <h3>References</h3> Jordan KM et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Ann. Rheum. Dis., 2003; 62:1145–1155 Maheu E. Les traitements intra-articulaires dans la gonarthrose par les rhumatologues. Résultats d'une enquête nationale: l'enquête TIGRE. Réflexions Rhumatologiques 2004 Wang CT, Lin J, Chang CJ, Lin YT, Hou SM. Therapeutic effect of hyaluronic acid on osteoarthritis of the knee. J Bone Joint Surg 2004;86-A:538-45 Zhang W et collOARSI recommendations for the management of hip and knee osteoarthritis. Osteoarthr. Cart., 2008; 16 (2): 137-162 <h3>Disclosure of Interest</h3> R.-L. Dreiser Grant/Research support from: Expanscience Labs, M. Guillaume: None Declared